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

A Toolkit for Health Care Professionals Screening for Kidney Disease to Reduce CVD Risk People Living With Diabetes CKD in people with any type of diabetes is prevalent, morbid and costly. About 537 million people worldwide were living with diabetes in 2021, a number expected to increase to 783 million by 2045, according to the International Diabetes Federation. As the prevalence of diabetes grows, so does the prevalence of CKD attributed to diabetes.15-Background Recognizing both the growing prevalence, morbidity and mortality associated with CKD in diabetes and the rapidly expanding treatment landscape, the American Diabetes Association (ADA)16 and KDIGO17 have both updated standards of care for those living with diabetes and CKD. The two organizations have also published a consensus statement outlining their broad areas of agreement in screening, diagnosis, risk stratification and management.15 Diabetes is now the leading cause of kidney failure requiring transplantation or dialysis worldwide. In the U.S., increasing prevalence of diabetes is fueling an increase in kidney failure. Diabetes is now responsible for half of all new cases of kidney failure.15-Background At the same time, CKD dramatically increases the risks of ASCVD, HF, cardiovascular death and all-cause mortality among people living with diabetes.15-Background The prevalence of CKD among people with diabetes is >25%, and about 40% of people with diabetes are estimated to develop CKD during their lifetime. >25% 40% Awareness of diabetes and CKD is dismal. One of every five adults with diabetes in the U.S. does not know it. Among those with CKD, up to 90% do not know it, including 40% of those with severe CKD. CKD is a silent disease, particularly in the earlier stages, and can be detected only through screening. Both the ADA and KDIGO recommend annual CKD screening for anyone living with diabetes.15-Screening and diagnosis CKD typically presents five to 15 years after diagnosis of T1D but may be present at diagnosis in T2D.16-Epidemiology of Diabetes and Chronic Kidney Disease CKD screening using uACR and eGFR should begin five years after diagnosis for those with T1D and beginning at diagnosis for those with T2D.16-Recommendation 11.1a If CKD is present, uACR and eGFR should be monitored one to four times per year, depending on the stage of kidney disease.16Recommendation 11.1b, Figure 11.1 5YEARS 15

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