Doença Renal Crônica na Atenção Primária à Saúde: Rastreamento, Diagnóstico Precoce e Desafios para o Cuidado no SUS

Abstract

Objective: to analyze evidence on risk-based screening, early detection of kidney abnormalities and organization of chronic kidney disease (CKD) care in Primary Health Care (PHC), with emphasis on risk groups and the Brazilian Unified Health System (SUS). Method: integrative literature review guided by the Whittemore and Knafl method, with the study selection process reported using an adaptation of PRISMA 2020. Searches were conducted in MEDLINE/PubMed, LILACS, BVS, SciELO and BDENF for publications from January 2016 to 13 August 2026. The guiding question was organized using the PICo strategy. A total of 422 records were identified, 96 duplicates were removed, 326 titles and abstracts were screened, 69 full texts were assessed, and 15 studies were included. Results: evidence was concentrated among people with hypertension, diabetes and other risk factors and was heterogeneous regarding CKD definitions, confirmation of chronicity, eGFR equations and albuminuria measurement. Some studies identified kidney abnormalities at a single assessment, which is not equivalent to confirmed CKD. Gaps remain in the combined use of eGFR and albuminuria, repeat testing after abnormal results, professional knowledge, process indicators and coordination with nephrology. Conclusion: the findings support risk-based screening and continuity of care, but do not support universal population screening or causal claims that screening reduces kidney replacement therapy.