Early detection of CKD: the benefits, limitations and effects on prognosis

The past decade has seen an increasing focus on chronic kidney disease (CKD) and its attendant complications, which has resulted in improved understanding of their impact on health-care resources. The early detection of CKD has been facilitated by the implementation of routine reporting of estimated glomerular filtration rates (eGFRs) and by education of primary care physicians on the implications of detecting a decreased eGFR with respect to patient safety as well as to cardiovascular and renal outcomes. The goals of early CKD detection are to prevent CKD progression and associated complications, thus improving patient outcomes and reducing the impact of CKD on health-care resources. This Review examines the benefits of the early detection of CKD, and describes the limitations of current knowledge with respect to screening, early detection and treatment, as well as the unintended consequences of detection. In addition, this article highlights what is currently known about cardiovascular and renal outcomes and the effects of intervention in patients with CKD.