Chronic Kidney Disease Staging

CHRONIC KIDNEY DISEASE STAGING

Introduction

Chronic kidney disease occur whenever the glomerular filtration rate (GFR) is less than 60 mL/min/1.73 m2 for about 3 months, with or without kidney damage, for examples : pathologic abnormalities or markers of damage including (proteinuria or kidney stones).

Classification - Staging

There are five stages of chronic kidney disease based on the GFR (Cockcroft-Gault Formula) :

* Stage 1: Normal or increased GFR (>= 90 mL/min/1.73m2) with evidence of kidney damage.

The emphasis is on diagnosis, treatment and prevention of disease progression.

* Stage 2: Mildly decreased GFR (60-89 mL/min/1.73m2) with evidence of kidney damage.

There is still interest in diagnosis and treatment of the underlying cause but the emphasis is shifting towards prevention of disease progression.

* Stage 3: Moderately decreased GFR (30-59 mL/min/1.73m2).

The emphasis is still on preventing disease progression but the evaluation and treatment of complications are becoming more of an issue.

* Stage 4: Severely decreased GFR (15-29 mL/min/1.73m2).

The emphasis is generally on treating complications and preparing for dialysis or kidney transplantation.

* Stage 5: Very little GFR left (<15 ml/min/1.73m2).

Treating complications becomes increasingly difficult and dialysis is usually started at this point.

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