What Is Chronic Kidney Disease?

Abstract

Chronic kidney disease (CKD) is a global public health burden. The 2002 KDOQI guidelines defined and proposed the classification of CKD based on glomerular filtration rate (GFR) into 5 stages: stages 1 and 2 as covert disease requiring the presence of kidney damage (proteinuria, abnormal urinalysis, biopsy, or imaging studies) and stages 3, 4, and 5 as overt diseases (i.e., when the estimated GFR (eGFR) is <60 ml/min/1.73 m²) with eGFR of 30–59, 29–15, and <15 ml/min/1.73 m², respectively. The 2012 KDIGO guidelines refined the definition of CKD as abnormalities of kidney structure or function that are present for >3 months with implications for health of the individual and classified CKD based on cause, GFR, and albuminuria. CKD is common, affects 1 in 10 adults, and is more common in the elderly, males, and certain racial and ethnic groups. CKD is a risk multiplier of mortality and morbidity of cardiovascular and other chronic diseases. Renal replacement therapy is costly, hence the importance of detecting CKD in its early stages to slow its progression and prevent its complications. Obesity and diabetes mellitus are now the leading causes of CKD worldwide. Recommendations to detect CKD support screening only high-risk populations. Governments must assume an active role in implementing detection programs of CKD in high-risk individuals and instituting initiatives for their management.