Chronic kidney disease: assessment and management

Evidence reviews – August 2021

In 2021 we reviewed the evidence in the following areas and made recommendations (labelled 2021):

• Diagnostic accuracy of eGFR calculations in adults, children, and young people from black, Asian and other minority ethnic groups with CKD
• Accuracy of albumin: creatinine ratio versus protein creatinine ratio measurements to quantify proteinuria in children and young people with CKD
• Accuracy of reagent strips for detecting protein and blood in urine in children and young people with CKD
• Children and young people who should be tested for CKD
• Optimal monitoring frequency
• The best combination of measures to identify increased risk of progression in adults, children and young people
• Optimal blood pressure targets for adults, children and young people with CKD
• Interventions to lower proteinuria
• eGFR threshold for the investigation of anaemia due to chronic kidney disease
• Aspirational haemoglobin target range for children and young people with CKD
• Managing anaemia with IV iron in people with GFR category G5 who are on dialysis
• Use of phosphate binders
• Cystatin C based equations to estimate GFR in adults, children and young people
• Defining clinically significant decline in eGFR in terms of risk of kidney disease progression

Evidence for the 2015 recommendations can be found in the 2015 full guideline on anaemia management in CKD.

Evidence for the 2014 and 2008 recommendations can be found in the 2014 full guideline on early identification and management of CKD in adults in primary and secondary care, which also includes appendices A to R.

Evidence for the 2013 recommendations can be found in the 2013 full guideline on hyperphosphataemia in CKD.