Monitoring CKD: what is checked and why

Why monitoring matters

CKD often changes slowly and quietly. Most people feel no different when their results shift, so tests are the only reliable way to know what is happening. Regular monitoring helps a doctor to:

• see whether kidney function is stable or falling, and how quickly
• spot problems that CKD can cause, such as anaemia or changes in blood salts
• check that blood pressure and, if you have diabetes, blood sugar are within the ranges agreed with you
• review whether medicines and their doses are still right for your kidney function
• decide when specialist input may help

What is usually monitored

Not everyone needs every test. Your doctor will choose based on your stage and history. Commonly used checks include:

• Creatinine and eGFR. A blood test for creatinine, turned into an eGFR by the lab using a validated equation. This tracks how well the kidneys filter. About eGFR.
• Urine ACR. Measures albumin in the urine, a sign of damage to the kidney filters and an important guide to risk. About urine ACR.
• Blood pressure. Checked at most visits. Some people are also asked to check it at home or at a pharmacy.
• Blood sugar control, often with an HbA1c test, for people with diabetes.
• Electrolytes, such as potassium and sodium, which the kidneys help to balance. Some medicines can also affect them.
• Haemoglobin, to check for anaemia (a low red blood cell level), which becomes more common as eGFR falls.
• Bone and mineral tests, such as calcium and phosphate, mainly in later stages.
• Urinalysis or a kidney ultrasound, when a doctor needs more information. See urinalysis and kidney ultrasound.

A doctor may also review your weight, any swelling and your full list of medicines, including anything bought over the counter or herbal remedies.

How often are tests done?

There is no single schedule that suits everyone. KDIGO 2024 suggests that people at lower risk may be tested around once a year, while people at higher risk, such as those with a lower eGFR or more albumin in the urine, are usually tested more often. The KDIGO risk chart is one of the tools doctors use to decide.

Tests may also be repeated sooner after a change in medicine, during or after an illness, or if a result is unexpected. Your doctor will tell you when your next tests are due. If you are not sure, it is reasonable to ask at the end of each appointment.

Changes between tests

It is normal for eGFR to move up or down a little from one test to the next. Things such as how much you have had to drink, a recent large meat meal, hard exercise or a short illness can all affect a single result. ACR also varies from day to day. This is why doctors look at the pattern over several tests rather than reacting to one number. A clear, sustained fall is more important than a small change.

Try not to compare your results with the "normal range" on a different lab's report. Reference ranges vary by lab, age, sex and muscle mass, so use the range printed on your own report, and let your doctor interpret it.

Keeping copies of your results

In Mombasa, many people have tests at different labs or clinics over the years. A simple personal record makes it much easier for any doctor to see your trend.

• Keep every printed report in one folder, in date order. A photo on your phone is a useful backup.
• Where possible, use the same lab for repeat tests, so results are measured the same way.
• Note the unit for ACR (mg/mmol or mg/g), because labs differ.
• Write down your blood pressure readings with the date if you check at home or at a pharmacy.
• Keep an up-to-date list of all your medicines and doses.
• Bring everything to each appointment, especially if you are seeing a new doctor.

Your results are personal health information. Keep them somewhere private and share them only with the people involved in your care.

Questions to ask your doctor

• What are my current G and A categories?
• Is my kidney function stable, improving or falling compared with before?
• Which tests do I need, and when should they next be done?
• Are any of my medicines affected by my kidney function?
• What blood pressure range should I aim for?
• Which symptoms or changes should make me come back sooner?
• Would it help for me to see a kidney specialist?

More ideas are on our questions to ask your doctor page.

Monitoring CKD in Mombasa

Blood and urine tests for kidney monitoring are available from many labs and hospital outpatient clinics across Mombasa Island, Nyali, Bamburi, Likoni and Changamwe. Ongoing care is often led by a general doctor or physician, with a nephrologist involved when needed. See CKD care in Mombasa or kidney testing in Mombasa for next steps.

This page explains what a test or condition involves. It is not a diagnosis and does not replace advice from a doctor who knows your history. Your results should be interpreted together with your symptoms, other tests and a clinical assessment. Medical disclaimer.