Via practica 3-4/2026

Chronic kidney disease in primary care according to KDIGO 2024

Chronic kidney disease (CKD) is common and often underdiagnosed in primary care. This review provides a practical workflow for adult primary care physicians based on the KDIGO 2024 guideline. It emphasizes targeted CKD case-finding in high-risk groups, especially patients with diabetes mellitus, arterial hypertension, cardiovascular disease, previous acute kidney injury, unexplained proteinuria or hematuria, and situations in which kidney function affects drug safety or dosing. The basic diagnostic package combines estimated glomerular filtration rate (eGF) and urine albumin-to-creatinine ratio (uACR). A single abnormal result should not be interpreted as CKD unless chronicity is confirmed, because CKD requires abnormalities of kidney structure or function for at least 3 months. The article summarizes the CGA classification system, combining cause, GF category, and albuminuria category, and highlights biological variability, particularly for albuminuria. When creatinine-based eGF is inconsistent with the clinical picture or when decisions depend on more accurate G category classification, combined creatinine–cystatin C-based eGF may be useful. The review concludes with practical criteria for nephrology assessment, a concise algorithm, and an autodidactic test.

Keywords: chronic kidney disease, estimated glomerular filtration rate, urine albumin-to-creatinine ratio, CGA classification, nephrology assessment