Definition and etiologies-chronic kidney disease (CKD)

(Lancet 2021;10302:786)

• GFR <60 for ≥3 mo and/or kidney damage (albuminuria, structural abnormality)

• Prevalence 15% in U.S.

• Albuminuria predicts all-cause & CV mortality, CKD progression (NEJM 2004;351:1296)

• Cr poor estimate of GFR, use equation (https://www.kidney.org/professionals/kdoqi/gfr calculator)

Cystatin-C–based formula less influenced by race than Cr-based (NEJM 2021;385:1737)

• Etiologies: DM (45%), HTN/RAS (27%), glomerular (10%), interstitial (5%), PKD (2%), congenital, drugs, myeloma, repeated insults (eg, Mesoamerican nephropathy)

• Progression to ESRD: kidney failure risk equation (JAMA 2016;315:164; kidneyfailurerisk.com)