1️⃣ Initial Screening — Check Risk & Symptoms

👀 Look for:

• Risk factors: Diabetes 🩸, Hypertension 🩺, Family history 👪, Age > 60 🕰️

• Symptoms: Swelling/edema 💧, Fatigue 😴, Foamy urine 🧼, Changes in urine color 🚽

2️⃣ Basic Lab Tests 🧪

💥 Order these:

• Serum Creatinine + eGFR 📉 (Check kidney function)

• Urinalysis 🔬 (Detect protein, blood, infection)

• Urine Albumin-to-Creatinine Ratio (ACR) 🧮 (Early sign of kidney damage)

📍 Interpret:

• Normal eGFR & no albumin → Routine monitoring

• Decreased eGFR or elevated ACR/protein → Proceed further

3️⃣ Confirm & Quantify Proteinuria 📏

• 24-hour Urine Protein or Albumin Collection ⏳

• Protein-to-Creatinine Ratio (PCR) 🧮

📍 Interpret:

• Mild proteinuria → Monitor + manage risk factors

• Moderate to severe proteinuria → Further workup

4️⃣ Evaluate Urine Sediment 🔍

• Urine Microscopy for RBCs, WBCs, casts 🩸🦠

• Helps identify glomerular vs tubular disease

5️⃣ Imaging Studies 🖼️

• Renal Ultrasound 📸 to check kidney size, stones, obstruction 🚫

• If needed, advanced imaging (CT/MRI)

6️⃣ Assess Electrolytes & Acid-Base Balance ⚖️

• Serum Na, K, Cl, Bicarbonate

• Detect complications of kidney dysfunction

7️⃣ Specialized Tests & Referral 🧬

• Autoimmune markers if suspected (ANA, ANCA) 🧪

• Kidney Biopsy 🩸 for definitive diagnosis if unclear cause

• Refer to nephrologist 👩‍⚕️👨‍⚕️

8️⃣ Management & Monitoring 🔄

• Control underlying cause (Diabetes, HTN)

• Monitor labs periodically (every 3-6 months or as needed)

• Lifestyle modifications 🥗🏃‍♂️

🌈 Summary Flowchart: