Chronic Kidney Disease (CKD) Monitoring at Warwickshire Hospital

What is chronic kidney disease monitoring?

Chronic kidney disease (CKD) monitoring is a set of regular blood and urine tests that check how well your kidneys are working over time. The main tests measure your estimated glomerular filtration rate (eGFR) and the amount of protein in your urine (ACR), so your doctor can spot any changes early.

Why might I need CKD monitoring?

Your doctor may recommend regular testing if:

• you have diabetes or high blood pressure, both of which are checked at least once a year
• you have cardiovascular disease, such as heart failure or a history of heart attack or stroke
• you've had acute kidney injury in the past, even if your kidney function has returned to normal
• you take long-term medicines that can affect the kidneys, such as lithium or anti-inflammatory painkillers (NSAIDs)
• you have a family history of advanced kidney disease, or blood or protein has been found in your urine without a clear cause.

What are the benefits of chronic kidney disease monitoring?

• CKD often has no symptoms until it's fairly advanced, so testing is the only reliable way to catch it early
• Finding changes early gives you and your doctor the chance to slow down any decline in kidney function
• It also helps manage your risk of heart disease and stroke, since these are strongly linked to kidney health
• Tracking trends over time is more useful than a single reading, so regular monitoring builds a clearer picture than a one-off test.

Are there different types of CKD monitoring test?

Monitoring usually combines two main tests: a blood test to work out your eGFR, and a urine test to check your albumin:creatinine ratio (ACR), which measures protein leaking into your urine.

Depending on your results, you might also need an ultrasound, MRI or CT scan to look at the structure of your kidneys, or occasionally a kidney biopsy, where a small sample of tissue is examined under a microscope.

How do I prepare for CKD monitoring?

A few simple things can help:

• avoid eating meat for at least 12 hours beforehand, since this can affect your creatinine result and skew your eGFR
• tell your doctor about any regular medicines you take, especially anti-inflammatory painkillers (NSAIDs), lithium, or other medicines that can affect the kidneys
• for the urine sample, an early morning sample is sometimes needed, particularly to confirm a borderline result.

What happens during CKD monitoring?

Here's what typically happens:

1. A blood sample is taken from a vein, usually in your arm, to measure your creatinine level and calculate your eGFR.
2. You'll also be asked to provide a urine sample, to check your albumin:creatinine ratio (ACR) and look for any blood or protein.
3. Your results, together with your age, sex and other health information, are used to work out your eGFR and CKD stage.

What happens after chronic kidney disease monitoring?

You can go back to your normal activities straight away, since these are simple blood and urine tests. Your results may be available in your online GP health record, and your doctor will use them, alongside your age, sex and medical history, to work out your eGFR and ACR categories.

If a result looks unusual or has dropped suddenly, your doctor will normally ask you to repeat the test within 1 to 2 weeks, to rule out a temporary cause such as acute kidney injury, before confirming anything as a long-term change.