A normal eGFR does not exclude early kidney disease, because albuminuria can appear first. A urine albumin-to-creatinine ratio, ideally on a first morning sample and repeated to confirm, picks up damage that creatinine misses.
Albuminuria also guides treatment and risk. Record both results, repeat them at least yearly, and review medicines that affect the kidney, including non-steroidal anti-inflammatory drugs, when either is abnormal.
- Request eGFR and urine albumin-to-creatinine ratio together at least once a year.
- Confirm a raised ratio on a repeat sample before labelling.
- Avoid NSAIDs and review nephrotoxic drugs when either result is abnormal.
- Check blood pressure at the same visit.
Why it matters
Albuminuria is often the first sign of kidney damage and creatinine alone misses it.
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