✓Standard Care

Is Kidney Function Testing Worth It?

With 93% of Australians with chronic kidney disease unaware they have it, this is the nation's most underdiagnosed condition. By the time symptoms appear, up to 90% of kidney function may already be lost—and that damage is irreversible. Here's why early detection isn't optional if you have risk factors.

Published 1 June 2025 · Updated 23 January 2026 · 10 min read

93%

of Australians with chronic kidney disease don't know they have it—until it's too late

Source: [1]

The Short Answer

Yes—if you have risk factors, this isn't negotiable. Kidney function testing (eGFR + urine ACR) is strongly guideline-backed for anyone with diabetes, hypertension, cardiovascular disease, or family history of kidney disease. KDIGO 2024 guidelines recommend annual testing for at-risk groups. CKD is completely silent until advanced stages—you feel perfectly fine whilst losing kidney function irreversibly. Early intervention can slow progression by up to 50%, and Australia could save $25 billion over 25 years with better detection. If you have risk factors, this test could add decades of healthy life.^[1][2]

What Kidney Tests Measure

Your kidneys filter approximately 180 litres of blood every day, removing waste products and excess fluid whilst maintaining electrolyte balance. Kidney function tests assess how efficiently this filtration system is working—and critically, they can detect deterioration years before you notice any symptoms.

Services like Function Health and Mito Health prioritise kidney markers in proactive testing panels because they represent "a shift from reactive to proactive kidney care"—identifying strain before irreversible damage occurs.^[3]

eGFR (Estimated Glomerular Filtration Rate)

The most critical kidney function marker. eGFR estimates how much blood your kidneys filter per minute, calculated from your creatinine level, age, and sex using the CKD-EPI equation.

What it reveals: Your kidneys' overall filtering capacity. An eGFR of 90+ is normal; below 60 for 3+ months indicates chronic kidney disease. Anything under 15 typically requires dialysis or transplant.^[2]

Normal range: 90-120 mL/min/1.73m²

Creatinine

A waste product from normal muscle metabolism. Your kidneys filter creatinine from the blood—when kidney function declines, creatinine levels rise.

What it reveals: Raw data used to calculate eGFR. However, creatinine alone is misleading—muscular individuals naturally have higher levels, and approximately 50% of kidney function must be lost before creatinine rises detectably.^[4]

Urea

A waste product from protein metabolism. Like creatinine, urea is filtered by the kidneys and rises when kidney function declines.

What it reveals: Supports eGFR findings but is less specific—urea can be elevated by high protein intake, dehydration, gastrointestinal bleeding, or corticosteroid use.

Why eGFR Matters More Than Creatinine Alone

Creatinine levels vary significantly based on muscle mass, diet, and hydration status. A muscular 30-year-old and a frail 80-year-old might have identical creatinine levels but vastly different kidney function.

eGFR adjusts for age and sex, providing a standardised measure. For even greater accuracy, the KDIGO 2024 guidelines recommend combined eGFR from creatinine plus cystatin C (eGFRcr-cys) when available—particularly for confirming borderline results or in patients with unusual muscle mass.^[2]

Why 93% Miss It Until It's Too Late

The Silent Progression

Here's what makes CKD so dangerous: you feel completely normal whilst losing kidney function irreversibly. There's no pain, no obvious symptoms, no warning signs in the early stages when intervention is most effective.

By the time you notice fatigue, swelling, changes in urination, or other symptoms, you may have already lost 90% of your kidney function. And that damage cannot be reversed—kidneys don't regenerate like liver tissue.^[1]

The Underdiagnosis Crisis

14.2% of Australians over 18 display CKD indicators (ABS 2025)

Only 7.4% of those with CKD indicators actually know they have it

44.7% of Australians aged 75+ show signs of CKD

1.7-2.7 million Australians with undiagnosed kidney disease^[1]

When Symptoms Finally Appear

Stage 4-5 only: Symptoms typically don't appear until less than 30% function remains

Too late for prevention: Dietary changes and medication can only slow—not reverse—damage at this stage

Limited options: Dialysis ($80,000+/year) or transplant become necessary

The Five Stages of CKD

Chronic kidney disease is classified into five stages based on eGFR. The KDIGO 2024 guidelines also factor in albumin-to-creatinine ratio (ACR) from urine testing—high protein in urine indicates kidney damage even if eGFR appears normal.

eGFR ≥90Stage 1

Normal kidney function (CKD only if other damage markers like protein in urine present)

eGFR 60–89Stage 2

Mildly decreased—usually no symptoms; monitor annually if risk factors present

eGFR 45–59Stage 3a

Mild-moderate decrease—cardiovascular risk increases; monitor every 3-6 months

eGFR 30–44Stage 3b

Moderate-severe decrease—medication review essential, dietary changes; nephrology referral likely needed

eGFR 15–29Stage 4

Severely decreased—nephrology care essential; prepare for possible dialysis or transplant

eGFR <15Stage 5

Kidney failure—dialysis or transplant typically required for survival

The $25 Billion Question: Why Early Detection Matters

The economics are staggering—and they reveal just how valuable early detection is:

The Cost of Late Detection

$80,000+ per year for dialysis per patient

~25,000 Australians currently on kidney replacement therapy

$2 billion annually spent on kidney replacement therapy

Growing crisis: CKD incidence increasing due to diabetes and ageing population^[5]

The Promise of Early Detection

$25.2 billion could be saved over 25 years with better early detection

50% slower progression with early treatment intervention

164,956 years of healthy life gained over 20 years

38,200 premature deaths prevented^[5]

The Problem with Waiting

Symptoms only appear at Stage 4-5 (less than 30% function remaining)
Kidney damage is largely irreversible once it occurs—kidneys don't regenerate
CKD increases heart disease risk by 2-4 times, even in early stages
Late detection means limited treatment options beyond slowing progression
Dialysis dependency profoundly impacts quality of life and costs $80,000+/year^[1][5]

Benefits of Early Detection

Lifestyle changes can slow progression by years or even decades
Blood pressure and diabetes control become prioritised and monitored closely
Nephrotoxic medications can be identified and avoided (NSAIDs, certain antibiotics)
SGLT2 inhibitors can protect remaining kidney function in diabetics
Adequate planning time for transplant (better outcomes than starting dialysis urgently)^[2][6]

Critical point: A 10-year head start on treatment can mean the difference between requiring a kidney transplant in your 50s versus maintaining adequate function into your 80s. This isn't a minor benefit—it's life-altering.

Who Must Get Tested: KDIGO 2024 Recommendations

The KDIGO 2024 guidelines and Kidney Health Australia recommend annual kidney function testing (eGFR + urine ACR) if you have any of these risk factors:^[2][6]

Diabetes or prediabetes: The #1 cause of kidney failure in Australia—CKD develops in 30-40% of people with diabetes
High blood pressure: The #2 cause of kidney disease, particularly if poorly controlled
Cardiovascular disease: Heart and kidney disease share common risk factors and frequently coexist
Family history: CKD, polycystic kidney disease, or kidney failure in first-degree relatives
Age 60 or older: Kidney function naturally declines with age; screening becomes more important
Aboriginal or Torres Strait Islander heritage: 3-4 times higher CKD rates, often with earlier onset
Obesity (BMI >30): Increases risk of diabetes and hypertensive kidney disease significantly
Smoking: Accelerates kidney function decline and worsens outcomes
Regular NSAID use: Long-term ibuprofen, naproxen, or other NSAIDs can cause cumulative kidney damage
Previous acute kidney injury: History of AKI increases long-term CKD risk substantially

If you have multiple risk factors, annual testing isn't optional—it's essential preventive care.

What Your GP Will Do: Clear Pathways Exist

Strong Guideline Support

Unlike some biomarkers where GPs may be uncertain about next steps, kidney function testing is strongly guideline-backed with clear management pathways from RACGP and Kidney Health Australia.^[6]

Your GP will know exactly what to do with these results:

Normal eGFR (≥60) + normal ACR: Reassurance; retest in 1-2 years if risk factors present, otherwise routine monitoring
Stage 3a (eGFR 45-59): More frequent monitoring (every 3-6 months), comprehensive medication review, blood pressure and diabetes optimisation, cardiovascular risk assessment
Stage 3b-4 (eGFR 15-44): Nephrology referral for specialist input, dietary review with consideration of protein restriction, anaemia and bone health monitoring
Stage 5 (eGFR <15): Active nephrology management, dialysis or transplant planning, supportive care

The Kidney Health Check: Three simple components—serum creatinine (for eGFR calculation), urine albumin-to-creatinine ratio (ACR), and blood pressure measurement. These three tests catch the vast majority of CKD cases.

Medicare rebate: Fully covered when ordered by your GP for patients with established risk factors.

Is It Worth the Cost?

✗ Probably Skip If...

You have no risk factors (no diabetes, hypertension, family history, age under 60, no cardiovascular disease)
Your eGFR was normal in the last 12 months with no new risk factors emerging
You're already under active nephrology care with regular monitoring established

✓ Worth Considering If...

Diabetes or prediabetes—CKD develops in 30-40% of people with diabetes^[1]
High blood pressure, especially if poorly controlled or requiring multiple medications
Family history of kidney disease, kidney failure, or polycystic kidney disease
Age 60 or older—routine screening strongly recommended by KDIGO guidelines^[2]
Aboriginal or Torres Strait Islander heritage (3-4x higher CKD rates with earlier onset)^[1]
Taking medications that can affect kidneys (NSAIDs regularly, certain blood pressure medications, lithium)
Cardiovascular disease (heart and kidney disease frequently coexist and share risk factors)
Previous acute kidney injury—significantly increases long-term CKD risk

The Bottom Line

Kidney function testing is one of the most evidence-backed screening tests available—if you have risk factors, it's not negotiable.

With 14.2% of Australians showing CKD indicators but only 7.4% aware of their condition, this is Australia's most underdiagnosed chronic disease. Unlike many biomarkers where the evidence is nuanced or uncertain, the case for kidney function testing is unambiguous: CKD is common, completely silent until advanced stages, and early intervention dramatically changes outcomes.

If you have diabetes, hypertension, or are over 60, annual testing isn't just "worth it"—it's standard of care endorsed by KDIGO, RACGP, and Kidney Health Australia. The $30-50 cost of an eGFR test is trivial compared to dialysis ($80,000+/year) or the profound human cost of late-stage kidney disease.

The numbers are stark: Australia could prevent 38,200 premature deaths and save $25 billion over 25 years by improving early detection. A 10-year head start on treatment can mean the difference between maintaining kidney function into your 80s versus requiring dialysis in your 50s.

This is preventive medicine at its best—simple, affordable, Medicare-covered, with clear treatment pathways and genuinely life-altering benefits. If you have risk factors and haven't been tested, this should be high on your priority list.

Frequently Asked Questions

eGFR (estimated Glomerular Filtration Rate) measures how efficiently your kidneys filter blood. It's the single most important kidney function marker. An eGFR of 90+ is normal; below 60 for 3+ months indicates chronic kidney disease. Unlike creatinine alone, eGFR adjusts for age and sex, providing a standardised measure of kidney function. The KDIGO 2024 guidelines recommend annual eGFR testing for anyone with diabetes, hypertension, cardiovascular disease, or age 60+.

This is exactly what makes CKD so dangerous. Your kidneys have enormous reserve capacity—you can lose 50-75% of kidney function before experiencing any symptoms at all. By the time you notice fatigue, swelling, changes in urination, or other symptoms, you're typically at Stage 4 or 5 CKD (less than 30% function remaining). At that point, the damage is irreversible and treatment options are limited to slowing progression or kidney replacement therapy. This is why early detection through blood testing is critical.

Normal eGFR is 90-120 mL/min/1.73m². However, kidney function naturally declines with age—approximately 1 mL/min per year after age 40. An eGFR of 60-89 in someone over 70 without other signs of kidney damage (like protein in urine) may not indicate disease. This is why eGFR must be interpreted in context—your GP will consider your age, whether the result is stable or declining, and whether you have other markers of kidney damage like elevated urine albumin.

Yes, kidney function testing (serum creatinine for eGFR calculation and urine ACR) is fully covered by Medicare when ordered by your GP for patients with risk factors such as diabetes, hypertension, cardiovascular disease, or family history of kidney disease. The Kidney Health Check—comprising eGFR, urine ACR, and blood pressure—is standard Medicare-rebatable testing. This makes it one of the most accessible preventive health tests available.

Based on KDIGO 2024 guidelines: If you have risk factors (diabetes, hypertension, cardiovascular disease, age 60+), annual testing is recommended as a minimum. If you have Stage 3a CKD (eGFR 45-59), testing every 3-6 months is appropriate. Stage 3b-4 requires more frequent monitoring under nephrology care. If you have no risk factors and normal previous results, testing every 2-3 years is reasonable. Your GP will determine the appropriate frequency based on your individual risk profile.

Unfortunately, kidney damage is largely irreversible—kidneys don't regenerate like liver tissue. However, early intervention can <strong>dramatically slow progression</strong>. With optimal blood pressure control, diabetes management, dietary modifications, and medications like SGLT2 inhibitors or ACE inhibitors, progression can be slowed by up to 50%. This can mean decades of additional kidney function. The key is catching decline early, in Stage 1-3, when these interventions are most effective. Once you reach Stage 4-5, options are limited to slowing progression or preparing for dialysis/transplant.

Your GP will first confirm the result with repeat testing (eGFR must be reduced for 3+ months to diagnose CKD) and check for reversible causes like dehydration or medication effects. If confirmed, management depends on the stage: Stage 3a involves medication review, blood pressure optimisation, and more frequent monitoring. Stage 3b-4 typically requires nephrology referral for specialist management, dietary modifications, and monitoring for complications like anaemia. Stage 5 requires planning for dialysis or transplant. Throughout, the focus is on slowing progression and managing cardiovascular risk, which increases substantially with CKD.

Absolutely. Family history of kidney disease—particularly polycystic kidney disease or kidney failure in first-degree relatives—significantly increases your risk. KDIGO 2024 guidelines specifically recommend regular screening for individuals with family history, starting from age 18 for polycystic kidney disease or earlier if indicated. Early detection allows for proactive management and lifestyle modifications that can slow progression. Given that the test is simple, Medicare-covered, and potentially life-altering in its benefits, there's no reason not to get tested if kidney disease runs in your family.

Disclaimer:This information is educational only and not medical advice. Results should be interpreted by your health practitioner in the context of your symptoms and health history. Treatment decisions should be made with your doctor or specialist.