Evidence-based blood tests for monitoring adults with chronic kidney disease stage G3 in primary care: rapid review, routine data analysis, and consensus study

There is substantial variation in routine monitoring blood tests for chronic kidney disease (CKD) stage G3, suggesting that many individuals are not receiving optimal care. This Review aimed to develop evidence-based testing panels for CKD stage G3. Commonly used and guideline-recommended tests were assessed through filtering questions and rapid evidence reviews to determine their clinical utility. A consensus group of general practitioners, primary care nurses, a renal consultant, and patient representatives voted on test inclusion. Wherever evidence was insufficient, additional rapid reviews and routine data analysis were undertaken. The Review found evidence to support routine testing of estimated glomerular filtration rate (eGFR), haemoglobin, and glycated hemoglobin (HbA1c). No evidence of benefit was found for other commonly ordered tests, including urea, lipids, vitamin B12, ferritin, folate, liver function, electrolytes, vitamin D, calcium, thyroid function, clotting, C-reactive protein, erythrocyte sedimentation rate, and B-type natriuretic peptide. These findings offer a simplified approach to CKD stage G3 monitoring, reducing unwarranted variation and focusing resources on evidence-based, sustainable primary care.