New data from the SCREAM project highlight a simple, low-cost strategy which may enable earlier detection and primary prevention of chronic kidney disease (CKD).1
The findings were published in Kidney International by investigators from Karolinska Institutet and are accompanied by a newly developed, web-based clinical tool utilizing age- and sex-specific estimated glomerular filtration rate (eGFR) percentiles.1
In the absence of systematic screening programs, CKD is often diagnosed late in its course, typically after patients cross fixed diagnostic thresholds, most commonly defined as falling to an eGFR <60 mL/min/1.73 m². By this point, more than >50% of kidney function may already be lost. Although urine albumin testing can detect kidney damage earlier, it remains underutilized in routine practice, leaving creatinine-based eGFR reporting as the primary driver of CKD detection.1,2
“This creates a passive approach to care, where action is delayed until kidney damage is already substantial,” Juan Jesús Carrero, MD, PhD, professor of epidemiology at Karolinska Institutet and senior author of the study, said in a statement. “In practice, we often wait until eGFR falls below 60, even though a large amount of kidney function has already been lost by then.”1
To address this gap, Carrero and colleagues applied growth charts, a concept often used in pediatrics, to kidney function. Using nearly 7 million eGFR measurements collected between 2006 and 2021, the investigators constructed age- and sex-specific population distributions for eGFR and examined whether deviations from the population median eGFR were associated with adverse outcomes.1
The SCREAM project included 1.1 million adults aged 40 to 100 years, representing approximately 80% of the population of Stockholm, Sweden.1
Upon analysis, investigators found only about 25% of individuals with eGFR values > 60 mL/min/1.73 m² but < the 25th percentile had undergone additional urine albumin testing, underscoring missed opportunities for early evaluation and prevention.1
Among individuals with eGFR values ≥ 60 mL/min/1.73 m², those with values < the 25th percentile for their age and sex had a significantly increased risk of kidney failure requiring dialysis or transplantation. They observed mortality followed a U-shaped pattern, with increased risk observed at both low and high extremes of the eGFR distribution.1
For example, investigators explained the case of a 55-year-old woman with an eGFR of 80 mL/min/1.73 m². In clinical practice, she would typically be considered to have normal kidney function. However, in the study’s age- and sex-specific charts, this value corresponds to approximately the 10th percentile and was associated with a 3-fold higher risk of future dialysis initiation.1
To support clinical implementation, the researchers made the eGFR distribution charts publicly available and developed a web-based calculator, allowing healthcare professionals to view a patient’s eGFR percentile relative to age- and sex-matched population norms.1
“This approach is low-cost and easy to implement. When a creatinine test is ordered, clinicians could automatically receive not only the eGFR value but also its percentile for age and sex,” concluded Carrero. This would provide a simple way to identify patients who appear “normal” but are already deviating from expected kidney function and may benefit from earlier evaluation and prevention efforts.”1
ReferencesSimple method can enable early detection and prevention of chronic kidney disease. EurekAlert! Published January 16, 2026. Accessed January 16, 2026. https://www.eurekalert.org/news-releases/1112495National Kidney Foundation. Estimated Glomerular Filtration Rate (eGFR). National Kidney Foundation. Published July 13, 2022. https://www.kidney.org/kidney-topics/estimated-glomerular-filtration-rate-egfr