Traditional serum creatinine (eGFR) testing may only reveal one side of the CKD story. For a more complete picture, guidelines recommend both the eGFR blood test and the urine albumin-to-creatinine ratio (uACR) test to assess kidney function and damage.5 This combination enables early detection, essential to managing CKD progression.
Guideline-based testing for chronic kidney disease
Assess kidney function and damage with help from guideline-based testing, for a more complete picture of your patient’s kidney health
Chronic kidney disease (CKD) affects 37 million people in the US, but the vast majority don’t know they have it.1 Despite efforts to prevent or delay disease progression, very little progress has been made over the last 3 decades.2
Assess kidney function and damage in your at-risk patients with the Kidney Profile
The Kidney Profile from Quest includes both tests, enabling earlier detection with just one test code. Quest offers the guideline-based testing you need to help diagnose CKD, manage disease progression, and establish follow-up testing frequency. You’ll also know when a referral to a nephrologist is recommended.
Cystatin C (eGFR) and the Kidney Profile
The KDIGO guideline recommends using cystatin C–based eGFR, or creatinine plus cystatin C–based eGFR, to confirm CKD when creatinine-based eGFR indicates a mild to moderately high risk of CKD progression (45 to 59 mL/min/1.73 m2) in a patient without albuminuria.6
In addition, cystatin C–based eGFR testing is less influenced by diet and muscle mass. This makes it more appropriate for patients in whom creatinine-based results may be misleading.6 These conditions include pregnancy, acute illness, serious comorbid conditions, high or low extremes of muscle mass, malnutrition, vegetarian or low-meat diet, and creatine dietary supplement use.
Reporting that makes detection and referral easier
Beyond testing, Quest provides access to clinical algorithms and other educational resources, as well as advanced expertise on kidney health, to help you navigate care along the complex cardiometabolic continuum.
With the Kidney Profile, you and your patients also benefit from a comprehensive results report. It maps follow-up testing frequency according to National Kidney Foundation recommendations.
Frequency of monitoring CKD based on risk of disease progression assessed using eGFR and uACR7,8
ACR, albumin-creatinine ratio; eGFR, estimated glomerular filtration rate; C, confirm using eGFR based on (1) cystatin C (test code 94588) or (2) creatinine plus cystatin C; R, refer to specialist.
This figure was adapted from references 7 (with permission) and 8, and is provided for informational purposes only as a guide for using laboratory tests, and is not intended as medical advice. A physician’s test selection and interpretation, diagnosis, and patient management decisions should be based on his/her education, clinical expertise, and assessment of the patient.
This figure was adapted from references 7 (with permission) and 8, and is provided for informational purposes only as a guide for using laboratory tests, and is not intended as medical advice. A physician’s test selection and interpretation, diagnosis, and patient management decisions should be based on his/her education, clinical expertise, and assessment of the patient.
A more complete picture to help patients slow CKD progression
Once CKD is detected, you can help your patients slow disease progression. This includes better management of the chronic conditions that contribute to CKD (eg, diabetes, hypertension), lifestyle changes such as physical activity and a lower-protein diet, and the avoidance of some medication where indicated. Quest offers testing solutions that can help, every step of the way.
Test Name |
Test Description |
Test Code |
CPT Code(s) |
Creatinine (includes eGFR) Albumin, Random Urine with Creatinine (includes Albumin/Creatinine Ratio) |
39165 |
82043, 82565, 82570 |
|
| Detects, stages, monitors CKD in adults | 94588 |
82610 |
* Panel components: 6517—Albumin, Random Urine with Creatinine; 375—Creatinine, Serum. Panel components may be ordered separately.
The CPT codes provided are based on American Medical Association guidelines and are for informational purposes only.
CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
Assess both sides of the kidney health equation. Learn more about guideline-based testing and the kidney profile.
- Centers for Disease Control and Prevention. Chronic kidney disease in the United States, 2019. Last reviewed March 4, 2021. Accessed April 2, 2021. https://www.cdc.gov/kidneydisease/publications-resources/2019-national-facts.html
- Centers for Disease Control and Prevention. Chronic kidney disease surveillance system: tracking kidney disease in the United States. https://nccd.cdc.gov/CKD/detail.aspx?Qnum=Q372#refreshPosition
- Vasalotti JA, DeVinney R, Lukasik S, et al. CKD quality improvement intervention with PCMH integration: health plan results. Am J Manag Care. 2019;25(11):e326-e333.
- Molnar AO, Hiremath S, Brown PA, et al. Risk factors for unplanned and crash dialysis starts: a protocol for a systematic review and meta-analysis. Syst Rev. 2016;5:117.
- National Kidney Foundation. Quick reference guide on kidney disease screening. Accessed April 2, 2021. https://www.kidney.org/kidneydisease/siemens_hcp_quickreference#
- Gounden V, Bhatt H, Jialal I. Renal function tests. In: StatPearls [Internet]. StatPearls Publishing; 2022. https://www.ncbi.nlm.nih.gov/books/NBK507821
- Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl. 2013;3(1):1-150.
- Myers GL, Miller WG, Coresh J, et al. Recommendations for improving serum creatinine measurement: a report from the Laboratory Working Group of the National Kidney Disease Education Program. Clin Chem. 2006;52(1):5-18. doi:10.1373/clinchem.2005.0525144
References
Questions?
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