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There are potentially some instances when this test may be useful (eg in a family when the mutation is already known), but widespread adoption of this test is not considered appropriate at the present time (i) Blood pressure control.BP control is mandatory in any patient with CKD, first to slow down the progress of renal impairment and, second, to reduce the risk of cardiovascular events.

Haem is found within haemoglobin (free in the urine or within erythrocytes) or myoglobin.Data from the United Kingdom suggests a similarly high prevalence of CKD in the general adult population (Anandarajah, 2005) Despite the high prevalence, only a minority of those with CKD will progress to end-stage renal disease (ESRD) (Hallen, 2006); and the majority of CKD patients will be identified and managed within the primary care setting.It is important to be able to identify those with early CKD; first because CKD has a very strong association with the risk of death, cardiovascular disease and hospitalisation (Go, 2005); and, second, to prevent/delay the progression to ESRD.This may easily be detected by testing urine using reagent strips, but these are not usually as sensitive as sending the sample to the biochemistry lab for measurement of ACR albumin:creatinine ratio) or PCR (protein:creatinine ratio).The ACR has greater sensitivity than PCR for low levels of proteinuria and is usually the preferred test, but nephrologists still tend to use PCR more than ACR.

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) and an intercurrent illness (usually an upper respiratory tract infection), and who is suspected of having acute glomerulonephritis For those with haematuria but no proteinuria, there should be annual testing for haematuria, albuminuria/proteinuria, e GFR and BP monitoring, as long as the haematuria persists.