The National Kidney Foundation and the American Society for Clinical Pathology have teamed up with laboratories and clinical laboratory societies to develop a standardized test to detect early signs of chronic kidney disease.
“One in three American adults are at risk for chronic kidney disease, and screening within the primary care setting is crucial in identifying patients with early-stage renal disease,” James Weisberger, MD, executive vice president, chief medical officer and laboratory director at BioReference Laboratories, said in a press release from the NKF. “Aligning with the National Kidney Foundation, the American Society for Clinical Pathology and other national laboratories to standardize testing will enable physicians to more easily identify and diagnose patients at risk and begin monitoring and appropriate therapy before disease progresses.”
The collaboration is believed to be the first to combine the resources of leading clinical laboratory societies, multiple laboratory providers and a patient advocacy group to advance improvements in chronic kidney disease (CKD) laboratory testing, according to the release.
“ARUP Laboratories, BioReference Laboratories Inc., LabCorp, Mayo Medical Laboratories, Memorial Sloan Kettering Cancer Center, Quest Diagnostics and Sonic Healthcare USA have aligned with the initiative recommendations to improve CKD screening, diagnosis and care management. Any interested laboratory can join the collaboration and execute the suggested changes,” according to the release.
The new test profile for CKD assessment and diagnosis follows evidence-based clinical practice guidelines which recommend two tests for CKD assessment: estimated glomerular filtration rate (eGFR; serum creatinine with eGFR: CPT code 82565) and urine albumin-creatinine ratio (ACR; albumin, urine [eg, microalbumin], quantitative: CPT code 82043 plus urine creatinine: CPT code 82570). The NKF noted that laboratories adopting the profile will simplify ordering of the tests by pairing them together under one heading on the laboratory requisition form or electronic health record order.
“Such streamlining of CKD test ordering could help to eliminate the need to search for each test separately and increases the ease of monitoring results,” according to the release.
The profile also makes it easier for people at risk for CKD to better understand and track their health.
“Diagnosing kidney disease early is critical to improving long-term health in patients; this was the impetus for uniting the laboratory community around solving this problem,” Joseph Vassalotti, MD, chief medical officer of the NKF, said in the release. “The new ‘kidney profile’ makes it easier for primary care physicians to determine if an at-risk patient has kidney disease, as it contains all the critical tests in one easy-to-order place.”
The NKF and American Society for Clinical Pathology also recommend that laboratories use the same equation to estimate GFR and rename the microalbumin test to one that more accurately reflects what it is measuring: the ACR. Albumin-creatinine ratio reporting that uses milligrams per gram will make it easier for clinicians to compare results received from different labs.
Resources for health care professionals on the kidney profile can be found at www.ascp.org/kidneyprofile. A fact sheet for doctors to share with their patients is also available.