Data will all be obtained electronically from automated extracts from the electronic health record. Our study endpoints will be measured at 18 months and are specified according to risk status. The primary endpoints among high risk patients will be 1) the presence of an office visit in nephrology within the prior 12 months, and 2) the use of ACE inhibitors or ARBs for those with hypertension or microalbuminuria. The primary endpoints among low risk patients will include 1) a urine microalbumin result within the prior 12 months, and 2) the use of ACE inhibitors or ARBs for those with hypertension or microalbuminuria. Hypertension will be assessed based on the presence of a most recent blood pressure greater than 130/80 mmHg or a current diagnosis of hypertension on the electronic problem list. A secondary endpoint for both patient groups will be achieving a blood pressure less than 130/80 mmHg. We will also assess primary care physician awareness of chronic kidney disease defined as use of appropriate problem list and encounter diagnosis codes; and rates of annual serum LDL cholesterol, hemoglobin, phosphorous, 25-OH-vitamin D, calcium, and parathyroid hormone testing; as well as rates of LDL cholesterol control (<100 mg/ dL) and anemia management (hemoglobin > 11 g/dL).