KEY POINTS ■ CKD is a major public health problem affecting approximately 20 million adults in the

United States. ■ All patients at risk for CKD (especially diabetics, elderly, hypertensives, family history of kidney

disease) should have a basic metabolic profile, calculate a glomerular filtration rate, do a urine analysis, and a spot urine for protein to creatinine ratio, and then stage their CKD if it is present.