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Chronic kidney disease

What the FAA's documents say about chronic kidney disease, in plain words, with the FAA's own words one press away.

FAA term: Chronic Kidney Disease (CKD)

FAA source: CACI – Chronic Kidney Disease Worksheet. FAA date 27 April 2022. Checked by Crosscheck 14 October 2026

Short version

The FAA's table sorts it into four rows.

How the FAA's table sorts Chronic kidney disease
SituationWhat the examiner doesPathway
Row AeGFR 45 to 59
Examiner issues
Examiner can issue
Row BeGFR 35 to 44
Worksheet
CACI
Row CeGFR 34 or less, and the other cases the row lists
Defers to the FAA
Special Issuance
Row DESRD requiring dialysis or kidney transplant
Defers to the FAA
FAA review
Show the FAA's words: the FAA's table for Chronic kidney disease
  1. Row A · Examiner can issue

    eGFR 45 to 59, with no symptoms or complications, and the underlying cause is not disqualifying. The table says ISSUE, and has the examiner summarize this history in Block 60.

    A . eGFR 45 to 59 … No symptoms or complications and the underlying cause is not disqualifying. … ISSUE … Summarize this history in Block 60.

    FAA source: Chronic Kidney Disease. FAA date 30 March 2023. Checked by Crosscheck 14 October 2026

  2. Row B · CACI

    eGFR 35 to 44. The table's line for this row says a single kidney does not go to the CACI. The table sends the examiner to the CACI worksheet for chronic kidney disease, and has the examiner annotate Block 60.

    B . eGFR 35 to 44 … See CACI worksheet. Single kidney – DO NOT CACI … Follow the CACI – Chronic Kidney Disease Worksheet … Annotate Block 60.

    FAA source: Chronic Kidney Disease. FAA date 30 March 2023. Checked by Crosscheck 14 October 2026

  3. Row C · Special Issuance

    eGFR 34 or less. Or symptoms or complications with any eGFR. Proteinuria 2+ or higher, or an ACR of 300 or higher. Or a single kidney with eGFR 44 or less. The examiner submits the listed items for FAA review, defers, and submits the information to the FAA for a possible Special Issuance.

    C . eGFR 34 or less … OR … Symptoms or complications with any eGFR … Proteinuria 2+ or higher or ACR is 300 or higher … OR … Single kidney with eGFR 44 or less … Submit the following to the FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance.

    FAA source: Chronic Kidney Disease. FAA date 30 March 2023. Checked by Crosscheck 14 October 2026

  4. Row D · FAA review

    ESRD requiring dialysis or kidney transplant. The table refers to the table above it on the same page for more information, and says DEFER. For renal dialysis, that table's evaluation data is a current status report and all pertinent medical reports, to include etiology, clinical manifestation, BUN, Ca, PO4, creatinine, electrolytes, and treatment plan, and it says renal dialysis requires an FAA decision. For a renal transplant it refers to the Renal Transplant Protocol and says it requires an FAA decision.

    ESRD requiring dialysis or kidney transplant … See the table above for more information. … DEFER

    FAA source: Chronic Kidney Disease. FAA date 30 March 2023. Checked by Crosscheck 14 October 2026

    Renal Dialysis … All … Submit a current status report, all pertinent medical reports to include etiology, clinical manifestation, BUN, Ca, PO 4 ,Creatinine, electrolytes, and treatment plan … Requires FAA Decision … Renal Transplant … All … See Renal Transplant Protocol … Requires FAA Decision

    FAA source: Chronic Kidney Disease. FAA date 30 March 2023. Checked by Crosscheck 14 October 2026

  5. A note on the table, 1

    The table notes that eGFR is a calculated or estimated value, and that if additional testing shows the actual renal function is higher than the eGFR, this should be stated in the note from the treating physician.

    Notes: eGFR is a calculated/estimated value. If additional testing shows the actual renal function is higher than the eGFR, this should be stated in the note from the treating physician.

    FAA source: Chronic Kidney Disease. FAA date 30 March 2023. Checked by Crosscheck 14 October 2026

  6. A note on the table, 2

    The table says ACR means albumin creatinine ratio.

    ACR = albumin creatinine ratio

    FAA source: Chronic Kidney Disease. FAA date 30 March 2023. Checked by Crosscheck 14 October 2026

What the pathway names mean

The FAA pathways for chronic kidney disease

Which exam

Which one describes yours?

The FAA's table sorts it these ways. Choose yours to see its plan.

Your step-by-step plan

  1. Step 1: The progress note from the treating doctor or specialist

    The note the examiner reviews, and what it verifies.Within 90 days before the exam

    A current, detailed progress note from a clinic visit with your treating physician or specialist, no more than 90 days before the exam. Your AME reviews it.

    It verifies

    • No symptoms, and stable
    • No new conditions or complications that would affect kidney function
    • 2 functioning kidneys
    • Any underlying conditions, such as diabetes, HTN, glomerulonephritis, PKD or chronic obstruction, well controlled
    • Dialysis or transplant not recommended or anticipated at this time
    Show the FAA's words: The progress note from the treating doctor or specialist

    the AME must review a current, detailed Clinical Progress Note generated from a clinic visit with the treating physician or specialist no more than 90 days prior to the AME exam.

    FAA source: CACI – Chronic Kidney Disease Worksheet. FAA date 27 April 2022; checked by Crosscheck 14 October 2026.

    The treating physician’s current, detailed Clinical Progress Note verifies:

    Is asymptomatic and stable;

    FAA source: CACI – Chronic Kidney Disease Worksheet. FAA date 27 April 2022; checked by Crosscheck 14 October 2026.

    The treating physician’s current, detailed Clinical Progress Note verifies:

    Has not developed any new conditions or complications that would affect renal function;

    FAA source: CACI – Chronic Kidney Disease Worksheet. FAA date 27 April 2022; checked by Crosscheck 14 October 2026.

    The treating physician’s current, detailed Clinical Progress Note verifies:

    Has 2 functioning kidneys;

    FAA source: CACI – Chronic Kidney Disease Worksheet. FAA date 27 April 2022; checked by Crosscheck 14 October 2026.

    The treating physician’s current, detailed Clinical Progress Note verifies:

    Any underlying conditions (such as diabetes, HTN, glomerulonephritis, PKD, or chronic obstruction) are well controlled; and

    FAA source: CACI – Chronic Kidney Disease Worksheet. FAA date 27 April 2022; checked by Crosscheck 14 October 2026.

    The treating physician’s current, detailed Clinical Progress Note verifies:

    Dialysis or transplant is not recommended or anticipated at this time.

    FAA source: CACI – Chronic Kidney Disease Worksheet. FAA date 27 April 2022; checked by Crosscheck 14 October 2026.

  2. Step 2: Your lab results

    The kidney and blood figures the worksheet sets.Three things to bring
    • eGFR

      Your most recent eGFR, 35 or higher, from within the last 6 months.

    • Urine albumin

      Albumin on a urine dipstick that is trace or negative, or an albumin creatinine ratio (ACR) of 29 or less.

    • Hemoglobin and hematocrit

      Hemoglobin of at least 10 gm/dL and hematocrit of at least 30%.

    Show the FAA's words: Your lab results

    eGFR is 35 or higher

    (Most recent value, must be within the last six (6) months.)

    FAA source: CACI – Chronic Kidney Disease Worksheet. FAA date 27 April 2022; checked by Crosscheck 14 October 2026.

    Albumin on urine dipstick is trace or negative OR albumin creatinine ratio (ACR) is 29 or less

    FAA source: CACI – Chronic Kidney Disease Worksheet. FAA date 27 April 2022; checked by Crosscheck 14 October 2026.

    Hemoglobin is at least 10 gm/dL AND hematocrit is at least 30%

    FAA source: CACI – Chronic Kidney Disease Worksheet. FAA date 27 April 2022; checked by Crosscheck 14 October 2026.

  3. Step 3: Your current treatment

    The treatment the worksheet allows.

    The worksheet's box under current treatment reads Allowed HTN medication.

    Show the FAA's words: Your current treatment

    Current treatment [ ] Allowed HTN medication

    FAA source: CACI – Chronic Kidney Disease Worksheet. FAA date 27 April 2022; checked by Crosscheck 14 October 2026.

What the examiner checks

It depends on which row of the FAA's table describes the case.

  • Row AExaminer issuesExaminer can issue

    The table says ISSUE, and has the examiner summarize this history in Block 60.

  • Row BWorksheetCACI

    The table sends the examiner to the CACI worksheet for chronic kidney disease, and has the examiner annotate Block 60.

  • Row CDefers to the FAASpecial Issuance

    The examiner submits the listed items for FAA review, defers, and submits the information to the FAA for a possible Special Issuance.

    If the examiner defers
  • Row DDefers to the FAAFAA review

    The table refers to the table above it on the same page for more information, and says DEFER. For renal dialysis, that table's evaluation data is a current status report and all pertinent medical reports, to include etiology, clinical manifestation, BUN, Ca, PO4, creatinine, electrolytes, and treatment plan, and it says renal dialysis requires an FAA decision. For a renal transplant it refers to the Renal Transplant Protocol and says it requires an FAA decision.

    If the examiner defers
Show the FAA's words: what the examiner does on each row
  1. Row A · Examiner can issue

    eGFR 45 to 59, with no symptoms or complications, and the underlying cause is not disqualifying. The table says ISSUE, and has the examiner summarize this history in Block 60.

    A . eGFR 45 to 59 … No symptoms or complications and the underlying cause is not disqualifying. … ISSUE … Summarize this history in Block 60.

    FAA source: Chronic Kidney Disease. FAA date 30 March 2023. Checked by Crosscheck 14 October 2026

  2. Row B · CACI

    eGFR 35 to 44. The table's line for this row says a single kidney does not go to the CACI. The table sends the examiner to the CACI worksheet for chronic kidney disease, and has the examiner annotate Block 60.

    B . eGFR 35 to 44 … See CACI worksheet. Single kidney – DO NOT CACI … Follow the CACI – Chronic Kidney Disease Worksheet … Annotate Block 60.

    FAA source: Chronic Kidney Disease. FAA date 30 March 2023. Checked by Crosscheck 14 October 2026

  3. Row C · Special Issuance

    eGFR 34 or less. Or symptoms or complications with any eGFR. Proteinuria 2+ or higher, or an ACR of 300 or higher. Or a single kidney with eGFR 44 or less. The examiner submits the listed items for FAA review, defers, and submits the information to the FAA for a possible Special Issuance.

    C . eGFR 34 or less … OR … Symptoms or complications with any eGFR … Proteinuria 2+ or higher or ACR is 300 or higher … OR … Single kidney with eGFR 44 or less … Submit the following to the FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance.

    FAA source: Chronic Kidney Disease. FAA date 30 March 2023. Checked by Crosscheck 14 October 2026

  4. Row D · FAA review

    ESRD requiring dialysis or kidney transplant. The table refers to the table above it on the same page for more information, and says DEFER. For renal dialysis, that table's evaluation data is a current status report and all pertinent medical reports, to include etiology, clinical manifestation, BUN, Ca, PO4, creatinine, electrolytes, and treatment plan, and it says renal dialysis requires an FAA decision. For a renal transplant it refers to the Renal Transplant Protocol and says it requires an FAA decision.

    ESRD requiring dialysis or kidney transplant … See the table above for more information. … DEFER

    FAA source: Chronic Kidney Disease. FAA date 30 March 2023. Checked by Crosscheck 14 October 2026

    Renal Dialysis … All … Submit a current status report, all pertinent medical reports to include etiology, clinical manifestation, BUN, Ca, PO 4 ,Creatinine, electrolytes, and treatment plan … Requires FAA Decision … Renal Transplant … All … See Renal Transplant Protocol … Requires FAA Decision

    FAA source: Chronic Kidney Disease. FAA date 30 March 2023. Checked by Crosscheck 14 October 2026

The CACI worksheet's criteria

Row B: eGFR 35 to 44

Progress note

  • No symptoms, and stable
  • No new conditions or complications that would affect kidney function
  • 2 functioning kidneys
  • Any underlying conditions, such as diabetes, HTN, glomerulonephritis, PKD or chronic obstruction, well controlled
  • Dialysis or transplant not recommended or anticipated at this time
Show the FAA's words: the CACI worksheet's criteria for Chronic kidney disease
  1. No symptoms, and stable

    FAA criterion: the progress note verifies the pilot is asymptomatic and stable.

    The treating physician’s current, detailed Clinical Progress Note verifies: … Is asymptomatic and stable;

    FAA source: CACI – Chronic Kidney Disease Worksheet. FAA date 27 April 2022. Checked by Crosscheck 14 October 2026

  2. No new conditions or complications that would affect renal function

    FAA criterion: the progress note verifies the pilot has not developed any new conditions or complications that would affect renal function.

    The treating physician’s current, detailed Clinical Progress Note verifies: … Has not developed any new conditions or complications that would affect renal function;

    FAA source: CACI – Chronic Kidney Disease Worksheet. FAA date 27 April 2022. Checked by Crosscheck 14 October 2026

  3. Two functioning kidneys

    FAA criterion: the progress note verifies the pilot has 2 functioning kidneys.

    The treating physician’s current, detailed Clinical Progress Note verifies: … Has 2 functioning kidneys;

    FAA source: CACI – Chronic Kidney Disease Worksheet. FAA date 27 April 2022. Checked by Crosscheck 14 October 2026

  4. Any underlying conditions well controlled

    FAA criterion: the progress note verifies that any underlying conditions are well controlled. The worksheet's examples are diabetes, HTN, glomerulonephritis, PKD and chronic obstruction.

    The treating physician’s current, detailed Clinical Progress Note verifies: … Any underlying conditions (such as diabetes, HTN, glomerulonephritis, PKD, or chronic obstruction) are well controlled; and

    FAA source: CACI – Chronic Kidney Disease Worksheet. FAA date 27 April 2022. Checked by Crosscheck 14 October 2026

  5. Dialysis or transplant not recommended or anticipated

    FAA criterion: the progress note verifies that dialysis or transplant is not recommended or anticipated at this time.

    The treating physician’s current, detailed Clinical Progress Note verifies: … Dialysis or transplant is not recommended or anticipated at this time.

    FAA source: CACI – Chronic Kidney Disease Worksheet. FAA date 27 April 2022. Checked by Crosscheck 14 October 2026

If the examiner defersSpecial Issuance

The table's row C lists eGFR 34 or less; symptoms or complications with any eGFR; proteinuria 2+ or higher or an ACR of 300 or higher; and a single kidney with eGFR 44 or less. The table marks it DEFER.

The table marks ESRD requiring dialysis or kidney transplant DEFER, and refers to the table above it for more information.

What the FAA lists to send

  1. Item 1. For row C, a current status report from the treating physician. The table says it should note if the condition is stable or if additional treatment or dialysis is recommended.
  2. Item 2. For row C, a list of medications and side effects, if any.
  3. Item 3. For row C, recent lab, within the last 90 days: renal function studies (creatinine, BUN and eGFR); albumin as a dipstick or ACR; and hemoglobin and hematocrit.
  4. Item 4. For row C, imaging reports, if performed by the treating physician.
  5. Item 5. For row C, an assessment by the treating physician of whether a cardiac evaluation is warranted.
Show the FAA's words: if the examiner defers

When the examiner defers

  1. Reason 1

    The table's row C lists eGFR 34 or less; symptoms or complications with any eGFR; proteinuria 2+ or higher or an ACR of 300 or higher; and a single kidney with eGFR 44 or less. The table marks it DEFER.

    C . eGFR 34 or less … OR … Symptoms or complications with any eGFR … Proteinuria 2+ or higher or ACR is 300 or higher … OR … Single kidney with eGFR 44 or less … DEFER Submit the information to the FAA for a possible Special Issuance.

    FAA source: Chronic Kidney Disease. FAA date 30 March 2023. Checked by Crosscheck 14 October 2026

  2. Reason 2

    The table marks ESRD requiring dialysis or kidney transplant DEFER, and refers to the table above it for more information.

    ESRD requiring dialysis or kidney transplant … See the table above for more information. … DEFER

    FAA source: Chronic Kidney Disease. FAA date 30 March 2023. Checked by Crosscheck 14 October 2026

What the FAA lists to send

  1. Item 1

    For row C, a current status report from the treating physician. The table says it should note if the condition is stable or if additional treatment or dialysis is recommended.

    Current status report from the treating physician. It should note if the condition is stable or if additional treatment or dialysis is recommended;

    FAA source: Chronic Kidney Disease. FAA date 30 March 2023. Checked by Crosscheck 14 October 2026

  2. Item 2

    For row C, a list of medications and side effects, if any.

    List of medications and side effects, if any;

    FAA source: Chronic Kidney Disease. FAA date 30 March 2023. Checked by Crosscheck 14 October 2026

  3. Item 3

    For row C, recent lab, within the last 90 days: renal function studies (creatinine, BUN and eGFR); albumin as a dipstick or ACR; and hemoglobin and hematocrit.

    Recent lab (within last 90 days): … Renal function studies(creatinine BUN and eGFR); … Albumin as dipstick or ACR; and … Hemoglobin and hematocrit

    FAA source: Chronic Kidney Disease. FAA date 30 March 2023. Checked by Crosscheck 14 October 2026

  4. Item 4

    For row C, imaging reports, if performed by the treating physician.

    Imaging reports (if performed by treating physician); and

    FAA source: Chronic Kidney Disease. FAA date 30 March 2023. Checked by Crosscheck 14 October 2026

  5. Item 5

    For row C, an assessment by the treating physician of whether a cardiac evaluation is warranted.

    Assessment by treating physician if a cardiac evaluation is warranted

    FAA source: Chronic Kidney Disease. FAA date 30 March 2023. Checked by Crosscheck 14 October 2026

After the FAA decides

AASI

The AASI sheet for chronic kidney disease says an FAA physician makes the first decision and grants the Authorization. After that, the sheet says the examiner may reissue under the Authorization when the pilot provides what it lists. Under a Special Issuance, the table says follow-up will be per the pilot's own Authorization Letter.

Show the FAA's words: after the FAA decides
An FAA physician provides the initial certification decision and grants the Authorization in accordance with 14 CFR 67.401 . … Examiners may re-issue an airman medical certificate under the provisions of an Authorization, if the applicant provides the following:

FAA source: AASI – Chronic Kidney Disease. FAA date 9 March 2023. Checked by Crosscheck 14 October 2026

Followup Special Issuance – Will be per the airman's Authorization Letter

FAA source: Chronic Kidney Disease. FAA date 30 March 2023. Checked by Crosscheck 14 October 2026

What a Special Issuance is

The Guide says an Authorization for Special Issuance, valid for a specified period, may be granted at the Federal Air Surgeon's discretion to a person who does not meet the established medical standards, if the person shows to the satisfaction of the Federal Air Surgeon that the duties authorized by the class of certificate applied for can be performed without endangering public safety during the period the Authorization would be in force.

How the FAA pathways work

At later examsAASI

First and second class
Every year
Third class
At each required exam

The worksheet says first- and second-class applicants must provide this information every year, and third-class applicants must provide it with each required exam.

Show the FAA's words: how often the FAA asks again
Applicants for first- or second-class must provide this information annually; applicants for third-class must provide the information with each required exam.

FAA source: CACI – Chronic Kidney Disease Worksheet. FAA date 27 April 2022. Checked by Crosscheck 14 October 2026

Under an FAA Authorization, the AASI sheet lists what the pilot provides for the examiner to reissue. That is the Authorization itself; a current status report from the treating physician detailing how long the condition has been stable and asymptomatic, any significant change in eGFR or renal function, and any interval development of other complications or abnormal physical exam findings; the most recent lab results including eGFR, creatinine, hemoglobin, hematocrit and urine albumin or ACR; the name and dosage of the medications and the presence or absence of any side effects; and a statement from the treating physician if there is any evidence of cardiovascular disease.

Show the FAA's words: at later exams
Examiners may re-issue an airman medical certificate under the provisions of an Authorization, if the applicant provides the following: … An Authorization granted by the FAA; … A current status report from the treating physician detailing: … How long the condition has been stable and asymptomatic; … If there has been any significant change in eGFR or renal function; … Any interval development of other complications or abnormal physical exam findings (such as diabetes, uncontrolled HTN, or clinically significant proteinuria); … Most recent lab results including eGFR, creatinine, hemoglobin, hematocrit and urine albumin or ACR; … The name and dosage of medication(s) and presence or absence of any side effects; and … Statement from the treating physician if there is any evidence of cardiovascular disease.

FAA source: AASI – Chronic Kidney Disease. FAA date 9 March 2023. Checked by Crosscheck 14 October 2026

What AASI is

AASI stands for AME Assisted Special Issuance. The Guide describes it as a process that lets the examiner reissue a certificate under the provisions of an Authorization for Special Issuance, to an applicant who has a medical condition that is disqualifying under 14 CFR part 67.

How the FAA pathways work
  • The Authorization granted by the FAA

    The AASI sheet's list for a reissue begins with the Authorization the FAA granted.

    Show the FAA's words: The Authorization granted by the FAA
    Examiners may re-issue an airman medical certificate under the provisions of an Authorization, if the applicant provides the following: … An Authorization granted by the FAA;

    FAA source: AASI – Chronic Kidney Disease. FAA date 9 March 2023. Checked by Crosscheck 14 October 2026

  • A current status report from the treating physician

    The AASI sheet asks for a current status report from the treating physician detailing how long the condition has been stable and asymptomatic; if there has been any significant change in eGFR or renal function; and any interval development of other complications or abnormal physical exam findings (such as diabetes, uncontrolled HTN, or clinically significant proteinuria).

    Show the FAA's words: A current status report from the treating physician
    A current status report from the treating physician detailing: … How long the condition has been stable and asymptomatic; … If there has been any significant change in eGFR or renal function; … Any interval development of other complications or abnormal physical exam findings (such as diabetes, uncontrolled HTN, or clinically significant proteinuria);

    FAA source: AASI – Chronic Kidney Disease. FAA date 9 March 2023. Checked by Crosscheck 14 October 2026

  • The most recent lab results

    The AASI sheet's list goes on with the most recent lab results, including eGFR, creatinine, hemoglobin, hematocrit and urine albumin or ACR.

    Show the FAA's words: The most recent lab results
    Most recent lab results including eGFR, creatinine, hemoglobin, hematocrit and urine albumin or ACR;

    FAA source: AASI – Chronic Kidney Disease. FAA date 9 March 2023. Checked by Crosscheck 14 October 2026

  • The name and dosage of medications, and any side effects

    The AASI sheet's list goes on with the name and dosage of the medications and the presence or absence of any side effects.

    Show the FAA's words: The name and dosage of medications, and any side effects
    The name and dosage of medication(s) and presence or absence of any side effects; and

    FAA source: AASI – Chronic Kidney Disease. FAA date 9 March 2023. Checked by Crosscheck 14 October 2026

  • A statement on any evidence of cardiovascular disease

    The AASI sheet's list ends with a statement from the treating physician if there is any evidence of cardiovascular disease.

    Show the FAA's words: A statement on any evidence of cardiovascular disease
    Statement from the treating physician if there is any evidence of cardiovascular disease.

    FAA source: AASI – Chronic Kidney Disease. FAA date 9 March 2023. Checked by Crosscheck 14 October 2026

  • What the Authorization letter comes with

    The AASI sheet says the Authorization letter comes with attachments that specify the information the treating physicians must provide for the reissue determination.

    Show the FAA's words: What the Authorization letter comes with
    The Authorization letter is accompanied by attachments that specify the information that treating physician(s) must provide for the re-issuance determination.

    FAA source: AASI – Chronic Kidney Disease. FAA date 9 March 2023. Checked by Crosscheck 14 October 2026

  • When the examiner defers a reissue

    The AASI sheet says the examiner must defer to the AMCD or Region if the condition is no longer stable (per the treating physician note); dialysis has been started or transplant has occurred; the pilot is taking a medication that is not acceptable (the sheet points to Pharmaceuticals - Antihypertensive) or has aeromedically significant side effects from the medication; anemia with hemoglobin less than 10 gm/dL or hematocrit less than 30% is present; or the eGFR is 29 or less. For an eGFR of 29 or less, the sheet says the pilot will need to submit additional testing to show stability, such as inulin clearance testing, creatinine clearance testing, or a 24-hour urine creatinine result, and the nephrologist's clinical interpretation of results, prognosis, and plan for follow up.

    Show the FAA's words: When the examiner defers a reissue
    The Examiner must defer to the AMCD or Region if: … The condition is no longer stable (per the treating physician note); … Dialysis has been started or transplant has occurred; … The airman is taking a medication that is not acceptable (See Pharmaceuticals - Antihypertensive ) or has aeromedically significant side effects from the medication; … Anemia with hemoglobin less than 10 gm/dL or hematocrit less than 30% is present; or … The eGFR is 29 or less; (if this occurs, the airman will need to submit additional testing to show stability [such as inulin clearance testing, creatinine clearance testing, or a 24-hour urine creatinine result] and the nephrologist's clinical interpretation of results, prognosis, and plan for follow up).

    FAA source: AASI – Chronic Kidney Disease. FAA date 9 March 2023. Checked by Crosscheck 14 October 2026

Good to know

Points from the FAA's own documents that are easy to miss.

  • What a progress note must include

    In most cases it should come from a visit with the treating physician no more than 90 days ago, and cover the history, medications with dosages and side effects, exam findings, test results, diagnosis, assessment and plan, prognosis and follow-up. The FAA's sheet says to make sure the physician adds the prognosis. A portal note or an After Visit Summary that does not meet these criteria is not enough, and neither is a simple "ok to fly" letter. The FAA's documents also call it a status report.

    Show the FAA's words: good to know, 1
    your patient portal to print out “notes” or an “After Visit Summary (AVS).” … Patient Portal notes or an AVS that do not meet the criteria listed below for a detailed Clinical Progress Note are NOT sufficient for FAA purposes. … To be “current,” in MOST CASES, the detailed Clinical Progress Note should be from an evaluation in which you saw your treating physician no more than 90 days ago. … It Must include the following items: … A summary of the history of the condition, … Current medications, dosages, and side effects (if any); … Clinical exam findings; … Results of any testing performed; … Diagnosis; … Assessment and Plan; … Prognosis (This item may not be on a standard progress note, make sure your physician adds this information.); and … Follow-up … Please note: A letter stating, “Mr. Smith is ok to fly” (or any other simple note), is NOT a current, detailed Clinical Progress Note and is NOT acceptable. … You may also see this called a “current status report” or “status report” in current FAA Guidance. Any reference to a “status report” equals the criteria listed on this sheet.

    FAA source: Pilot Information – What a Detailed Clinical Progress Note must contain. FAA date 25 September 2024. Checked by Crosscheck 14 October 2026

  • No CACI for a single kidney

    The table's line for eGFR 35 to 44 says a single kidney does not go to the CACI. Its row C, a single kidney with eGFR 44 or less, is marked DEFER. The worksheet's criteria include 2 functioning kidneys.

    Show the FAA's words: good to know, 2
    B . eGFR 35 to 44 … See CACI worksheet. Single kidney – DO NOT CACI … Single kidney with eGFR 44 or less … DEFER Submit the information to the FAA for a possible Special Issuance.

    FAA source: Chronic Kidney Disease. FAA date 30 March 2023. Checked by Crosscheck 14 October 2026

    The treating physician’s current, detailed Clinical Progress Note verifies: … Has 2 functioning kidneys;

    FAA source: CACI – Chronic Kidney Disease Worksheet. FAA date 27 April 2022. Checked by Crosscheck 14 October 2026

  • Two different albumin figures

    The worksheet's albumin criterion is trace or negative on a urine dipstick, or an ACR of 29 or less. The table's row C names proteinuria 2+ or higher, or an ACR of 300 or higher.

    Show the FAA's words: good to know, 3
    Albumin on urine dipstick is trace or negative OR albumin creatinine ratio (ACR) is 29 or less

    FAA source: CACI – Chronic Kidney Disease Worksheet. FAA date 27 April 2022. Checked by Crosscheck 14 October 2026

    Proteinuria 2+ or higher or ACR is 300 or higher

    FAA source: Chronic Kidney Disease. FAA date 30 March 2023. Checked by Crosscheck 14 October 2026

  • When kidney function is higher than the eGFR

    The table notes that eGFR is a calculated or estimated value. If more testing shows the actual kidney function (renal function) is higher, this should be stated in the treating physician's note.

    Show the FAA's words: good to know, 4
    Notes: eGFR is a calculated/estimated value. If additional testing shows the actual renal function is higher than the eGFR, this should be stated in the note from the treating physician.

    FAA source: Chronic Kidney Disease. FAA date 30 March 2023. Checked by Crosscheck 14 October 2026

  • eGFR from the last six months

    The worksheet uses the most recent eGFR value, and it must be within the last six (6) months.

    Show the FAA's words: good to know, 5
    eGFR is 35 or higher … (Most recent value, must be within the last six (6) months.)

    FAA source: CACI – Chronic Kidney Disease Worksheet. FAA date 27 April 2022. Checked by Crosscheck 14 October 2026

  • The first AASI is deferred to the FAA

    For a first-time AASI application for this condition, with all the medical information needed for a determination, the AASI sheet says the examiner must defer and submit all of it to the AMCD or RFS for the initial determination.

    Show the FAA's words: good to know, 6
    If this is a first-time application for an AASI for the above disease/condition, and the applicant has all the requisite medical information necessary for a determination, the Examiner must defer and submit all of the documentation to the AMCD or RFS for the initial determination.

    FAA source: AASI – Chronic Kidney Disease. FAA date 9 March 2023. Checked by Crosscheck 14 October 2026

  • An eGFR of 29 or less under an AASI

    The AASI sheet has the examiner defer a reissue when the eGFR is 29 or less, and says the pilot will then need to submit additional testing to show stability and the nephrologist's clinical interpretation of results, prognosis and plan for follow up.

    Show the FAA's words: good to know, 7
    The eGFR is 29 or less; (if this occurs, the airman will need to submit additional testing to show stability [such as inulin clearance testing, creatinine clearance testing, or a 24-hour urine creatinine result] and the nephrologist's clinical interpretation of results, prognosis, and plan for follow up).

    FAA source: AASI – Chronic Kidney Disease. FAA date 9 March 2023. Checked by Crosscheck 14 October 2026

FAA sources

Every FAA document this page relies on, with the FAA's own date and the date Crosscheck last read it. The documents to print open at the FAA, so they are always the FAA's current ones.

Each has its own page, with what the FAA's documents say about it.

This reports what the FAA has published. It is not medical advice, and it does not say how the FAA or an examiner will decide a case.