Early Detection of Chronic Kidney Disease in High-Risk Populations in Indonesian Primary Care: A Narrative Review
Adimas Aditya Rudiananda1*, Shafira Meidyana2
Abstract
Chronic kidney disease (CKD) prevalence in Indonesia is 0.18–0.38%, but most patients are diagnosed late due to its asymptomatic nature, increasing hemodialysis cases and BPJS health insurance spending. This study synthesizes Indonesia’s CKD burden, identifies high-risk groups and early detection tests, evaluates primary-care platforms, and proposes an implementable care pathway. This narrative review of peer-reviewed literature, international guidelines, and Indonesian policy and programme documents published between 2009 and October 2026, in English and Bahasa Indonesia. A Jakarta clinic showed a 14.8% CKD prevalence among adults with diabetes or hypertension, with nearly half at moderate-to-very-high risk. However, 90% of dialysis patients at a national referral hospital were referred late, driving BPJS spending from Rp6.5 trillion in 2019 to Rp11 trillion in 2024. Despite primary care screening platforms reaching 70 million people in 2025, current methods are flawed, relying only on urea/creatinine for adults aged ≥40, omitting albuminuria tests, and failing to link detection to treatment. Introducing point-of-care albumin-to-creatinine testing and targeted screening alongside SGLT2 inhibitors would be highly cost-effective. Indonesia must transition from one-off, creatinine-only checks to a closed-loop primary-care pathway. This system should identify high-risk individuals, test both eGFR and albuminuria, confirm chronicity, and stage patients using KDIGO criteria. Finally, it must manage treatment at the primary-care level and refer patients based on explicit clinical criteria.
Keywords
chronic kidney disease; early detection; screening; albuminuria; primary health care; puskesmas; Indonesia
Cite This Article
Rudiananda, A. A., Meidyana, S. (2026). Early Detection of Chronic Kidney Disease in High-Risk Populations in Indonesian Primary Care: A Narrative Review. International Journal of Scientific Advances (IJSCIA), Volume 7| Issue 6: Nov – Dec 2026, Pages 1069-1082. URL: https://www.ijscia.com/wp-content/uploads/2026/11/Volume7-Issue6-Nov-Dec-No.1131-1069-1082.pdf
Volume 7 | Issue 6: Nov – Dec 2026
