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New drugs have increased the potential benefits of screening but many unanswered questions remain about the best way to identify people for treatment, say Vageesh Jain and colleagues Chronic kidney disease (CKD) is a major cause of mortality and morbidity that is often diagnosed late. Data from a large medical records study found a high prevalence of undiagnosed stage 3 kidney disease (62-96%) across five high income countries.1 An estimated 11-13% of the global population have diagnosed CKD,2 and it is independently associated with increased risk of cardiovascular disease, end stage kidney disease, and all-cause mortality. CKD is increasingly common in the ageing UK population, with a prevalence of 7.4% among women and men 60-79 years of age in England and 29% in adults older than 80 years of age in 2021.3 It is responsible for 40 000-45 000 premature deaths and £1.5bn (€1.7bn; $2bn) in expenditure each year,4 with most people dying from cardiovascular disease rather than end

United kingdomKate bramhamCatriona shawCatherine croucherVageesh jainSmeeta sinhaNational institute for healthUnited kingdom national screening committeeNational instituteCare excellence