CHRONIC KIDNEY DISEASE
Chronic kidney disease (CKD) care
For people told that their kidney function is reduced or that protein was found in their urine
Medically reviewed by Koshiro Nishimoto, MD, PhD (Director)
Updated October 18, 2026
What is chronic kidney disease?
Have you been told that a kidney test result was abnormal or that protein was found in your urine? Kidney disease often causes few symptoms in its early stages. Please seek advice if a health check finds an abnormality, even if you feel well.
At our clinic, we combine blood and urine tests and review changes from earlier results to guide your care.
Chronic kidney disease (CKD) is diagnosed when signs of kidney damage, such as persistent protein in the urine, or an eGFR below 60 mL/min/1.73 m² continue for more than three months. Diabetes and high blood pressure can be contributing conditions. We use previous results and repeat tests to check whether an abnormality is persistent.
You do not need to wait three months before seeking medical advice.
Japanese Society of Nephrology: CKD Guideline 2023, Chapter 1, Table 1, p. 3 (Japanese PDF)
Blood and urine tests tell us different things
The blood test eGFR estimates how well your kidneys filter blood. Urine protein and albumin tests look for protein leaking into the urine. Albumin is one type of protein.
People with the same eGFR can have different risks depending on their urine results. The tables below show our patient counts, including people without a matching urine measurement. In the Japanese classification, urine albumin/creatinine ratio is generally used for people with diabetes and urine protein/creatinine ratio for people without diabetes. We select the appropriate test for your condition.
Find your eGFR row and the column matching your urine test result. Cr means creatinine; these ratios help adjust for how concentrated or dilute the urine is. A dipstick result such as + or ++ cannot be used directly as an A category.
Imported patient register as of August 2026: 1158 people
The two tables include everyone in that imported patient register, including people without usable urine or eGFR results. The register is a snapshot and does not necessarily include every current clinic patient. Groups are based on recorded diabetes diagnoses; no recorded diagnosis does not confirm the absence of diabetes. These groups are not restricted to people with confirmed CKD or DKD.
For each person, we use the latest usable eGFR and the nearest usable quantitative urine result within 90 days before or after it. If two urine tests are equally close, the newer test is used. People with only a urine dipstick result or no usable quantitative result within that window are shown in the separate “No quantitative urine result” column. Missing results are not treated as normal.
No recorded diabetes diagnosis: CKD assessment
Test data period: October 2025 – August 2026. People included: 1089 people
Scroll sideways to see A1, A2, A3 and the column for missing quantitative urine results.
| Kidney functioneGFRmL/min/1.73 m² | A1Urine protein/Cr (g/gCr)<0.15 | A2Urine protein/Cr (g/gCr)0.15 to <0.50 | A3Urine protein/Cr (g/gCr)≥0.50 | No quantitative urine resultWithin 90 days before or after the eGFR test |
|---|---|---|---|---|
| G1≥90 | <10Low* | <10Moderately increased | 0High | 33Risk not classified |
| G260–89 | 21Low* | <10Moderately increased | <10High | 165Risk not classified |
| G3a45–59 | 40Moderately increased | 11High | <10Very high | 50Risk not classified |
| G3b30–44 | <10High | <10Very high | <10Very high | 15Risk not classified |
| G415–29 | <10Very high | 0Very high | 0Very high | <10Risk not classified |
| G5<15 | 0Very high | <10Very high | 0Very high | <10Risk not classified |
No usable eGFR value in the imported data: 717 people. These people are included in this group's total but cannot be assigned to a G row.
Recorded diabetes diagnosis: DKD assessment
Test data period: October 2025 – August 2026. People included: 69 people
Diabetic kidney disease (DKD) is assessed using kidney function and urine albumin findings. This group is based on a recorded diabetes diagnosis; it is not restricted to people with a confirmed DKD diagnosis.
Scroll sideways to see A1, A2, A3 and the column for missing quantitative urine results.
| Kidney functioneGFRmL/min/1.73 m² | A1Urine albumin/Cr (mg/gCr)<30 | A2Urine albumin/Cr (mg/gCr)30 to <300 | A3Urine albumin/Cr (mg/gCr)≥300 | No quantitative urine resultWithin 90 days before or after the eGFR test |
|---|---|---|---|---|
| G1≥90 | <10Low* | <10Moderately increased | 0High | <10Risk not classified |
| G260–89 | 15Low* | <10Moderately increased | 0High | <10Risk not classified |
| G3a45–59 | <10Moderately increased | <10High | 0Very high | <10Risk not classified |
| G3b30–44 | <10High | <10Very high | 0Very high | 0Risk not classified |
| G415–29 | <10Very high | 0Very high | <10Very high | <10Risk not classified |
| G5<15 | 0Very high | 0Very high | 0Very high | <10Risk not classified |
No usable eGFR value in the imported data: 12 people. These people are included in this group's total but cannot be assigned to a G row.
Counts from 1 to 9 are shown as “<10”. Additional values may be marked “Not shown” to prevent small counts from being calculated from totals. Exact small counts and percentages are not published. Data as of October 2026.
* G1 or G2 with A1 does not meet the definition of CKD if there are no other signs of kidney damage. Coloured A1–A3 cells indicate relative risk of outcomes such as kidney failure and cardiovascular disease. The grey column is unclassified and does not mean low risk. Numbers are counts of people, not an individual's probability of disease. Results taken on different dates are paired for this aggregate and do not establish a diagnosis.
Clinic kidney function and urine statistics / Risk classification: JSN CKD Guideline 2023, Table 2, p. 4 (Japanese PDF)
This table helps us understand risk. We also consider the cause and duration of the abnormality, age and changes over time when planning care. The table alone does not determine whether to start a medicine.
We review changes over time
We compare your latest results with previous tests, using graphs when helpful. We review the trend in eGFR and urine findings alongside blood pressure, diabetes and current medicines.
We adjust treatment and the interval between tests to your condition. When needed, we work with a specialist medical centre for further assessment or treatment.
Treatment to protect your kidneys
Care includes managing blood pressure and blood glucose, reducing salt, suitable physical activity and support to stop smoking. Dietary advice is tailored to kidney function and nutritional needs. Our aim is to reduce the risk of worsening kidney function and progression to kidney failure.
At our clinic, we assess your kidney health with blood and urine tests and use kidney-protective medicines called SGLT2 inhibitors when appropriate.
We consider eGFR, urine findings, diabetes or heart failure, conditions that make the medicine unsuitable and the risk of side effects.
Guideline recommendations and the DAPA-CKD and EMPA-KIDNEY trials support treatment in appropriate patients. These trials evaluated combined outcomes that include several events, such as kidney disease progression; their results do not mean every patient will have the same benefit. KDIGO 2024 / DAPA-CKD / EMPA-KIDNEY
What to bring to your appointment
- Previous health check, blood test and urine test results
- Your medication record or a list of medicines
- Home blood pressure records, if available
If urine output suddenly decreases or swelling worsens, seek medical advice promptly instead of waiting for your next scheduled appointment. Severe breathlessness requires emergency medical care.
Frequently asked questions
Should I see a doctor even if I feel well?
If a health check shows reduced kidney function or protein in your urine, please seek advice even without symptoms. We compare earlier results and repeat tests when needed to assess your condition and discuss further testing or treatment.
Does CKD always lead to dialysis?
Not everyone diagnosed with CKD will need dialysis. We review the cause, kidney function, urine results and changes over time, and continue treatment with the aim of reducing the risk of progression.