The Role of Endocrinologists and Primary Care Professionals in Diagnosing Chronic Kidney Disease

Type 2 diabetes and chronic kidney disease (CKD) are closely intertwined – in fact, approximately half of the 37 million adults in the U.S. living with CKD also have type 2 diabetes. Given the shared pathology of the two conditions, disease progression in one can accelerate the onset of dysfunction or amplify the risks in the other. Yet, studies show that there remains a lack of comprehensive testing – defined as the use of both the estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) tests – in adults with type 2 diabetes, which can help identify and diagnose CKD.   

Most people with CKD don’t experience symptoms until their disease has progressed significantly, contributing to the growing burden of CKD and the rising frequency of kidney failure worldwide. Given that approximately 90% of people living with CKD aren’t aware of their condition, it is critical for the healthcare community and society at large to implement successful strategies for early testing, prompting diagnosis and effective treatment in adults risk of developing CKD, including those with type 2 diabetes and other related comorbidities such as hypertension.

Endocrinologists, alongside primary care professionals, are part of the front line of kidney-metabolic care. They play a fundamental role in identifying risk factors and instituting the necessary screening measures in a timely manner. They are also poised to implement effective treatment plans in collaboration with nephrologists. Proper early testing and an informed, integrated care strategy, as recommended by professional guidelines including KDIGO (Kidney Disease: Improving Global Outcomes) and the American Diabetes Association, can help diagnose CKD and delay CKD progression, especially for at-risk patients, like those with type 2 diabetes.

Understanding the connection between type 2 diabetes and CKD is essential for healthcare professionals to implement holistic care models and can help patients get a complete picture of their kidney health. Without early comprehensive testing of kidney function in at-risk patients using both eGFR and UACR to guide appropriate therapeutic decisions, it will continue to be a challenge to help delay disease progression and reduce potential serious complications in people with CKD.