CKD staging Microlearning
Based on the 2024 KDIGO Clinical Practice Guideline for CKD
Start >
Definition
What is CKD?
>
Classification
How is CKD classified and why is this important?
>
Categories
Learn more about the stages of CKD and kidney failure
>
references
Please check out the reference!
>
DefinitionCKD
DefinitionCKD
The table above lists examples of markers of kidney damage as well as the cutoff for decreased GFR (KDIGO, 2024). It is important to identify the etiology of CKD in order to individualize management.
End of category definition
Good job!
Back to index
Classification
Classification
Albuminuria (albumin-to-creatinine ratio [ACR]) and GFR are required to determine the stage of CKD and to determine the risk of progression to negative outcomes (e.g. mortality, cardiovascular disease, and kidney failure with replacement therapy) (KDIGO, 2024).
Classification
GFR
- Using 2 biomarkers to estimate GFR is recommended as each biomarker alone has benefits/limitations.
- Biomarkers:
- Creatinine
- Alone: creatinine-based estimated GFR (eGFRcr)
- Cystatin C
- Combined: Creatinine and cystatin C-based GFR (eGFRcr-cys)
- Preferred when available but costly
(KDIGO, 2024)
Classification
Albuminuria (albumin-to-creatinine ratio [ACR])
- The ACR is calculated using the first void in the morning midstream
- Albumin may be falsely elevated/decreased by variabilities in urine albumin/protein (e.g. hematuria, menstruation, exercise, infection) and/or variabilities in urinary creatinine concentration (e.g. biological sex, weight)
(KDIGO, 2024)
Classification
The cause of CKD should be identified when staging
- Identifying cause allows the provider to target therapy to lower the risk of progression to kidney failure as well as understand contributing factors.
- There may be a genetic cause, which can be communicating to family members for preventative self-care
(KDIGO, 2024)
End of category classification
Congratulations, you have completed all activities with effort and dedication. Good job!
Back to index
Categories
Categories
An eGFR of 30-60 has been shown to equate to a 3-5% risk of kidney failure over 5 years. Per GFR categories, this can be anywhere from G3a to G3b. Timing of nephrology consult should also take into account other clinical considerations such as comorbidities. (KDIGO, 2024)
Categories
Multidisciplinary care (e.g. pharmacist, renal dietitian, etc.) should be considered when eGFR < 30, which correlates to CKD G4-G5 because their 2-year kidney failure risk climbs to > 10%. Concurrent complications such as anemia and hyperkalemia as well as adverse events like AKI and hopsitalizations are also higher in likelihood, necessitating interprofessional care. (KDIGO, 2024)
Categories
Lastly, a 2-year kidney failure risk of >40% at an eGFR of <20 prompts discussion for vascular access, kidney replacement therapy, and kidney transplantation. An eGFR of < 20 would be considered the lower end of CKD G4 to G5. (KDIGO, 2024)
End of section categories
Congratulations, you have completed all activities with effort and dedication. Good job!
Back to index
references
Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. (2024). KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney international, 105(4S), S117–S314. https://doi.org/10.1016/j.kint.2023.10.018
Back to index
Learning objective
The learner will be able to identify the three components required for staging chronic kidney disease (CKD) after reviewing the entirety of the microlearning on CKD staging.
CKD Staging Microlearning
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Transcript
CKD staging Microlearning
Based on the 2024 KDIGO Clinical Practice Guideline for CKD
Start >
Definition
What is CKD?
>
Classification
How is CKD classified and why is this important?
>
Categories
Learn more about the stages of CKD and kidney failure
>
references
Please check out the reference!
>
DefinitionCKD
DefinitionCKD
The table above lists examples of markers of kidney damage as well as the cutoff for decreased GFR (KDIGO, 2024). It is important to identify the etiology of CKD in order to individualize management.
End of category definition
Good job!
Back to index
Classification
Classification
Albuminuria (albumin-to-creatinine ratio [ACR]) and GFR are required to determine the stage of CKD and to determine the risk of progression to negative outcomes (e.g. mortality, cardiovascular disease, and kidney failure with replacement therapy) (KDIGO, 2024).
Classification
GFR
- Using 2 biomarkers to estimate GFR is recommended as each biomarker alone has benefits/limitations.
- Biomarkers:
- Creatinine
- Alone: creatinine-based estimated GFR (eGFRcr)
- Cystatin C
- Combined: Creatinine and cystatin C-based GFR (eGFRcr-cys)
- Preferred when available but costly
(KDIGO, 2024)Classification
Albuminuria (albumin-to-creatinine ratio [ACR])
- The ACR is calculated using the first void in the morning midstream
- Albumin may be falsely elevated/decreased by variabilities in urine albumin/protein (e.g. hematuria, menstruation, exercise, infection) and/or variabilities in urinary creatinine concentration (e.g. biological sex, weight)
(KDIGO, 2024)Classification
The cause of CKD should be identified when staging
- Identifying cause allows the provider to target therapy to lower the risk of progression to kidney failure as well as understand contributing factors.
- There may be a genetic cause, which can be communicating to family members for preventative self-care
(KDIGO, 2024)End of category classification
Congratulations, you have completed all activities with effort and dedication. Good job!
Back to index
Categories
Categories
An eGFR of 30-60 has been shown to equate to a 3-5% risk of kidney failure over 5 years. Per GFR categories, this can be anywhere from G3a to G3b. Timing of nephrology consult should also take into account other clinical considerations such as comorbidities. (KDIGO, 2024)
Categories
Multidisciplinary care (e.g. pharmacist, renal dietitian, etc.) should be considered when eGFR < 30, which correlates to CKD G4-G5 because their 2-year kidney failure risk climbs to > 10%. Concurrent complications such as anemia and hyperkalemia as well as adverse events like AKI and hopsitalizations are also higher in likelihood, necessitating interprofessional care. (KDIGO, 2024)
Categories
Lastly, a 2-year kidney failure risk of >40% at an eGFR of <20 prompts discussion for vascular access, kidney replacement therapy, and kidney transplantation. An eGFR of < 20 would be considered the lower end of CKD G4 to G5. (KDIGO, 2024)
End of section categories
Congratulations, you have completed all activities with effort and dedication. Good job!
Back to index
references
Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. (2024). KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney international, 105(4S), S117–S314. https://doi.org/10.1016/j.kint.2023.10.018
Back to index
Learning objective
The learner will be able to identify the three components required for staging chronic kidney disease (CKD) after reviewing the entirety of the microlearning on CKD staging.