Pharmacists Can Catch Missed CKD With One Question

In an interview with Pharmacy Times, Ashish Verma, MBBS, assistant professor of nephrology at Boston University Chobanian & Avedisian School of Medicine, and Sophie Claudel, MD, a clinical instructor and resident physician in nephrology at Boston Medical Center and Boston University Chobanian & Avedisian School of Medicine, discussed their study on trends in chronic kidney disease (CKD) prevalence in the United States. Although overall CKD prevalence has remained flat in recent years, Verma explained that this stability masks a significant shift: CKD associated with diabetes is increasing, even though overall diabetes prevalence has not changed substantially between earlier survey cycles and the 2021–2023 cycle. He attributed this to people with diabetes living longer and accumulating kidney disease over time, combined with an aging population and the availability of newer kidney-protective therapies, such as sodium-glucose cotransporter 2 inhibitors, that are not yet fully implemented in practice.

Claudel noted that the overlap between CKD, diabetes, and heart failure presents an opportunity for earlier identification and treatment, since these patients are already engaging frequently with the health care system. Both experts emphasized that albuminuria—measured via the urine albumin-to-creatinine ratio (UACR)—is significantly underchecked compared with estimated glomerular filtration rate (eGFR), creating a major blind spot in CKD detection. Verma noted that much of the CKD identified in their data, particularly among community-dwelling adults, was driven by albuminuria alone, with normal eGFR values masking real risk.

Both experts pointed to pharmacists as key players in closing this gap, encouraging them to ask patients with diabetes, hypertension, or heart failure whether their urine albumin has been checked and to follow up on guideline-directed medication use. With roughly 14% of the population estimated to have CKD, the researchers stressed that many affected individuals remain unaware of their diagnosis, underscoring the importance of consistent screening, patient education, and pharmacist-led intervention to help reverse current trends.