Chronic kidney disease

Laboratory tests

• Serum creatinine with eGFR (CKD-EPI)

Urine tests

• Urine albumin:creatinine ratio (ACR) on a spot urine sample (preferably first morning urine)

Fasting laboratory tests

• FBC
• Reticulocyte countif neededThe search for complications begins at stage 3 or 3B: FBC with reticulocyte count and serum ferritin, the first-line test for iron deficiency, which is routinely associated ^[1].
• Serum ferritinif neededThe search for complications begins at stage 3 or 3B: FBC with reticulocyte count and serum ferritin, the first-line test for iron deficiency, which is routinely associated ^[1].
• Serum electrolytes
• Serum calcium
• Serum phosphate
• Bicarbonate
• Urea (reimbursed)
• Serum creatinine with eGFR
• Total serum protein
• Serum albumin
• Serum protein electrophoresis (and immunofixation as a reflex test)
• Lipid profile
• Fasting plasma glucose
• HIV serologyif neededDepending on the context (risk factor for HIV exposure): the HAS guide on chronic kidney disease cites it only in the pre-transplant work-up ^[1].
• Hepatitis C serology
• Hepatitis B serology: anti-HBs antibodies, anti-HBc antibodies (the procedure also includes HBsAg)

Urine tests

• Urine protein:creatinine ratio (spot sample)
• Urine albumin:creatinine ratio (ACR) on a spot urine sample
• Urine microscopy and culture

Fasting laboratory tests

• Serum creatinine with eGFR
• Lipid profile
• Fasting plasma glucose
• FBCif needednon-French guidelineKDIGO (2026) considers it reasonable to look for anaemia and iron deficiency at least once a year from stage 3 ^[12], and the Australian general practice manual provides for a yearly blood count at this stage ^[5]. The HAS guide provides for blood count and serum ferritin only from stage 3B, except in people with diabetes, in whom it recommends screening for complications from stage 3A ^[1].
• Serum ferritinif needednon-French guidelineKDIGO (2026) considers it reasonable to look for anaemia and iron deficiency at least once a year from stage 3 ^[12], and the Australian general practice manual provides for a yearly blood count at this stage ^[5]. The HAS guide provides for blood count and serum ferritin only from stage 3B, except in people with diabetes, in whom it recommends screening for complications from stage 3A ^[1].

Urine tests

• Urine albumin:creatinine ratio (ACR) on a spot urine sample
• Or urine protein:creatinine ratio on a spot urine sample (kidney disease without albuminuria: HIV, monoclonal gammopathy, etc.)if neededKidney disease in which albuminuria may be absent (HIV infection, monoclonal gammopathy): the HAS guide accepts the ACR or the PCR for follow-up ^[1].

Twice-yearly tests

Fasting laboratory tests

• Serum creatinine with eGFR
• FBC with reticulocyte count
• Serum electrolytes
• Bicarbonate
• Serum calcium
• Serum phosphate
• Serum ferritin
• Transferrin saturation (if ferritin abnormal)if neededSecond-line, if serum ferritin is abnormal: iron and transferrin sampled in the morning, fasting, away from acute inflammation ^[1]; the laboratory may add it on its own after ferritin ^[10].
• Serum albumin
• Lipid profile (once a year)if neededOnce a year, according to the follow-up table of the HAS guide ^[1].
• Fasting plasma glucose (once a year)if neededOnce a year, in non-diabetic patients (follow-up table of the HAS guide) ^[1].
• HBsAg (if not vaccinated) or anti-HBs (if vaccinated) (every 3 years)if neededEvery 3 years at stage 3B: HBsAg if the patient is not vaccinated, anti-HBs antibodies if vaccinated (target > 10 IU/L) ^[1].
• PTHif neededFrequency according to the initial concentration and progression of CKD (HAS guide) ^[1]; outside the NABM indications in non-dialysed patients: write “NR” (not reimbursable in France) ^[13].
• 25-hydroxyvitamin D (first tests for phosphocalcic complications)if neededThe HAS guide places it in the search for phosphocalcic complications from stage 3B ^[1]; KDIGO suggests it may be measured from stage 3A ^[14]. Outside the NABM indications: write “NR” (not reimbursable in France) ^[13].

Urine tests

• Urine protein:creatinine ratio (spot sample)

Three-monthly tests

Fasting laboratory tests

• Serum creatinine with eGFR
• FBC with reticulocyte count
• Serum electrolytes
• Bicarbonate
• Serum calcium
• Serum phosphate
• Serum ferritin
• Transferrin saturation (if ferritin abnormal)if neededSecond-line, if serum ferritin is abnormal: iron and transferrin sampled in the morning, fasting, away from acute inflammation ^[1]; the laboratory may add it on its own after ferritin ^[10].
• Serum albumin
• PTH
• Alkaline phosphatase
• Blood urea
• Lipid profile (once a year)if neededOnce a year, according to the follow-up table of the HAS guide ^[1].
• Fasting plasma glucose (once a year)if neededOnce a year, in non-diabetic patients (follow-up table of the HAS guide) ^[1].
• HBsAg (if not vaccinated) or anti-HBs (if vaccinated) (once a year)if neededOnce a year at stage 4: HBsAg if the patient is not vaccinated, anti-HBs antibodies if vaccinated (target > 10 IU/L) ^[1].

Urine tests

• Urine protein:creatinine ratio (spot sample)

Monthly tests

Fasting laboratory tests

• Serum creatinine with eGFR
• FBC with reticulocyte count
• Serum electrolytes
• Bicarbonate
• Serum calcium
• Serum phosphate
• Serum ferritin
• Transferrin saturation (if ferritin abnormal)if neededSecond-line, if serum ferritin is abnormal: iron and transferrin sampled in the morning, fasting, away from acute inflammation ^[1]; the laboratory may add it on its own after ferritin ^[10].
• Serum albumin
• Alkaline phosphatase
• Blood urea
• PTH (every 3 to 6 months)if neededEvery 3 to 6 months at stage 5 (HAS guide, KDIGO) ^[1,14]; before dialysis, outside the NABM indications: write “NR” (not reimbursable in France) ^[13].
• PTH, reimbursed (dialysis patient)if neededIn dialysed patients, PTH monitoring falls within the NABM indications of code 0983: do not write “NR” (not reimbursable in France); before dialysis, use the previous line ^[13].
• Lipid profile (once a year)if neededOnce a year, according to the follow-up table of the HAS guide ^[1].
• Fasting plasma glucose (once a year)if neededOnce a year, in non-diabetic patients (follow-up table of the HAS guide) ^[1].
• HBsAg (if not vaccinated) or anti-HBs (if vaccinated) (once a year)if neededOnce a year at stage 5: HBsAg if the patient is not vaccinated, anti-HBs antibodies if vaccinated (target > 10 IU/L) ^[1].

Urine tests

• Urine protein:creatinine ratio (spot sample)

Laboratory tests, 2 to 4 weeks after the change

• Serum creatinine with eGFR
• Serum electrolytes (sodium, potassium)
• Sample at the laboratory rather than at home, without a prolonged tourniquet or muscle contraction (spurious hyperkalaemia).
• Serum potassium at 1 month then every 4 months (finerenone)if needednon-French guidelineOn finerenone: serum potassium 1 month after initiation then every 4 months; suspend if it exceeds 5.5 mmol/L ^[3].