Renal & Urology

Chronic kidney disease

Diagnose CKD by persistent reduced GFR or a marker of kidney damage, stage it with eGFR and ACR, then reduce cardiovascular and kidney-failure risk through blood-pressure control, renoprotective treatment, monitoring and timely renal referral.

Definition

Chronic kidney disease is an abnormality of kidney structure or function present for more than 3 months with implications for health. NICE stages adults using GFR and ACR categories and recognises kidney failure as G5, eGFR below 15 ml/min/1.73 m2.

First principles

CKD requires persistence or a marker of damage

An isolated low eGFR or positive urine result is not enough to label chronic disease. Confirm persistence over at least 3 months or identify a persistent marker of kidney damage, while excluding acute kidney injury and reversible causes.

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