What condition is indicated by an eGFR of less than 45 and ACR greater than 25 for males or 35 for females?

A reduced estimated Glomerular Filtration Rate (eGFR) and elevated Albumin-to-Creatinine Ratio (ACR) indicate chronic kidney disease (CKD). In this case, an eGFR of less than 45 mL/min/1.73 m² signifies that the kidneys are not filtering waste effectively, which is a hallmark of CKD. Additionally, an ACR of greater than 25 mg/mmol in men or 35 mg/mmol in women indicates significant proteinuria, another key marker of kidney damage or dysfunction.

Together, these two measurements reflect the severity of kidney impairment and suggest that the kidneys are likely affected by chronic disease processes, which commonly include diabetes and hypertension. However, CKD specifically encompasses these findings, highlighting the progressive loss of kidney function over time.

In contrast, while type 2 diabetes mellitus is a common cause of CKD, it is not diagnosed solely by the lab values provided. Adrenal insufficiency does not correlate with these specific renal parameters, and familial hypercholesterolemia primarily affects lipid metabolism rather than renal function directly. Thus, the clinical picture outlined in the question clearly aligns with chronic kidney disease.