About 30% to 40% of people with diabetes will experience chronic kidney disease (CKD), and most won’t know they have worsening kidney function. According to a recent study, approximately 90% of people with CKD in the United States don’t even know they are experiencing a decline in kidney function. This lack of awareness is due to inadequate annual renal function testing.
A recently published study from the National Kidney Foundation and National Committee for Quality Assurance showed that fewer than 40% of adults with diabetes received the clinically recommended testing for chronic kidney disease in 2017.
To measure testing frequency, researchers looked at Kidney Health Evaluation for People with Diabetes (KED). Ked is a component of the Healthcare Effectiveness Data Information Set, built on the American Diabetes Association (ADA) and National Kidney Foundation recommendations.
To meet KED fulfillment criteria, the standards require that people with diabetes get tested for kidney disease at least annually using both:
- A blood test to measure kidney function or estimated glomerular filtration rate (eGFR) and
- A urine test, urine albumin-creatinine ratio (UACR), to measure kidney damage (see image below for ADA Standards and measurements)
In addition to low testing frequency overall, the study highlights disparities in KED fulfillment among Black Americans and socioeconomically disadvantaged groups, underscoring the urgent need to address these disparities to ensure equitable care for all.
Since only 40% of people with diabetes are getting GFR and UACR tested annually, a significant portion of individuals with diabetes are not be receiving the recommended kidney function monitoring. Regular kidney function testing is crucial to identify any signs of kidney damage early and take appropriate measures to prevent or slow down the progression of kidney disease in individuals with diabetes.
Annual GFR and UACR testing fulfillment is associated with improved diabetes care, earlier CKD diagnosis, and initiation of evidence-based kidney protective interventions, according to the results. In addition, annual KED testing increases the prescription of evidence-based drugs for blood pressure and blood sugar management, along with interdisciplinary care. However, researchers observed disparities in meeting these criteria among Black adults, those with Medicare-Medicaid dual eligibility status, residents of low-income neighborhoods, and individuals with limited education.
Diabetes Care and Education Specialists have a Critical Role
Diabetes care and education specialists, along with healthcare providers, can play a critical role in helping track annual testing and encouraging people with diabetes to undergo kidney function evaluation as part of their diabetes management plan. Increasing awareness about the importance of these tests and improving access to healthcare services can help enhance the annual GFR and UACR testing rate among people with diabetes, especially in under-resourced communities.
Additionally, individuals with diabetes can proactively discuss these tests with their healthcare providers to ensure they are engaged in preserving kidney health.
Fulfillment and Validity of the Kidney Health Evaluation Measure for People with Diabetes
Read more for a quick summary of what to look for when evaluating kidney function in our blog here.
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