Monitoring

Patients with risk factors for CKD, such as diabetes, hypertension, or a family member with CKD, should be evaluated annually with serum creatinine and mathematical formulation for estimation of the glomerular filtration rate in addition to urinalysis for hematuria and/or proteinuria.

For those with established CKD, the rate of progression of CKD should be serially assessed starting in glomerular filtration rate (GFR) category G3a/G3b disease. Patients should be screened for anemia and bone mineral disorders at least every 6 to 12 months with a hemoglobin, calcium, phosphorus, and intact parathyroid hormone (PTH). For those in GFR category G4 disease, hemoglobin, calcium, phosphorus should be monitored every 3 to 6 months and intact PTH every 6 to 12 months. For patients in GFR category G5 CKD, anemia should be evaluated with a monthly hemoglobin, and bone mineral disease with a calcium and phosphorus every 1 to 3 months and an intact PTH every 3 to 6 months. Lipids should be checked annually for all patients with CKD.

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