Proteinuria : investigations in context of CKD

This comprehensive table provides clinicians with evidence-based guidelines on how to approach investigations for proteinuria, a key marker for chronic kidney disease (CKD). From the initial detection using albumin to creatinine ratio (ACR) to specific risk factors that warrant testing, the table aligns with the latest NICE recommendations. It serves as a quick reference for healthcare professionals, including primary care physicians and nephrologists, ensuring the best practices in CKD management and early intervention.

Investigations for Proteinuria	Rationale Behind Recommendations
Do not use reagent strips in children and young people	Reagent strips lack the specificity and sensitivity needed for accurate assessment in this population.
Use reagent strips in adults only if they can measure albumin specifically at low concentrations and express results as ACR	Conventional reagent strips lack the precision required for proteinuria detection, especially at lower concentrations.
Use urine ACR for initial detection instead of PCR	ACR is more sensitive to lower levels of proteinuria and is hence preferable for initial screening.
Confirm ACR between 3 and 70 mg/mmol with a subsequent early morning sample	To ensure the consistency of results, particularly within this ACR range where the clinical implications may differ.
Regard a confirmed ACR of 3 mg/mmol or...

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