Kidney Function Screening for Patients with Diabetes

Annual kidney function screening is a cornerstone of high-quality care for patients with type 2 diabetes, as it enables early identification and management of chronic kidney disease (CKD) — a common and often silent complication. Because CKD can progress without symptoms until advanced stages, routine, proactive testing is essential to prevent long-term morbidity and reduce the risk of kidney failure and cardiovascular disease. 

Key Screening Labs

• eGFR — to evaluate kidney filtration function 
• uACR — to detect kidney damage via albumin leakage 

Best Practice Suggestions

• Screen both labs. Both eGFR and uACR should be ordered annually and ideally on the same day to provide a complete and timely picture of kidney function and damage. 
• Establish standing lab orders. Implement protocols that allow patients to complete labs prior to scheduled visits. This ensures results are available for real-time discussion and care planning. 
• Patient education. Educate patients about the link between diabetes and kidney disease, the purpose of screening tests, and the importance of adherence to routine monitoring. 
• Medication review. Regularly assess for use of potentially nephrotoxic medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), and adjust treatment plans as needed to protect kidney function. 
• Schedule annual screening proactively. Incorporate reminders in the electronic health record (EHR) or care management workflows to ensure yearly testing is not missed. 
• Timely specialist referral. Refer patients to nephrology for significantly reduced eGFR, rapidly declining kidney function, or persistent albuminuria. Referral to endocrinology may also be appropriate for complex diabetes management impacting kidney health.