Kidney Health Evaluation for Patients With Diabetes (KED)

The percentage of persons 18–85 years of age with diabetes (type 1 or type 2) who received a kidney health evaluation, defined by an estimated glomerular filtration rate (eGFR) and a urine albumin-creatinine ratio (uACR), during the measurement period. 

Why it Matters

The American Diabetes Association recommends that kidney function be assessed in people with type 1 diabetes with duration of ≥5 years and in all people with type 2 diabetes regardless of treatment . 

The eGFR test evaluates kidney function; the uACR test evaluates kidney damage. Together they form a comprehensive kidney health evaluation that is essential for both primary detection and ongoing monitoring of chronic kidney disease (CKD) prevention and treatment. The measure aligns with guidelines from the American Diabetes Association that recommend at least annual urinary albumin and eGFR evaluation ⁽¹⁾. 

To evaluate the risk of kidney disease progression and kidney failure, clinical practice guidelines for CKD specify use of quantitative values of both eGFR and uACR. Combining these quantitative results enables accurate classification of a patient’s risk and tailoring of optimal treatment and care strategies. Guidelines recommend that screening done using a semi-quantitative uACR test at home or point-of-care be confirmed with a quantitative uACR test performed by a certified laboratory. 

Despite guideline recommendations, fewer than 50% of adults with diabetes receive annual kidney health evaluation ⁽¹⁾. The leading cause of kidney disease is diabetes ⁽²⁾. Diabetes places adults at a significant risk for developing CKD due to vascular abnormalities that cause damage to kidneys ⁽³⁾. Diabetic kidney disease is one of the most common adverse outcomes of diabetes, affecting 20%–40% of patients with diabetes. CDC simulation studies showed that uACR screening for early detection of CKD was cost-effective in patients with diabetes, at $50 thousand per quality-adjusted life-year. 

Detection of CKD and monitoring that guides prevention and treatment is an important aspect of diabetes management. Undiagnosed CKD can increase chances of related health problems, such as early death, heart disease, stroke, kidney failure and end-stage renal disease (ESRD). If a person is aware of their CKD, they can lower their risk for related health problems and kidney failure ⁽⁴⁾. Regular kidney health evaluations among adults with diabetes are crucial for guiding early diagnosis and treatment that can prevent or delay progression of CKD. 

*This measure was developed by NCQA with input from the National Kidney Foundation. 

Historical Results – National Averages