AHA24 Screening for Kidney Disease to Reduce CVD Risk: uACR and eGFR

12 Early Testing Can Improve Clinical Outcomes CKD is an insidious disease, typically silent and unnoticed until it progresses to advanced stages.9-Introduction There are recommendations for at-risk population screening for CKD.7 The elements of CKD screening, eGFR and uACR, are widely available and used in both primary and specialty care,6-pg 2, 1-Results but seldom used in combination to screen for CKD.10-Who should be screened for CKD? Asymptomatic and unrecognized CKD can only be diagnosed and staged using both eGFR and uACR. Find it early and treat it early.11-Testing and Treatment But there is no consensus around CKD screening in patients with risk factors. Despite significant prevalence among Americans, there are no federal government screening recommendations for CKD, which could increase testing and diagnosis and potentially allow for earlier treatment intervention. Although studies recommend screening individuals with diabetes and hypertension at high risk for CVD, data on the potential benefits of general population screening are conflicting. Fortunately, the CKD treatment landscape has changed. Unlike 2012, clinicians have growing numbers of effective agents to save kidneys, hearts and lives.10-Why screen for CKD? Multiple classes of medications have demonstrated benefit in slowing the progression of CKD, including ACE inhibitors/ ARBs, SGLT2 inhibitors, GLP-1 receptor agonists and nsMRA (finerenone).4-Evidence supporting CKM-related screening, 9-Introduction, 10-Why screen for CKD? Emerging therapies , such as GLP-1 receptor agonists and aldosterone synthase inhibitors, are being investigated for their potential role in CKD management. The kidney benefits of these medication classes far exceed the benefits expected from improved blood pressure and glycemic control, including reductions of cardiovascular death and heart failure.9Introduction, 10, 14-Conclusion 7, 18-introduction, 20-Gaps Between Knowledge and Implementation in Kidney Care By 2021, more than 850 million people globally suffered from kidney disease, about double the number who live with diabetes and 20 times the global prevalence of cancer or AIDS/HIV.7-The global burden of CKD In the United States alone, about 16% of the adult population is affected by CKD. Ninety percent of these individuals are unaware they have CKD.9-Introduction Screening is an obvious approach to raising awareness of CKD status and promoting effective treatment. Screening is the detection of previously unrecognized, subclinical disease in asymptomatic individuals to facilitate early intervention to reduce morbidity and mortality.9-Introduction Between 1990 and 2019, the global CKD incidence more than doubled.10-Why Screen for CKD?

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