TABLE 6.
CKD Stages and Corresponding Focus of Kidney-Related Care
| CKD Stage† | Focus of Kidney-Related Care | |||||
|---|---|---|---|---|---|---|
| Stage | eGFR (mL/min/1.73 m2) | Evidence of kidney damage* | Diagnose cause of kidney injury | Evaluate and treat risk factors for CKD progression** | Evaluate and treat CKD complications*** | Prepare for renal replacement therapy |
| No clinical evidence of CKD | ≥60 | − | ||||
| 1 | ≥90 | + | ✓ | ✓ | ||
| 2 | 60–89 | + | ✓ | ✓ | ||
| 3 | 30–59 | +/− | ✓ | ✓ | ✓ | |
| 4 | 15–29 | +/− | ✓ | ✓ | ✓ | |
| 5 | <15 | +/− | ✓ | ✓ | ||
CKD stages 1 and 2 are defined by evidence of kidney damage (+), while CKD stages 3–5 are defined by reduced eGFR with or without evidence of kidney damage (+/−). At any stage of CKD, the degree of albuminuria, observed history of eGFR loss, and cause of kidney damage (including possible causes other than diabetes) may also be used to characterize CKD, gauge prognosis, and guide treatment decisions.
Kidney damage is most often manifest as albuminuria (urine albumin-to-creatinine ratio ≥30 mg/g Cr) but can also include glomerular hematuria, other abnormalities of the urinary sediment, radiographic abnormalities, and other presentations.
Risk factors for CKD progression include elevated blood pressure, hyperglycemia, and albuminuria.
See Table 11.2 in the complete Standards of Care.