Stages of Kidney Disease

29/03/2013 22:34

All individuals with a glomerular filtration rate (GFR) <60 mL/min/1.73 m2 for 3 months are classified as having chronic kidney disease, irrespective of the presence or absence of kidney damage. The rationale for including these individuals is that reduction in kidney function to this level or lower represents loss of half or more of the adult level of normal kidney function, which may be associated with a number of complications.

All individuals with kidney damage are classified as having chronic kidney disease, irrespective of the level of GFR. The rationale for including individuals with GFR > 60 mL/min/1.73 m2 is that GFR may be sustained at normal or increased levels despite substantial kidney damage and that patients with kidney damage are at increased risk of the two major outcomes of chronic kidney disease: loss of kidney function and development of cardiovascular disease. The loss of protein in the urine is regarded as an independent marker for worsening of renal function and cardiovascular disease. Hence, British guidelines append the letter "P" to the stage of chronic kidney disease if there is significant protein loss.


 

Stage 1

Slightly diminished function; kidney damage with normal or relatively high GFR (≥90 mL/min/1.73 m2). Kidney damage is defined as pathological abnormalities or markers of damage, including abnormalities in blood or urine test or imaging studies.

Stage 2

Mild reduction in GFR (60–89 mL/min/1.73 m2) with kidney damage. Kidney damage is defined as pathological abnormalities or markers of damage, including abnormalities in blood or urine test or imaging studies.

Stage 3

Moderate reduction in GFR (30–59 mL/min/1.73 m2).[1] British guidelines distinguish between stage 3A (GFR 45–59) and stage 3B (GFR 30–44) for purposes of screening and referral.

Stage 4

Severe reduction in GFR (15–29 mL/min/1.73 m2)[1] Preparation for renal replacement therapy

Stage 5

Established kidney failure (GFR <15 mL/min/1.73 m2, permanent renal replacement therapy (RRT), or end stage renal disease (ESRD)

                                         Table 1.1 Stages of Chronic Kidney Disease

Stage

Description

GFR*
mL/min/1.73m2

1

Slight kidney damage with normal or increased filtration

More than 90

2

Mild decrease in kidney function

60-89

3

Moderate decrease in kidney function

30-59

4

Severe decrease in kidney function

15-29

5

Kidney failure

Less than 15 (or dialysis)

                    *GFR is glomerular filtration rate, a measure of the kidney's function.

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