Kidney disease: risk factors

Chronic kidney disease

NICE kidney disease guidance recommends that people with any of the following risk factors are tested for CKD:

  • Diabetes
  • Hypertension
  • Acute kidney injury
  • Cardiovascular disease (ischaemic heart disease, chronic heart failure, peripheral vascular disease or cerebro-vascular disease)
  • Structural renal tract disease, recurrent renal stones or enlargement of the prostate
  • Multisystem diseases with potential kidney involvement – for example, systemic lupus erythematosus
  • Family history of end-stage kidney disease (GFR category G5) or hereditary kidney disease
  • Blood in urine

Other risk factors include:

  • Smoking
  • Increasing age
  • Chronic use of non-steroidal anti-inflammatory drugs (NSAIDs)
  • Obesity
  • Low socioeconomic status

Acute kidney injury

NICE kidney disease guidance recommends that acutely ill adults with any of the following risk factors should be investigated for AKI:

  • Chronic kidney disease (adults with an estimated glomerular filtration rate [eGFR] less than 60 ml/min/1.73m2 are at particular risk)
  • Heart failure
  • Liver disease
  • Diabetes
  • History of acute kidney injury
  • Oliguria (urine output less than 0.5 ml/kg/hour)
  • Neurological or cognitive impairment or disability, which may mean limited access to fluids because of reliance on a carer
  • Hypovolaemia (low blood volume)
  • Use of drugs with the potential to damage kidneys (such as NSAIDs, aminoglycosides, angiotensin-converting enzyme [ACE] inhibitors, angiotensin II receptor antagonists [ARBs] and diuretics) within the past week, especially if hypovolaemic
  • Use of iodinated contrast agents within the past week
  • Symptoms or history of urological obstruction, or conditions that may lead to obstruction.
  • Sepsis
  • Deteriorating early warning scores (based on scoring systems for acute illness)
  • Age 65 years or over