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Fact or fiction of the epidemic of chronic kidney disease—let us not squabble about estimated GFR only, but also focus on albuminuria
Division of Nephrology, Department of Medicine, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
Paul E. de Jong, Division of Nephrology, Department of Medicine, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 EZ Groningen, The Netherlands. Tel: +31-50-3613434; Fax: +31-50-3619310; E-mail: p.e.de.jong@int.umcg.nl
Keywords: albuminuria; chronic kidney disease; glomerular filtration rate; proteinuria; screening
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Introduction |
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In this issue of the journal, Glassock and Winearls question the need to conclude that there is an epidemic of chronic kidney disease (CKD) [1], while Coresh et al. emphasize in their response that there definitely is a need to study glomerular filtration rate (GFR) estimates [2]. This is an important debate since after the publication of the KDOQI guidelines on the classification of CKD in 2002, many programs have been started to screen subjects for CKD, in an attempt towards preventing complications in the subjects involved. In this respect, it is important to note that CKD is not only associated with an enhanced risk of developing ESRD, but also with an increased risk of cardiovascular events [3].
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The definition of the five stages of chronic kidney disease |
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The detection of subjects with CKD is facilitated by clear definitions on what we should screen for and who we should screen. For this purpose, the
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The risks associated with elevated albuminuria and impaired GFR |
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The renal and cardiovascular risk of stages 1 and 2 versus that of stage 3 |
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Screening only for an impaired GFR or also for elevated albuminuria? |
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Conclusions |
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A. S. Levey, L. A. Stevens, and J. Coresh Reply Nephrol. Dial. Transplant., August 1, 2008; 23(8): 2696 - 2698. [Full Text] [PDF]
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