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FAA CACI Chronic Kidney Disease Worksheet

Pilots with chronic kidney disease can be certified at the AME's office under the FAA's CACI program when the disease is stable and lab values stay within set limits. This worksheet, updated 04/27/2022, requires an eGFR of 35 or higher within six months, minimal albuminuria, hemoglobin of at least 10 gm/dL and two functioning kidneys, with no dialysis or transplant anticipated.

Who completes it

The AME completes the worksheet from a current, detailed Clinical Progress Note written after a clinic visit with the treating physician or specialist, such as a nephrologist, no more than 90 days before the AME exam.

Submitting and payment

How to submit it
If all criteria are met, the AME issues, notes 'CACI qualified Chronic Kidney Disease' in Block 60 and keeps the documents on file without sending them to the FAA; otherwise the AME defers and submits them.
Who pays
The FAA does not set AME examination fees; the pilot pays the examiner, and the FAA recommends the usual and customary local fee for similar services.

Good to know

  • Albumin on urine dipstick must be trace or negative, or the albumin creatinine ratio must be 29 or less.
  • Hemoglobin must be at least 10 gm/dL and hematocrit at least 30%, and the eGFR must be the most recent value, from within the last six months.
  • Underlying conditions such as diabetes, hypertension, glomerulonephritis, polycystic kidney disease or chronic obstruction must be well controlled, with no new complications affecting renal function.
  • The only treatment the worksheet lists is allowed hypertension medication, and the pilot must be asymptomatic and stable.

Get the official form

Download the current version from the source each time; forms change without notice.

CACI – Chronic Kidney Disease (CKD) Worksheet

Official pagePDF

Fill it with Vero

If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.

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A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

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Frequently asked questions

What eGFR does a pilot need for the FAA CKD CACI?

An eGFR of 35 or higher, using the most recent value, which must be from the last six months. The treating physician's note must also confirm the pilot is asymptomatic and stable, has two functioning kidneys and is not expected to need dialysis or a transplant.

Can a pilot with one kidney use the FAA CKD CACI?

No. The worksheet requires two functioning kidneys, so a pilot with a single functioning kidney does not meet the CACI criteria. In that case, or if any other item is not met, the AME defers and submits the supporting documents to the FAA.