Applying clinical guidelines –
diagnosing and identifying
stages of CKD
✓ The presence of chronic kidney disease (CKD) is confirmed when clinical marker(s) are present ≥ 3 months.
- Albuminuria: > 30 mg of urinary albumin per gram of urinary creatinine (UACR) and/or
- eGFR: < 60 ml per minute per 1.73m2.
✓ Further evaluation is needed to determine the underlying cause to:
- Identify acute, reversible, and/or treatable conditions,
- Provide baseline data for both the primary care provider (PCP) and nephrologist, when consultation is needed, and
- Include in the patient treatment plan.
|Initial evaluation may include:||Further workup may include:|
✓ Classify and stage patient based on eGFR and UACR values at 3 months and clinical diagnosis; for example, stage 2 CKD with moderate albuminuria, secondary to hypertension.
Source: Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney inter., Suppl. 2013; 3: 1-150.
✓ Develop patient treatment plan according to level of severity/risk. Key components to prevent and slow disease progression:
- Control blood pressure with angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB).
- Decrease albuminuria.
- Manage diabetes.
- Avoid acute kidney injury (AKI).