Module 1: Understanding Chronic Kidney Disease (ckd)

Monitor the eGFR trends

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• Stable eGFR levels may mean non-progressive disease or current therapy is working.
• A rapid decline in eGFR may indicate rapid progression of kidney disease.

Activity

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• Use NKDEP’s CKD-EPI calculator to determine eGFR for various levels of creatinine, different genders and races.
• eGFR < 60 = CKD
• eGFR < 15 = kidney failure
• GFR Calculator can be found at: nkdep.nih.gov/gfr-calculator

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Age, Race, Gender of Patient	Serum Creatinine	eGFR
35-year-old African American male	1.2	blank
35-year-old White female	1.2	blank
80-year-old Asian American female	1.2	blank
58-year-old White male	2.4	blank
58-year-old African American female	2.4	blank
80-year-old Hispanic female	2.4	blank

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Age, Race, Gender of Patient	Serum Creatinine	eGFR
35-year-old African American male	1.2	≥ 60
35-year-old White female	1.2	80
80-year-old Asian American female	1.2	43
58-year-old White male	2.4	29
58-year-old African American female	2.4	25
80-year-old Hispanic female	2.4	18

How to explain eGFR results to patients

• Normal: ≥ 60 mL/min/1.73 m2
• Kidney disease: 15–80 mL/min/1.73 m2
• Kidney failure: < 15 mL/min/1.73 m2

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CKD is reduced kidney function and/or KIDNEY DAMAGE

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• Chronic Kidney Disease
• Kidney function
• Glomerular filtration rate (GFR) < 60 mL/min/1.73 m2 for > 3 months with or without kidney damage
• AND/OR
• Kidney damage
• > 3 months, with or without decreased GFR, manifested by either
• Pathological abnormalities
• Markers of kidney damage, i.e., albuminuria
• Urine albumin-to-creatinine ratio (UACR) > 30 mg/g

• Reference: Kidney International Supplements, 2013; 3(1): 5-14

Urine albumin is a marker for kidney damage

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• Urine albumin measures albumin in the urine.
• An abnormal urine albumin level is a marker for glomerular disease, including diabetes.
• Urine albumin is a marker for cardiovascular disease and is a hypothesized marker of generalized endothelial dysfunction.
• May be associated with increased mortality.