* 20 million Americans - 1 in 9 US adults - have CKD and another 20 million more are at increased risk.
* Early detection can help prevent the progression of kidney disease to kidney failure.
* Glomerular filtration rate (GFR) is the best estimate of kidney function. But because of logistics issues, not all labs are reporting GFR at this time. A free GFR calculator is available at http://www.kdoqi.org. The key is to know BOTH serum creatinine and GFR.
* Hypertension causes CKD and CKD causes hypertension.
* Persistant proteinuria means CKD.
* High risk groups include those with diabetes, hypertension and family history of kidney disease.
*African Americans, Hispanics, Pacific Islanders, Native Americans and Seniors are at increased risk.
* Three simple tests can detect CKD: blood pressure, urine and serum creatinine.
Stages of Chronic Kidney
Disease:A Clinical Action Plan
|
Stage
|
Description
|
GFR
(mL/min/1.73 m2)
|
Action*
|
|
|
At increased risk
|
≥90
(with CKD risk factors)
|
Screening,
CKD risk reduction
|
|
1
|
Kidney damage with normal or increased GFR
|
≥90
|
Diagnosis and treatment,
Treatment of comorbid conditions,
Slowing progression,
CVD risk reduction
|
|
2
|
Kidney damage with mildly decreased GFR
|
60–89
|
Estimating progression
|
|
3
|
Moderately decreased GFR
|
30–59
|
Evaluating and treating
complications
|
|
4
|
Severely decreased GFR
|
15–29
|
Preparation for kidney
replacement therapy
|
|
5
|
Kidney failure
|
<15
(or dialysis)
|
Replacement (if uremia
present)
|
Chronic
kidney disease is defined as either kidney damage or GFR <60 mL/min/1.73 m2
for >3 months. Kidney damage is defined as pathologic abnormalities
or markers of damage, including abnormalities in blood or urine tests or
imaging studies.
*
Includes actions from preceding stages.
Abbreviations: GFR, glomerular filtration rate;
CKD, chronic kidney disease; CVD, cardiovascular disease
National Kidney Foundation. K/DOQI Clinical
Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification and
Stratification. Am J Kidney Dis 39:S1-S000, 2002 (suppl 1)
