CKD screening is targeted case finding, not universal population screening. The aim is to identify kidney disease early in people at increased risk, because CKD is often asymptomatic until advanced.
- Who should be screened annually
- Diabetes
- Hypertension
- Aboriginal and Torres Strait Islander people aged ≥18 years
- Previous AKI: annually for the first 3 years after the episode.
- For expanded detail: ATSI Screening
- Who should be screened every 2 years
- established cardiovascular disease
- obesity
- current or past smoking/vaping
- family history of kidney failure, dialysis or transplantation
- age >60 years
- previous AKI after the first 3 years.
- Who does not need routine screening
- People without recognised CKD risk factors do not need a routine Kidney Health Check.
- Kidney Health Check
- Blood pressure
- eGFR from serum creatinine
- urine albumin:creatinine ratio (uACR)
- If the screen is abnormal
- A single abnormal result does not establish CKD.
- Confirm persistent reduced eGFR and/or kidney damage over ≥3 months.
- Confirm raised uACR with repeat testing.
- A rapidly falling eGFR may represent acute kidney injury and requires prompt assessment rather than routine CKD follow-up.
- For expanded detail: Chronic Kidney Disease
The previous apparent conflict with Aboriginal and Torres Strait Islander guidance has disappeared. The old 3rd edition National Guide recommended screening all Aboriginal and Torres Strait Islander people from age 30, or age 18–29 with risk factors. The current 4th edition recommends a full Kidney Health Check annually from age 18 years.
The useful exam skeleton is:
- Risk → Kidney Health Check
- Kidney Health Check = BP + eGFR + uACR
- Diabetes / HTN / ATSI ≥18 → annual
- Other risk factors → every 2 years
- Abnormal → confirm → CKD page