{ "release_id": "f4600233112e1c27", "id": "cardio:guide-kidney-diabetes-lab-tests", "owner": "cardio", "kind": "patient_guide", "slug": "kidney-diabetes-lab-tests", "name": "Kidney and diabetes lab tests explained", "aliases": [], "atlases": [ "cardio" ], "summary_plain": "What eGFR, urine albumin (UACR) and HbA1c tests measure, the ranges that two US government sources name, and what four trials of medicines tested for kidney outcomes reported.", "summary_technical": "A static guide to three lab tests, written from three MedlinePlus test pages, one NIDDK page and four trial abstracts. It interprets no one’s results and gives no advice for one reader.", "editorial_state": "draft", "last_substantive_edit": "2026-10-15", "last_evidence_check": "2026-10-15", "next_review_due": "2027-04-15", "identifiers": [], "navigation": { "cardio": { "condition-area": [ "kidney-connections", "diabetes-and-metabolic-disease" ] } }, "payload": { "purpose": "explainer", "audience": "Adults with diabetes, high blood pressure or kidney disease, and the people with them", "about": [ "cardio:egfr", "cardio:uacr", "cardio:hba1c", "cardio:chronic-kidney-disease", "cardio:type-2-diabetes", "cardio:finerenone", "cardio:dapagliflozin", "cardio:empagliflozin", "cardio:semaglutide", "cardio:fidelio-dkd", "cardio:dapa-ckd", "cardio:empa-kidney", "cardio:flow-trial" ], "reading_grade_target": 9, "scope_note": "Written from three MedlinePlus test pages, one NIDDK page on kidney disease tests and the abstracts of four published trials. It describes what these sources say and gives no advice for one person.", "warning_blocks": [], "sections": [ { "heading": "What MedlinePlus says the three tests measure", "statements": [ { "id": "egfr-what", "text": "An eGFR test is used to see if the kidneys are filtering waste at a healthy rate.", "cites": [ { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "What is it used for?, para 1" } ] }, { "id": "egfr-how", "text": "Providers often start by measuring creatinine, a waste product from muscles, and also consider age, weight, height and sex.", "cites": [ { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "What are estimated glomerular filtration rate (eGFR) and GFR tests?, para 3" }, { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "What are estimated glomerular filtration rate (eGFR) and GFR tests?, para 3" }, { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "What are estimated glomerular filtration rate (eGFR) and GFR tests?, para 4" } ] }, { "id": "egfr-cys", "text": "eGFR may also be calculated from cystatin C, a protein many cells make, and some researchers think it gives a more accurate estimate than creatinine.", "cites": [ { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "What are estimated glomerular filtration rate (eGFR) and GFR tests?, para 6" }, { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "What are estimated glomerular filtration rate (eGFR) and GFR tests?, para 6" }, { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "What are estimated glomerular filtration rate (eGFR) and GFR tests?, para 6" } ] }, { "id": "egfr-use1", "text": "eGFR tests are used to screen for kidney disease in people without symptoms.", "cites": [ { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "What is it used for?, para 2" }, { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "What is it used for?, para 2, list item 1" } ] }, { "id": "egfr-use2", "text": "eGFR tests also help diagnose kidney disease in people who have symptoms.", "cites": [ { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "What is it used for?, para 2" }, { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "What is it used for?, para 2, list item 2" } ] }, { "id": "egfr-use3", "text": "eGFR tests help find out how serious kidney disease is.", "cites": [ { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "What is it used for?, para 2" }, { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "What is it used for?, para 2, list item 3" } ] }, { "id": "egfr-use4", "text": "eGFR tests are used to monitor people treated for chronic kidney disease or taking medicines that could harm the kidneys.", "cites": [ { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "What is it used for?, para 2" }, { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "What is it used for?, para 2, list item 4" } ] }, { "id": "egfr-use5", "text": "eGFR tests are also used to check kidney health before certain treatments that could affect the kidneys.", "cites": [ { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "What is it used for?, para 2" }, { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "What is it used for?, para 2, list item 5" } ] }, { "id": "uacr-what", "text": "A microalbumin creatinine ratio test, also called UACR, compares the amount of the protein albumin in urine with the amount of creatinine.", "cites": [ { "snapshot_id": "cardio:medlineplus-uacr-test-2026-10-14", "locator": "What is a microalbumin creatinine ratio test?, para 1" }, { "snapshot_id": "cardio:medlineplus-uacr-test-2026-10-14", "locator": "What is a microalbumin creatinine ratio test?, para 4" }, { "snapshot_id": "cardio:medlineplus-uacr-test-2026-10-14", "locator": "What is a microalbumin creatinine ratio test?, para 5" } ] }, { "id": "uacr-trace", "text": "Healthy kidneys let only a trace of albumin, at most, into the urine, and abnormal amounts may be an early sign of kidney disease.", "cites": [ { "snapshot_id": "cardio:medlineplus-uacr-test-2026-10-14", "locator": "What is a microalbumin creatinine ratio test?, para 3" }, { "snapshot_id": "cardio:medlineplus-uacr-test-2026-10-14", "locator": "What is a microalbumin creatinine ratio test?, para 1" } ] }, { "id": "uacr-use", "text": "The test is most often used to look for signs of kidney disease in people at high risk who have no symptoms, such as people with diabetes or high blood pressure.", "cites": [ { "snapshot_id": "cardio:medlineplus-uacr-test-2026-10-14", "locator": "What is it used for?, para 1" }, { "snapshot_id": "cardio:medlineplus-uacr-test-2026-10-14", "locator": "What is it used for?, para 1" } ] }, { "id": "uacr-monitor", "text": "The test may also be used to monitor the kidneys of people diagnosed with kidney disease.", "cites": [ { "snapshot_id": "cardio:medlineplus-uacr-test-2026-10-14", "locator": "What is it used for?, para 2" } ] }, { "id": "uacr-yearly", "text": "MedlinePlus calls testing for kidney disease every year important for anyone with diabetes.", "cites": [ { "snapshot_id": "cardio:medlineplus-uacr-test-2026-10-14", "locator": "Why do I need a microalbumin creatinine ratio test?, para 2" }, { "snapshot_id": "cardio:medlineplus-uacr-test-2026-10-14", "locator": "Why do I need a microalbumin creatinine ratio test?, para 2" } ] }, { "id": "a1c-what", "text": "An A1C test is a blood test that shows the average level of blood glucose over the past two to three months.", "cites": [ { "snapshot_id": "cardio:medlineplus-hba1c-test-2026-10-14", "locator": "What is a hemoglobin A1C (HbA1C) test?, para 1" } ] }, { "id": "a1c-measure", "text": "It measures the percentage of red blood cells that have glucose-coated hemoglobin.", "cites": [ { "snapshot_id": "cardio:medlineplus-hba1c-test-2026-10-14", "locator": "What is a hemoglobin A1C (HbA1C) test?, para 3" } ] }, { "id": "a1c-use", "text": "An A1C test may be used to screen for or diagnose type 2 diabetes and prediabetes, and to help monitor people who have diabetes or prediabetes.", "cites": [ { "snapshot_id": "cardio:medlineplus-hba1c-test-2026-10-14", "locator": "What is it used for?, para 2" }, { "snapshot_id": "cardio:medlineplus-hba1c-test-2026-10-14", "locator": "What is it used for?, para 2, list item 2" }, { "snapshot_id": "cardio:medlineplus-hba1c-test-2026-10-14", "locator": "What is it used for?, para 3" } ] }, { "id": "a1c-type1", "text": "The A1C test is not used to diagnose type 1 diabetes but may be used to monitor blood glucose levels.", "cites": [ { "snapshot_id": "cardio:medlineplus-hba1c-test-2026-10-14", "locator": "What is it used for?, para 4" } ] } ] }, { "heading": "eGFR ranges from two sources", "statements": [ { "id": "egfr-b1", "text": "In general, MedlinePlus says an eGFR between 90 and 100 means a person probably does not have kidney disease.", "cites": [ { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "What do the results mean?, para 3" }, { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "What do the results mean?, para 3, list item 1" } ] }, { "id": "egfr-b2", "text": "In general, MedlinePlus says an eGFR between 60 and 90 means a person may have early-stage kidney disease.", "cites": [ { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "What do the results mean?, para 3" }, { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "What do the results mean?, para 3, list item 2" } ] }, { "id": "egfr-b3", "text": "In general, MedlinePlus says an eGFR between 15 and 60 means a person may have kidney disease.", "cites": [ { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "What do the results mean?, para 3" }, { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "What do the results mean?, para 3, list item 3" } ] }, { "id": "egfr-b4", "text": "In general, MedlinePlus says an eGFR below 15 means a person may have kidney failure.", "cites": [ { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "What do the results mean?, para 3" }, { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "What do the results mean?, para 3, list item 4" } ] }, { "id": "egfr-vary", "text": "MedlinePlus says eGFR varies with age, body size and other health conditions, so a provider can explain how the general ranges apply.", "cites": [ { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "What do the results mean?, para 2" }, { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "What do the results mean?, para 2" } ] }, { "id": "egfr-imperfect", "text": "It adds that an eGFR is not a perfect test, may not always reflect kidney damage, and can be abnormal in a person who has no kidney damage.", "cites": [ { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "What do the results mean?, para 2" }, { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "What do the results mean?, para 2" } ] }, { "id": "niddk-gfr1", "text": "A NIDDK page last reviewed in October 2016 called a GFR of 60 or more the normal range.", "cites": [ { "snapshot_id": "cardio:niddk-ckd-tests-diagnosis-2026-10-15", "locator": "Page footer, review date" }, { "snapshot_id": "cardio:niddk-ckd-tests-diagnosis-2026-10-15", "locator": "Blood test for GFR, para 1, list item 1" } ] }, { "id": "niddk-gfr2", "text": "The same page said a GFR of less than 60 may mean kidney disease.", "cites": [ { "snapshot_id": "cardio:niddk-ckd-tests-diagnosis-2026-10-15", "locator": "Page footer, review date" }, { "snapshot_id": "cardio:niddk-ckd-tests-diagnosis-2026-10-15", "locator": "Blood test for GFR, para 1, list item 2" } ] }, { "id": "niddk-gfr3", "text": "It called a GFR of 15 or less kidney failure.", "cites": [ { "snapshot_id": "cardio:niddk-ckd-tests-diagnosis-2026-10-15", "locator": "Page footer, review date" }, { "snapshot_id": "cardio:niddk-ckd-tests-diagnosis-2026-10-15", "locator": "Blood test for GFR, para 1, list item 3" } ] }, { "id": "niddk-gfr4", "text": "The two sources describe an eGFR between 60 and 90 differently, and the NIDDK page is the older of the two.", "cites": [ { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "What do the results mean?, para 3, list item 2" }, { "snapshot_id": "cardio:niddk-ckd-tests-diagnosis-2026-10-15", "locator": "Page footer, review date" } ] } ] }, { "heading": "Urine albumin: a cut-off and repeat tests", "statements": [ { "id": "uacr-niddk", "text": "That NIDDK page also said a urine albumin result of 30 or less, in milligrams of albumin per gram of creatinine (mg/g), is normal, and more than 30 may be a sign of kidney disease.", "cites": [ { "snapshot_id": "cardio:niddk-ckd-tests-diagnosis-2026-10-15", "locator": "Page footer, review date" }, { "snapshot_id": "cardio:niddk-ckd-tests-diagnosis-2026-10-15", "locator": "Urine Test for Albumin, para 7" }, { "snapshot_id": "cardio:niddk-ckd-tests-diagnosis-2026-10-15", "locator": "Urine Test for Albumin, para 7, list item 2" }, { "snapshot_id": "cardio:pubmed-33264825-2026-10-14", "locator": "Abstract, METHODS, sentence 2, fragment 1 of 4" } ] }, { "id": "uacr-repeat1", "text": "MedlinePlus says an abnormal result likely leads to more tests to confirm it.", "cites": [ { "snapshot_id": "cardio:medlineplus-uacr-test-2026-10-14", "locator": "What do the results mean?, para 1" } ] }, { "id": "uacr-repeat2", "text": "It says two more tests usually follow over the three to six months after the first test.", "cites": [ { "snapshot_id": "cardio:medlineplus-uacr-test-2026-10-14", "locator": "What do the results mean?, para 2" } ] }, { "id": "uacr-repeat3", "text": "It adds that a person may have early-stage kidney disease if two of the three tests are abnormal.", "cites": [ { "snapshot_id": "cardio:medlineplus-uacr-test-2026-10-14", "locator": "What do the results mean?, para 2" } ] }, { "id": "uacr-higher1", "text": "MedlinePlus says higher or increasing amounts of albumin usually mean kidney disease that is more serious and likely to get worse faster.", "cites": [ { "snapshot_id": "cardio:medlineplus-uacr-test-2026-10-14", "locator": "What do the results mean?, para 3" }, { "snapshot_id": "cardio:medlineplus-uacr-test-2026-10-14", "locator": "What do the results mean?, para 3, list item 1" } ] }, { "id": "uacr-higher2", "text": "It says they also usually mean a higher risk of heart and blood vessel problems.", "cites": [ { "snapshot_id": "cardio:medlineplus-uacr-test-2026-10-14", "locator": "What do the results mean?, para 3" }, { "snapshot_id": "cardio:medlineplus-uacr-test-2026-10-14", "locator": "What do the results mean?, para 3, list item 2" } ] } ] }, { "heading": "A1C percentages used for diagnosis", "statements": [ { "id": "a1c-r1", "text": "For diagnosing diabetes or prediabetes, MedlinePlus says the percentages commonly used call an A1C below 5.7% normal.", "cites": [ { "snapshot_id": "cardio:medlineplus-hba1c-test-2026-10-14", "locator": "What do the results mean?, para 2" }, { "snapshot_id": "cardio:medlineplus-hba1c-test-2026-10-14", "locator": "What do the results mean?, para 2, list item 1" } ] }, { "id": "a1c-r2", "text": "For diagnosing diabetes or prediabetes, MedlinePlus says the percentages commonly used call an A1C between 5.7% and 6.4% prediabetes.", "cites": [ { "snapshot_id": "cardio:medlineplus-hba1c-test-2026-10-14", "locator": "What do the results mean?, para 2" }, { "snapshot_id": "cardio:medlineplus-hba1c-test-2026-10-14", "locator": "What do the results mean?, para 2, list item 2" } ] }, { "id": "a1c-r3", "text": "For diagnosing diabetes or prediabetes, MedlinePlus says the percentages commonly used call an A1C of 6.5% or higher diabetes.", "cites": [ { "snapshot_id": "cardio:medlineplus-hba1c-test-2026-10-14", "locator": "What do the results mean?, para 2" }, { "snapshot_id": "cardio:medlineplus-hba1c-test-2026-10-14", "locator": "What do the results mean?, para 2, list item 3" } ] }, { "id": "a1c-guide", "text": "MedlinePlus calls the ranges just a guide and says what is normal for a person depends on health, age and other factors.", "cites": [ { "snapshot_id": "cardio:medlineplus-hba1c-test-2026-10-14", "locator": "What do the results mean?, para 1" }, { "snapshot_id": "cardio:medlineplus-hba1c-test-2026-10-14", "locator": "What do the results mean?, para 1" } ] }, { "id": "a1c-more1", "text": "MedlinePlus says providers often use more than one test to diagnose diabetes.", "cites": [ { "snapshot_id": "cardio:medlineplus-hba1c-test-2026-10-14", "locator": "What do the results mean?, para 3" } ] }, { "id": "a1c-more2", "text": "It adds that a higher than normal result may lead to another A1C test or to a different diabetes test, usually a fasting blood glucose test or an oral glucose tolerance test.", "cites": [ { "snapshot_id": "cardio:medlineplus-hba1c-test-2026-10-14", "locator": "What do the results mean?, para 3" }, { "snapshot_id": "cardio:medlineplus-hba1c-test-2026-10-14", "locator": "What do the results mean?, para 3" } ] }, { "id": "a1c-gdm", "text": "MedlinePlus says the A1C test is not used to diagnose gestational diabetes.", "cites": [ { "snapshot_id": "cardio:medlineplus-hba1c-test-2026-10-14", "locator": "Is there anything else I need to know about an A1C test?, para 1" } ] } ] }, { "heading": "How the sources link the tests", "statements": [ { "id": "link-cause", "text": "NIDDK and MedlinePlus say diabetes and high blood pressure are the most common causes of chronic kidney disease in adults.", "cites": [ { "claim": "cardio:claim-diabetes-ckd-cause" } ] }, { "id": "link-niddk", "text": "NIDDK says providers check for kidney disease with a blood test for GFR and a urine test for albumin, and use the same two tests to monitor it.", "cites": [ { "snapshot_id": "cardio:niddk-ckd-tests-diagnosis-2026-10-15", "locator": "What tests do doctors use to diagnose and monitor kidney disease?, para 1" }, { "snapshot_id": "cardio:niddk-ckd-tests-diagnosis-2026-10-15", "locator": "What tests do doctors use to diagnose and monitor kidney disease?, para 1, list item 2" }, { "snapshot_id": "cardio:niddk-ckd-tests-diagnosis-2026-10-15", "locator": "What tests do doctors use to diagnose and monitor kidney disease?, para 2" } ] }, { "id": "link-a1c1", "text": "MedlinePlus says high A1C levels are a sign of high blood glucose from diabetes.", "cites": [ { "snapshot_id": "cardio:medlineplus-hba1c-test-2026-10-14", "locator": "What is a hemoglobin A1C (HbA1C) test?, para 5" } ] }, { "id": "link-a1c2", "text": "It adds that diabetes can cause serious health problems, including heart disease, kidney disease and nerve damage.", "cites": [ { "snapshot_id": "cardio:medlineplus-hba1c-test-2026-10-14", "locator": "What is a hemoglobin A1C (HbA1C) test?, para 5" } ] } ] }, { "heading": "How four trials of medicines used the tests", "statements": [ { "id": "tr-1", "text": "Who could join each of four kidney trials depended on eGFR, and for at least some participants on the urine albumin-to-creatinine ratio, with different cut-offs in each trial.", "cites": [ { "snapshot_id": "cardio:pubmed-33264825-2026-10-14", "locator": "Abstract, METHODS, sentence 2, fragment 1 of 4" }, { "snapshot_id": "cardio:pubmed-33264825-2026-10-14", "locator": "Abstract, METHODS, sentence 2, fragment 2 of 4" }, { "snapshot_id": "cardio:pubmed-33264825-2026-10-14", "locator": "Abstract, METHODS, sentence 2, fragment 3 of 4" }, { "snapshot_id": "cardio:pubmed-32970396-2026-10-14", "locator": "Abstract, METHODS, sentence 1, fragment 1 of 3" }, { "snapshot_id": "cardio:pubmed-32970396-2026-10-14", "locator": "Abstract, METHODS, sentence 1, fragment 2 of 3" }, { "snapshot_id": "cardio:pubmed-32970396-2026-10-14", "locator": "Abstract, METHODS, sentence 1, fragment 3 of 3" }, { "snapshot_id": "cardio:pubmed-36331190-2026-10-14", "locator": "Abstract, METHODS, sentence 1, fragment 1 of 4" }, { "snapshot_id": "cardio:pubmed-36331190-2026-10-14", "locator": "Abstract, METHODS, sentence 1, fragment 2 of 4" }, { "snapshot_id": "cardio:pubmed-36331190-2026-10-14", "locator": "Abstract, METHODS, sentence 1, fragment 3 of 4" }, { "snapshot_id": "cardio:pubmed-36331190-2026-10-14", "locator": "Abstract, METHODS, sentence 1, fragment 4 of 4" }, { "snapshot_id": "cardio:pubmed-38785209-2026-10-14", "locator": "Abstract, METHODS, sentence 1, fragment 1 of 4" }, { "snapshot_id": "cardio:pubmed-38785209-2026-10-14", "locator": "Abstract, METHODS, sentence 1, fragment 2 of 4" }, { "snapshot_id": "cardio:pubmed-38785209-2026-10-14", "locator": "Abstract, METHODS, sentence 1, fragment 3 of 4" }, { "snapshot_id": "cardio:pubmed-38785209-2026-10-14", "locator": "Abstract, METHODS, sentence 1, fragment 4 of 4" } ] }, { "id": "tr-2", "text": "In each of these trials, a fall in eGFR of at least 40% or 50% from the starting level was part of the main outcome.", "cites": [ { "snapshot_id": "cardio:pubmed-33264825-2026-10-14", "locator": "Abstract, METHODS, sentence 4, fragment 1 of 2" }, { "snapshot_id": "cardio:pubmed-32970396-2026-10-14", "locator": "Abstract, METHODS, sentence 2, fragment 1 of 2" }, { "snapshot_id": "cardio:pubmed-36331190-2026-10-14", "locator": "Abstract, METHODS, sentence 3, fragment 2 of 3" }, { "snapshot_id": "cardio:pubmed-38785209-2026-10-14", "locator": "Abstract, METHODS, sentence 2, fragment 2 of 3" } ] } ] }, { "heading": "A trial of finerenone in chronic kidney disease and type 2 diabetes", "statements": [ { "id": "fin-1", "text": "The trial randomly assigned 5734 patients with chronic kidney disease and type 2 diabetes to finerenone or placebo.", "cites": [ { "claim": "cardio:claim-fidelio-dkd-kidney-effect" }, { "snapshot_id": "cardio:pubmed-33264825-2026-10-14", "locator": "Abstract, METHODS, sentence 1" } ] }, { "id": "fin-2", "text": "All of the patients were treated with a renin-angiotensin system blocker.", "cites": [ { "snapshot_id": "cardio:pubmed-33264825-2026-10-14", "locator": "Abstract, METHODS, sentence 3, fragment 1 of 2" }, { "snapshot_id": "cardio:pubmed-33264825-2026-10-14", "locator": "Abstract, METHODS, sentence 3, fragment 2 of 2" } ] }, { "id": "fin-3", "text": "Over a median of 2.6 years, the main outcome occurred in 17.8% of patients on finerenone and 21.1% on placebo.", "cites": [ { "snapshot_id": "cardio:pubmed-33264825-2026-10-14", "locator": "Abstract, RESULTS, sentence 1, fragment 1 of 3" }, { "snapshot_id": "cardio:pubmed-33264825-2026-10-14", "locator": "Abstract, RESULTS, sentence 1, fragment 2 of 3" } ] }, { "id": "fin-4", "text": "The main outcome was kidney failure, a sustained fall in eGFR of at least 40%, or death from kidney causes.", "cites": [ { "snapshot_id": "cardio:pubmed-33264825-2026-10-14", "locator": "Abstract, METHODS, sentence 4, fragment 1 of 2" }, { "snapshot_id": "cardio:pubmed-33264825-2026-10-14", "locator": "Abstract, METHODS, sentence 4, fragment 2 of 2" } ] }, { "id": "fin-5", "text": "Stopping the trial regimen because of high potassium (hyperkalemia) was more common on finerenone than on placebo, 2.3% against 0.9%.", "cites": [ { "snapshot_id": "cardio:pubmed-33264825-2026-10-14", "locator": "Abstract, RESULTS, sentence 4" } ] } ] }, { "heading": "A trial of dapagliflozin in chronic kidney disease", "statements": [ { "id": "dap-1", "text": "The trial randomly assigned 4304 participants with chronic kidney disease, with or without type 2 diabetes, to dapagliflozin or placebo.", "cites": [ { "snapshot_id": "cardio:pubmed-32970396-2026-10-14", "locator": "Abstract, METHODS, sentence 1, fragment 1 of 3" }, { "snapshot_id": "cardio:pubmed-32970396-2026-10-14", "locator": "Abstract, METHODS, sentence 1, fragment 3 of 3" }, { "snapshot_id": "cardio:pubmed-32970396-2026-10-14", "locator": "Abstract, RESULTS, sentence 5" } ] }, { "id": "dap-2", "text": "An independent data monitoring committee recommended stopping the trial because of efficacy.", "cites": [ { "snapshot_id": "cardio:pubmed-32970396-2026-10-14", "locator": "Abstract, RESULTS, sentence 1" } ] }, { "id": "dap-3", "text": "Over a median of 2.4 years, the main outcome occurred in 9.2% of participants on dapagliflozin and 14.5% on placebo.", "cites": [ { "snapshot_id": "cardio:pubmed-32970396-2026-10-14", "locator": "Abstract, RESULTS, sentence 2, fragment 1 of 3" }, { "snapshot_id": "cardio:pubmed-32970396-2026-10-14", "locator": "Abstract, RESULTS, sentence 2, fragment 2 of 3" } ] }, { "id": "dap-4", "text": "The main outcome was a sustained fall in eGFR of at least 50%, end-stage kidney disease, or death from kidney or cardiovascular causes.", "cites": [ { "snapshot_id": "cardio:pubmed-32970396-2026-10-14", "locator": "Abstract, METHODS, sentence 2, fragment 1 of 2" }, { "snapshot_id": "cardio:pubmed-32970396-2026-10-14", "locator": "Abstract, METHODS, sentence 2, fragment 2 of 2" } ] } ] }, { "heading": "A trial of empagliflozin in chronic kidney disease at risk of progression", "statements": [ { "id": "emp-1", "text": "The trial randomly assigned 6609 patients with chronic kidney disease at risk of disease progression to empagliflozin or placebo.", "cites": [ { "snapshot_id": "cardio:pubmed-36331190-2026-10-14", "locator": "Abstract, RESULTS, sentence 1" }, { "snapshot_id": "cardio:pubmed-36331190-2026-10-14", "locator": "Abstract, CONCLUSIONS, sentence 1, fragment 1 of 2" }, { "snapshot_id": "cardio:pubmed-36331190-2026-10-14", "locator": "Abstract, METHODS, sentence 2" } ] }, { "id": "emp-2", "text": "Over a median of 2.0 years, kidney disease progression or death from cardiovascular causes occurred in 13.1% of patients on empagliflozin and 16.9% on placebo.", "cites": [ { "snapshot_id": "cardio:pubmed-36331190-2026-10-14", "locator": "Abstract, RESULTS, sentence 2, fragment 1 of 3" }, { "snapshot_id": "cardio:pubmed-36331190-2026-10-14", "locator": "Abstract, RESULTS, sentence 2, fragment 2 of 3" } ] }, { "id": "emp-3", "text": "The results were consistent among patients with or without diabetes and across subgroups defined by eGFR range.", "cites": [ { "snapshot_id": "cardio:pubmed-36331190-2026-10-14", "locator": "Abstract, RESULTS, sentence 3" } ] } ] }, { "heading": "A trial of semaglutide in type 2 diabetes and chronic kidney disease", "statements": [ { "id": "sem-1", "text": "The trial randomly assigned 3533 patients with type 2 diabetes and chronic kidney disease to semaglutide or placebo.", "cites": [ { "snapshot_id": "cardio:pubmed-38785209-2026-10-14", "locator": "Abstract, METHODS, sentence 1, fragment 1 of 4" }, { "snapshot_id": "cardio:pubmed-38785209-2026-10-14", "locator": "Abstract, METHODS, sentence 1, fragment 4 of 4" }, { "snapshot_id": "cardio:pubmed-38785209-2026-10-14", "locator": "Abstract, RESULTS, sentence 1, fragment 1 of 2" } ] }, { "id": "sem-2", "text": "Median follow-up was 3.4 years, after early trial cessation was recommended at a prespecified interim analysis.", "cites": [ { "snapshot_id": "cardio:pubmed-38785209-2026-10-14", "locator": "Abstract, RESULTS, sentence 1, fragment 1 of 2" }, { "snapshot_id": "cardio:pubmed-38785209-2026-10-14", "locator": "Abstract, RESULTS, sentence 1, fragment 2 of 2" } ] }, { "id": "sem-3", "text": "The risk of major kidney disease events was 24% lower with semaglutide than with placebo.", "cites": [ { "snapshot_id": "cardio:pubmed-38785209-2026-10-14", "locator": "Abstract, METHODS, sentence 2, fragment 1 of 3" }, { "snapshot_id": "cardio:pubmed-38785209-2026-10-14", "locator": "Abstract, RESULTS, sentence 2, fragment 1 of 2" } ] }, { "id": "sem-4", "text": "These events were kidney failure, at least a 50% fall in eGFR, or death from kidney-related or cardiovascular causes.", "cites": [ { "snapshot_id": "cardio:pubmed-38785209-2026-10-14", "locator": "Abstract, METHODS, sentence 2, fragment 1 of 3" }, { "snapshot_id": "cardio:pubmed-38785209-2026-10-14", "locator": "Abstract, METHODS, sentence 2, fragment 2 of 3" }, { "snapshot_id": "cardio:pubmed-38785209-2026-10-14", "locator": "Abstract, METHODS, sentence 2, fragment 3 of 3" } ] } ] } ], "checklists": [ { "heading": "What the sources say can change a result", "items": [ { "id": "ck-1", "text": "eGFR can vary with age, body size and other health conditions.", "cites": [ { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "What do the results mean?, para 2" } ] }, { "id": "ck-2", "text": "Some foods, such as meat, and certain medicines can affect an eGFR result.", "cites": [ { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "Will I need to do anything to prepare for these tests?, para 1" } ] }, { "id": "ck-3", "text": "Severe malnutrition, muscle wasting conditions and advanced liver disease are named as conditions that can make an eGFR unreliable.", "cites": [ { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "Why do I need a GFR test?, para 8, list item 2" }, { "snapshot_id": "cardio:medlineplus-gfr-test-2026-10-14", "locator": "Why do I need a GFR test?, para 8, list item 2" } ] }, { "id": "ck-4", "text": "Hard exercise may raise the amount of albumin in urine for a short time.", "cites": [ { "snapshot_id": "cardio:medlineplus-uacr-test-2026-10-14", "locator": "Will I need to do anything to prepare for the test?, para 1, list item 1" } ] }, { "id": "ck-5", "text": "Fever, inflammation and certain medicines may also cause temporary rises in urine albumin.", "cites": [ { "snapshot_id": "cardio:medlineplus-uacr-test-2026-10-14", "locator": "What do the results mean?, para 1" } ] }, { "id": "ck-6", "text": "Urinary tract infections, gum infections and hepatitis may raise albumin in urine.", "cites": [ { "snapshot_id": "cardio:medlineplus-uacr-test-2026-10-14", "locator": "What do the results mean?, para 5" } ] }, { "id": "ck-7", "text": "Muscle density, diet, age and race may also affect urine albumin results.", "cites": [ { "snapshot_id": "cardio:medlineplus-uacr-test-2026-10-14", "locator": "What do the results mean?, para 6" } ] }, { "id": "ck-8", "text": "Anemia or another type of blood disorder may make an A1C test inaccurate for diagnosing diabetes.", "cites": [ { "snapshot_id": "cardio:medlineplus-hba1c-test-2026-10-14", "locator": "Is there anything else I need to know about an A1C test?, para 1" }, { "snapshot_id": "cardio:medlineplus-hba1c-test-2026-10-14", "locator": "Is there anything else I need to know about an A1C test?, para 1" } ] }, { "id": "ck-9", "text": "Kidney failure and liver disease can also affect A1C results.", "cites": [ { "snapshot_id": "cardio:medlineplus-hba1c-test-2026-10-14", "locator": "Is there anything else I need to know about an A1C test?, para 1" } ] }, { "id": "ck-10", "text": "Certain medicines, such as opioids and some HIV medicines, and pregnancy may affect A1C results.", "cites": [ { "snapshot_id": "cardio:medlineplus-hba1c-test-2026-10-14", "locator": "Will I need to do anything to prepare for the test?, para 1" }, { "snapshot_id": "cardio:medlineplus-hba1c-test-2026-10-14", "locator": "Will I need to do anything to prepare for the test?, para 1" } ] } ] } ], "questions": [ { "text": "Which of these tests have I had, and how often are they done for someone with my conditions?", "grounded_in": [ "egfr-use1", "uacr-use", "uacr-yearly" ] }, { "text": "Which ranges does my lab use for these results, and how do they apply to me?", "grounded_in": [ "egfr-vary", "niddk-gfr1", "a1c-guide" ] }, { "text": "Could any of my medicines, conditions or recent activities have affected these results?", "grounded_in": [ "ck-2", "ck-4", "ck-5", "ck-10" ] }, { "text": "If a result is abnormal, will the test be repeated, and when?", "grounded_in": [ "uacr-repeat1", "uacr-repeat2", "a1c-more1" ] }, { "text": "Which of the tests will be used to follow my kidney health over time?", "grounded_in": [ "egfr-use4", "uacr-monitor", "link-niddk" ] }, { "text": "Do the results of these trials apply to someone with my kidney function, urine albumin results and diabetes status?", "grounded_in": [ "tr-1", "fin-1", "dap-1", "emp-3" ] }, { "text": "Is a medicine like those tested in these trials something to discuss for my situation?", "grounded_in": [ "fin-3", "dap-3", "emp-2", "sem-3" ] } ] }, "content_digest": "6e7fffd2d4d43823cbc818ec1ba576a6ef0267a40813c44c8d91997ef259dcae", "review": { "content_digest": "6e7fffd2d4d43823cbc818ec1ba576a6ef0267a40813c44c8d91997ef259dcae", "current": [], "conflicting": [], "stale": [], "inactive": [] }, "claims": [], "decisions": [], "milestones": [], "relationships": { "outgoing": [], "incoming": [] }, "page_path": "guides/kidney-diabetes-lab-tests/", "context_path": "api/v1/context/cardio--guide-kidney-diabetes-lab-tests.md" }