RT Journal Article
SR Electronic
T1 Chronic kidney disease: towards a risk-based approach
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP s117
OP s120
DO 10.7861/clinmedicine.16-6-s117
VO 16
IS Suppl 6
A1 Maarten W Taal
YR 2016
UL http://www.rcpjournals.org/content/16/Suppl_6/s117.abstract
AB Chronic kidney disease (CKD) affects 8–16% of adults worldwide and is associated with multiple adverse outcomes. It includes a heterogeneous group of conditions with widely varied associated risks; risk stratification is therefore vital for clinical management. Use of the CKD Epidemiology Collaboration (CKD-EPI) equation to estimate glomerular filtration rate (GFR) instead of the Modification of Diet in Renal Disease (MDRD) equation will reduce, though not eliminate, over-diagnosis of CKD. Cystatin C is recommended as an alternative measure of GFR but is not yet widely used. A new classification system for CKD, which includes GFR and albuminuria, has been endorsed by the National Institute for Health and Care Excellence to aid risk stratification and a recently validated formula, requiring only age, gender, eGFR and albuminuria, is useful to predict risk of end-stage kidney disease (ESKD). A risk-based approach will facilitate appropriate treatment for people at high risk of developing ESKD while sparing the majority, who are at low risk, from unnecessary intervention.