Despite the high prevalence and ease of screening for chronic kidney disease (CKD) in the United States, this condition remains markedly underdiagnosed. Laboratory assays readily identify CKD, but often are not ordered and interpreted appropriately. Consequently, necessary referrals and treatments don’t take place promptly, causing poor outcomes that could have been avoided. The National Kidney Foundation (NKF) Laboratory Engagement Initiative has been formed to generate a wide-spread and harmonized approach for ordering and interpreting laboratory tests for CKD.
In the President’s Invited Session on Wednesday, December 16 at 11:00 am Central, “Fighting CKD Together: The Patient, Clinician, and Laboratory Perspective,” attendees learn about interdisciplinary efforts to implement a laboratory-driven initiative to improve CKD diagnosis and treatment nationwide.
In February 2018, NKF and the American Society for Clinical Pathology (ASCP) announced a collaboration with several aims. NKF and ASCP sought to harmonize tests for CKD, improve assay reporting and result interpretation to minimize the number of missed CKD diagnoses, and improve patients’ understanding of the condition. This collaboration generated a publication titled, “Laboratory Engagement Plan: Transforming Kidney Disease Detection,” which recommends that laboratories adopt a kidney profile test comprised of estimated glomerular filtration rate (eGFR) to assess kidney function, and urinary albumin to creatinine ratio (uACR) to assess kidney damage.
This simplifies the ordering of tests needed to diagnose CKD, and the results of these two assays have been shown to predict risk for kidney failure and cardiovascular mortality.
As session moderator and AACC President, David Grenache, PhD, explains, “I think clinical laboratory professionals, like many individuals, are unaware of the seriousness that surrounds CKD and of the NKF’s plan to help raise awareness of the importance of the eGFR and the uACR. While most clinical labs already perform these two tests, they aren’t utilized to the extent needed.”
This session presents a patient’s, a clinician’s, and a laboratorian’s perspectives on this initiative. The insight of the patient, Alex Conell, is beneficial, as one of the efforts of the Laboratory Engagement Initiative is to promote patients’ understanding of CKD and related diagnostic testing. Likewise, physicians’ involvement ensures appropriate ordering and interpreting of the kidney profile. Therefore, Joseph Vassalotti, MD, of NKF, speaks about the clinical role for the kidney profile.
Finally, Greg Miller, PhD, discusses how labs contribute to better CKD diagnosis and management by offering the kidney profile. As Grenache points out, “While this seems like an easy initiative to operationalize, there are barriers that labs have to consider and address if they are to do so.” This session speaks to those barriers and how to overcome them.
Only about 10% of the 30 million Americans with CKD are aware of their condition. A significant public health need exists to increase recognition and diagnosis of CKD. Attendees of this session can learn about the critical role laboratories play in tackling this public health problem by identifying previously undiagnosed patients.