Management of Chronic Kidney Disease Stages 1–3
Background: Chronic Kidney Disease Stages
Chronic kidney disease (CKD) is usually asymptomatic, except in its most advanced stage. Consequently, blood and/or urine tests are required to make a diagnosis. The current definitions of CKD stages, as established by KDIGO (Kidney Disease: Improving Global Outcomes) at their conference in 2004, are:
- Stage 1: Kidney damage with a glomerular filtration rate (GFR) ≥90 mL/min/1.73 m2
- Stage 2: Kidney damage with a GFR of 60–89 mL/min/1.73 m2
- Stage 3a: A GFR of 45–59 mL/min/1.73 m2
- Stage 3b: A GFR of 30–44 mL/min/1.73 m2
- Stage 4: A GFR of 15–29 mL/min/1.73 m2
- Stage 5: A GFR <15 mL/min/1.73 m2 or kidney failure treated by dialysis or transplantation
KDIGO also recommended that albuminuria strata, represented as the urinary albumin/creatinine ratio (UACR), be added within each GFR stage (UACR <30 mg/g, 30–299 mg/g, or ≥300 mg/g) and that the cause of CKD be assigned when possible.
- Fink HA, Ishani A, Taylor BC, et al. Chronic Kidney Disease Stages 1–3: Screening, Monitoring, and Treatment. Comparative Effectiveness Review No. 37 (Prepared by the Minnesota Evidence-based Practice Center under Contract No. HHSA 290-2007-10064-I). Rockville, MD: Agency for Healthcare Research and Quality; January 2012. AHRQ Publication No. 11(12)-EHC075-EF. Available at www.effectivehealthcare.ahrq.gov/ckd.cfm.
- Levy AS, de Jong PE, Coresh J, et al. The definition, classification, and prognosis of chronic kidney disease: a KDIGO Controversies Conference report. Kidney Int 2010 Jul;80(1):17-28. PMID: 21150873.
- National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 2001 Feb;29(2 Suppl 1):S1-S266. PMID: 11904577.
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