American Board of Internal Medicine (ABIM) Certification Practice Exam

What screening method is appropriate for chronic kidney disease (CKD) in patients with risk factors?

1. Serum creatinine measurement

2. Urine albumin excretion measurement

3. Blood pressure monitoring

4. Complete blood count

The correct answer is: Urine albumin excretion measurement

Measuring urine albumin excretion is crucial for screening chronic kidney disease (CKD), especially in individuals with risk factors such as diabetes, hypertension, or a family history of kidney disease. The presence of albumin in the urine (albuminuria) is an early marker of kidney damage. Detecting even small amounts of albumin can help identify patients at risk of progression to more severe CKD and those who may benefit from interventions to slow the progression of their kidney disease. This method provides a means to not only screen for CKD but also assess the severity of kidney damage. Early identification of CKD through urine albumin measurement allows for timely management strategies, such as controlling blood pressure or blood sugar levels, which can help prevent further kidney damage and improve overall patient outcomes. Other options such as serum creatinine measurement can indicate reduced kidney function but may not reflect early kidney damage as sensitively as urine albumin. Blood pressure monitoring is essential in managing CKD but not directly a screening tool for its diagnosis. A complete blood count does not provide specific information regarding kidney function or damage. Therefore, urine albumin excretion measurement stands out as the most appropriate screening approach for CKD in at-risk patients.