Kidney failure is a dire consequence of chronic kidney disease (CKD) progression and leads to substantial morbidity, mortality, and health care costs. Prompt referral to nephrology care is associated with improved clinical outcomes among patients with CKD.1 However, the severe shortage in the nephrology workforce precludes evaluation of all patients with CKD by a nephrologist.2 Thus, clinical guidelines recommend nephrology referral based on clinical criteria3,4 that primarily focus on advanced CKD stages.