Thirty million American adults are estimated by the Centers for Disease Control to be living with chronic kidney disease (CKD) today, with over 80% unaware of the condition that puts them at increased risk for cardiovascular events and progression to kidney failure and death. Almost 90% of adults with type-2 diabetes and CKD are not currently diagnosed, and as many as 50% of patients with advanced CKD (Stage G4) remain undiagnosed in primary care populations. Several national surveys have shown only 10 to 20% of Americans who have laboratory evidence of CKD are aware that they have the condition. While current clinical practice guidelines for CKD assessment recommend that adults with diabetes and/or hypertension be tested annually for albuminuria, there is underutilization of yearly urinary albumin-creatinine ratio testing in people at risk for CKD. Less than 10% of those with hypertension and less than 40% of those with diabetes are appropriately assessed.