Table 1.

Action plan for determining and monitoring the prevalence of chronic kidney disease¹

Goals	Activities	Partners	Possible deliverables
1. Monitor CKD prevalence	Disseminate the rationale for monitoring CKD prevalence	Ministries of health Policy experts Health care administrators Third-party payers	Published position statement National kidney policies Clarify the different measures of CKD burden (RRT, CKD stages, health care utilization, kidney mortality, costs) in general population and high-risk groups
	Achieve uniform CKD marker measurements in CKD prevalence studies	IFCC Diagnostic manufacturers Proficiency Testing and External Quality Assurance providers Reference Laboratories The Joint Committee for Traceability in Laboratory Medicine organizational members The National Institute of Standards and Technology	Published position statement Develop and share quality control procedures and materials
	Promote inclusion of CKD measurement and awareness in all large chronic disease cohorts and health surveys	Organizers of large studies, registries, such as WHO STEPS (102 countries), CVD, diabetes, oncology surveillance, and studies	Inventory of studies including and not including CKD and CKD awareness Task force to identify key contacts and include CKD and CKD awareness reporting
	Develop a plan to harness claims data for CKD surveillance	Health care providers Aggregators of health data (e.g., US Medicare, national health data repositories)	Established collaborations with regional and national societies and registries Workshop to assess feasibility and define action plan details Encourage validation of diagnostic codes in different regions Develop a plan to monitor strengths and limitations of claims data over time
	Incorporate the new CKD classification into WHO ICD coding	The WHO ICD-11 Revision Steering Group	Incorporation into the ICD-11
2. Establish CKD registries in special populations	Establish registries of chronic dialysis and transplantation in all countries	Established registries in Europe and North America as well as in Singapore, Morocco, Tunisia, Columbia, Argentina, and Uruguay GKHA37 of the International Society of Nephrology	Inventory of CKD registries as part of the GKHA project37 Task force to explore the development of a generic software application Define minimal dataset required for these registries, facilitate implementation, suggest methods to assess comprehensiveness Encourage the use and usefulness of the registries to enhance policy, observational research, and clinical trials
	Establish registries for special CKD groups, such as, children, rare diseases, special etiologies, and regions where CKD appears to be endemic (i.e., hotspots)	Established registries Special disease interest groups	Inventory of CKD registries as part of the GKHA project37 Task force to explore the development of a generic software application to facilitate the establishment of CKD registries Define criteria for when a registry is high priority Encourage impactful use of the registries to enhance policy, observational research, and clinical trials
3. Identify individuals with CKD in high-risk groups	Implement KDIGO CKD guidelines for screening and testing	KDIGO Implementation Strategies Work Group	Implementation surveys Case finding strategies in high-risk groups to be implemented in most countries
	Carry out randomized studies to expand the evidence base for CKD screening strategies	CKD investigators	Research reports (focus on high-risk groups by condition, ethnicity, and region)
	Ensure that wherever serum creatinine concentration is measured, eGFR is reported	Clinical chemists (IFCC) EMR companies	Focused extension of the GKHA project37 IFCC committees, National and international laboratory professional groups and health care institutions
	Develop and share protocols and electronic decision support tools for the identification and follow-up of CKD cases	EMR experts KDIGO Implementation Strategies Work Group	Workshops to assess feasibility Deployment of guidelines on novel web platforms

CKD, chronic kidney disease; CVD, cardiovascular disease; eGFR, estimated glomerular filtration rate; EMR, electronic medical records; GKHA, Global Kidney Health Atlas; ICD, International Classification of Disease; IFCC, International Federation of Clinical Chemists; KDIGO, Kidney Disease: Improving Global Outcomes; RRT, renal replacement therapy; WHO STEPS, World Health Organization STEPwise approach to Surveillance.