WHAT’S NEW IN CHRONIC KIDNEY

DISEASEThomas G. Ferguson, MD

State Lead, CKD

4/30/13

HOW DO PATIENTS BECOME INCLUDED IN THE REGISTRY?

Lab with GFR ≤ 60 from any source Wait ≥ 90 days Repeat GFR GFR ≤ 60 included in the database

NEW GUIDELINESCHANGES IN THE CLASSIFICATION

SYSTEMOLD CLASSIFICATION

Stage 1 GFR ≥ 90 Stage 2 GFR 60 - 89 Stage 3 GFR 30 - 59 Stage 4 GFR 15 - 29 Stage 5 GFR < 15

NEW CLASSIFICATION

Stage 1 GFR ≥ 90 Stage 2 GFR 60 – 89 Stage 3a GFR 45 – 59 Stage 3b GFR 30 – 44 Stage 4 GFR 15 – 29 Stage 5 GFR < 15

NEW GUIDELINESCHANGES IN THE eGFR EQUATION

OLD EQUATION

MDRD EQUATION Unable to give a value for GFR > 60

NEW EQUATION

EPI EQUATION Able to give values of GFR > 60 Needed for new classification system

NEW GUIDELINESURINE PROTEIN (ALBUMIN) / CREATININE

New classification system recognizes risk with abnormal urine protein (albumin) / creatinine ratio—increased proteinuria

Appropriate actions required for abnormal ratio

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