CV risk: if you aren't testing ACR, you aren't seeing the full picture

Area of Science:

• Nephrology
• Cardiology
• Public Health

Background:

• Chronic kidney disease (CKD) is a widespread, often undiagnosed condition.
• CKD significantly increases cardiovascular (CV) risk, even in early, asymptomatic stages.
• Elevated urinary albumin-to-creatinine ratio (UACR) is a key indicator of CV risk and early kidney damage.

Purpose of the Study:

• To emphasize the importance of early CKD detection through UACR testing.
• To highlight UACR's role in identifying cardiovascular risk before estimated glomerular filtration rate (eGFR) decline.
• To advocate for the integration of UACR testing into routine care for at-risk populations.

Main Methods:

• Expert opinion presented, not original research.
• Recommendations are based on current clinical guidelines and evidence.
• Focus on the diagnostic utility of UACR in at-risk individuals.

Main Results:

• UACR testing enables early identification of CKD and CV risk.
• Early detection allows for prompt implementation of guideline-directed therapies.
• Intervention at the earliest clinical indication can modify disease progression.

Conclusions:

• Routine UACR testing in at-risk individuals (e.g., with diabetes, CV disease, hypertension) is essential for early CKD and CV risk detection.
• Timely initiation of guideline-directed therapies based on UACR results can optimize patient outcomes.
• Integrating UACR testing into standard practice is a key strategy to combat the CKD epidemic.