Table.

Screening, Monitoring, and Management of the Complications of Chronic Kidney Disease (CKD)

Complication	Relevant Tests	Frequency of Repeat Testing	Management
Anemia	Hemoglobin	No anemia: CKD stages G1-G2: when clinically indicated CKD stage G3: at least once per year CKD stages G4-G5: at least twice per year With anemia: CKD stages 3–5: at least every 3 months	Rule out other causes of anemia: iron deficiency, vitamin B12 deficiency, folate deficiency, occult bleeding Consider iron supplementation and referral to a nephrologist for erythropoietin-stimulating agent therapy when hemoglobin <10 g/dL
Mineral and bone disorder	Serum calcium, phosphate, parathyroid hormone, 25-hydroxyvitamin D	Calcium/phosphate: CKD stage G3: every 6–12 months CKD stage G4: every 3–6 months CKD stage G5: every 1–3 months Parathyroid hormone: CKD stage G3: at baseline, then as needed CKD stage G4: every 6–12 months CKD stage G5: every 3–6 months Vitamin D: CKD stages 3–5: at baseline, then as needed	Consider phosphate-lowering therapy (eg, calcium acetate, sevelamer, iron-based binders) and vitamin D supplementation
Hyperkalemia	Serum potassium	At baseline and as needed	Low-potassium diet, correction of hyperglycemia and acidemia, consider potassium binders
Metabolic acidosis	Serum bicarbonate	At baseline and as needed	Oral bicarbonate supplementation (eg, sodium bicarbonate, baking soda, or sodium citrate/citric acid) for values persistently <22 mmol/L
Cardiovascular disease	Lipid panel	At baseline and as needed	Low- to moderate-dose statin therapy for patients aged ≥50 years with CKD Statin therapy for patients aged 18–49 years with CKD and coronary artery disease, diabetes, prior ischemic stroke, or high risk of myocardial infarction or cardiovascular death