A Toolkit for Health Care Professionals Screening for Kidney Disease to Reduce CVD Risk Individuals With CVD CKD often coexists with CVD and often goes undetected. Those with CKD are at increased risk for CVD events. Cardiovascular-associated mortality accounts for up to 50% in advanced and kidney failure versus 26% in individuals with normal kidney function. Patients with CKD are at increased risk for CVD even after adjusting for familiar CVD risk factors such as hypertension, diabetes and dyslipidemia. Even in early-stage CKD, patients carry an increased risk for CVD. Patients with CKD are more likely to die from cardiovascular events than to progress to kidney failure and the need for kidney replacement therapy.5-Introduction and Background Although CKD and CVD have often been treated as separate health entities, growing recognition that these conditions are closely linked by shared biological and social risk factors necessitates reconsideration. Most specialty organizations support the importance of identifying CKD and including kidney parameters as part of comprehensive CKM screening to better predict and prevent clinically relevant events.4Evidence supporting CKM-related screening Hyperglycemia is strongly associated with the development of both CKD and CVD.3-Traditional Risk Factors of Vascular Disease in CKD-Diabetes KDIGO consortium recommends routine CKD assessments, including eGFR and albuminuria, to provide prognostic information for both kidney and cardiovascular risks. Assessment of eGFR and uACR has the greatest utility in those with CKD and established metabolic risk factors such as diabetes. Individuals with moderate CKD risk, including excess weight or prior gestational diabetes, can also benefit from CKM screening. Otherwise healthy adults can benefit from less frequent but routine screening for CKM risk.4-Gaps in Screening for Metabolic Risk Factors and CKD in Adulthood The American Diabetes Association and KDIGO recommend annual screening of individuals with diabetes for CKD. Screening should begin at diagnosis for those with T2D because CKD is often already present. For type 1 diabetes (T1D), screening should begin five years after diagnosis.7-Screening and Prevention Individuals With Diabetes and Others at Risk for CVD 11
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