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Updated: Jan 31, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Chronic kidney disease screening to reduce cardiovascular risk: a call to action
Erin D Michos1, David Cherney2, Pam Kushner3
1Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Blalock 524-B, 600 N Wolfe Street, Baltimore, MD 21287, USA.
Insights
Chronic kidney disease (CKD) affects millions, often undiagnosed. Early screening using estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (UACR) is crucial for managing cardiorenal risk and improving outcomes.
Area of Science:
- Nephrology
- Cardiology
- Public Health
Background:
- Chronic kidney disease (CKD) is a prevalent global health issue, impacting approximately 1 in 7 US adults.
- A significant portion of individuals with CKD remain undiagnosed, increasing their risk of cardiovascular disease (CVD) and heart failure.
- CKD patients are more likely to succumb to CVD than to reach end-stage kidney disease.
Purpose of the Study:
- To emphasize the critical need for early CKD diagnosis and management.
- To highlight the importance of dual screening with estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (UACR).
- To advocate for improved standard of care to reduce cardiorenal risk and enhance patient outcomes.
Main Methods:
- The study reviews current approaches to CKD management, focusing on dual evaluation of eGFR and UACR.
- It examines the underuse of dual screening despite its importance in risk stratification.
- Evidence-based therapies targeting various pathological pathways for cardiorenal risk reduction are discussed.
Main Results:
- Dual evaluation of eGFR and UACR is essential for risk assessment and treatment guidance in CKD.
- Despite modifiable risk factors, dual screening for CKD is underutilized.
- Combining evidence-based therapies can significantly reduce cardiorenal risk in diagnosed CKD patients.
Conclusions:
- A call to action is issued to enhance CKD diagnosis and management standards.
- Implementing guideline-directed therapies by primary care and cardiology can mitigate CKD progression and adverse CV events.
- Improved care strategies are vital for minimizing complications and improving overall patient prognosis.
Abstract:
Chronic kidney disease (CKD) has a high global prevalence, affecting around 1 in 7 adults in the United States; however, most adults with CKD are unaware that they have the condition. Diagnosis and treatment of CKD is essential due to the associated increased morbidity and mortality, including increased risk of cardiovascular disease (CVD) and heart failure. Importantly, people with CKD are more likely to die from CVD than progress to end-stage kidney disease. Dual evaluation of estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (UACR) is essential to determine the level of risk and to guide appropriate treatment. Although abnormalities in both eGFR and UACR can be modifiable risk factors for CKD progression and adverse CV outcomes, there is evidence of underuse of this dual screening for CKD. However, for patients with diagnosed CKD, striking reductions in cardiorenal risk may be achieved by combining appropriate evidence-based therapies. Current approaches to management of CKD involve the use of multiple therapies that target different pathological pathways to reduce cardiorenal risk. Therefore, we raise a call to action to improve the standard of care for early diagnosis and management of CKD, to minimize the risk of disease progression and complications, reduce CV risk, and ultimately improve patient outcomes. Alongside primary care clinicians, cardiologists can also lead the way for preventive efforts and implementation of guideline-directed therapies that can reduce the risk of both CKD progression and adverse CV outcomes.
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