Screening for chronic kidney disease in general practice in NSW

Lumos data highlight opportunities for increased chronic kidney disease screening in general practice.

Last updated: 19 May 2026
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​​​Chronic kidney disease (CKD) is impaired or reduced kidney function lasting 3 months or more, regardless of the cause of reduced kidney function1. Risk of CKD is increased among people with diabetes, high blood pressure (hypertension), cardiovascular disease, obesity and past or current smoking2. CKD is categorised into five stages based on kidney function, with the most severe form being kidney failure (end-stage kidney disease). People with end-stage kidney disease require a kidney transplant or dialysis to survive. Early detection of CKD can improve outcomes.

In 2022-24, a biomedical survey reported that around 1 in 7 adults in NSW (14.2%) had pathology measures that indicated a level of CKD3. However, as up to 90% of kidney function may be lost before symptoms occur, the condition is often undiagnosed. This highlights the importance of kidney health screening for the early detection and management of CKD, to delay disease progression, improve patient outcomes and reduce burden on the health system.

Here we present the use of linked general practice (GP) and hospital records from the Lumos program to provide an understanding of rates of CKD screening in at-risk groups in primary care.​


​Summary of findings

  • Just under half of patients (47.5%) attending a Lumos GP have one or more CKD risk factors.
  • 1 in 5 patients at risk of CKD are not receiving recommended kidney health screening on time.
  • Younger at-risk patients and those with obesity or smoking as risk factors are less likely to receive timely screening for kidney disease.

Key Findings:

Nearly half of patients in NSW have a risk for CKD​

​Patients with risk factors for CKD were identified in Lumos from GP and hospital records. Of the 1,890,541 patients who visited a Lumos practice at least twice in 12 months, 897,488 (47.5%) had at least one of these risk factors.

Up to 1 in 5 at-risk patients are not screened in recommended timeframes

​Early detection of CKD is critical for delaying the progression of disease, leading to improved patient outcomes and reducing burden on the health system. Kidney Health Australia provides guidelines for how often patients deemed at risk of CKD should be screened2. Health screening includes estimated Glomerular Filtration Rate (eGFR), Urine Albumin-Creatinine Ratio (uACR) and blood pressure.

Among patients that had visited a Lumos GP at least twice per year in the three years 2022, 2023 and 2024, 472,027 were identified as at risk of CKD but with no evidence of CKD diagnosis in their GP record. In accordance with Kidney Health Australia guidelines, these patients should be screened regularly.

  • Over 80% (over 4 out of 5) of patients with a CKD risk factor had a kidney assessment in the recommended timeframe, including 90% of patients with cardiovascular disease.
  • Almost 20% (up to 1 in 5) of patients with a CKD risk factor are not screened within the recommended timeframes. Those with obesity or those who are a current or past smoker are the least likely groups to be screened for CKD within the recommended timeframe.​

Younger at-risk patients are less likely to receive timely CKD screening

The proportion of patients that had between 2 and 3 yearly encounters with Lumos GPs and have no record of screening within the recommended timeframes was estimated* to be 39%. In contrast, for patients with 12 or more Lumos GP encounters, this proportion fell to 12%.

While 51% of patients at risk of CKD are under 60 years of age, this age group represents 75% of all patients who are not screened within recommended timeframes. An estimated* 38% of people aged 0-39 years and 21% aged 40-59 years had no record of screening within recommended timeframes as per Kidney Health Australia guidelines.​


​About the study

This study was completed on Lumos tranche 11, extracted in April 2025, including 836 general practices. This represented approximately 36% of all NSW general practices.

This study utilises data from 1,890,541 patients that had at least two encounters with Lumos GPs in the calendar year 2022, which represents approximately 23% of the NSW population at the time.​

​Reference Footnote:

1.  https://www.aihw.gov.au/reports-data/health-conditions-disability-deaths/chronic-kidney-disease/overview

2. Chronic Kidney Disease (CKD) Management in Primary Care (5th edition). Kidney Health Australia, Melbourne, 2024.

3. Australian Bureau of Statistics (2022-2024), National Health Measures Survey, ABS Website, accessed 2 Sept 2025.

* We present estimated proportions to account for under-reporting of eGFR measurements from one of the GP extraction vendors. These estimates come from a logistic regression model that quantifies and adjusts for the under-reporting.​

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​Disclaimer:

Information contained in this publication is based on knowledge and understanding at the time of writing and is subject to change. ​​​


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Current as at: Tuesday 19 May 2026
Contact page owner: System Information and Analytics​​