Diagnosis and screening of chronic kidney disease

Kwon, Soon Hyo; Han, Dong Cheol

Abstract

A simple definition of chronic kidney disease (CKD) is necessary to establish clinical practical guidelines. The Kidney Disease Outcomes Quality Initiative (K/DOQI) defined CKD as kidney damage or a glomerular filtration rate (GFR) <60 mL/min/1.73 m2 for 3 months or more, irrespective of cause. In addition, the Kidney Disease: Improving Global Outcome (KDIGO), provided evidence-based understanding of CKD and established global consensus while identifying a collaborative research agenda and plan for the practical definition and classification of CKD. To identify CKD, estimation of the GFR from the serum creatinine and the presence of albuminuria are essential. The GFR estimation needs the application of appropriate equations, such as the Modification of Diet in Renal Disease Study equation or the Cockcroft-Gault formula, and calibration of the serum creatinine. Albuminuria can be detected using an albumin-to-creatinine ratio >30 mg/g in two of three spot urine collections. With the CKD guidelines of K/DOQI and KDIGO, the diagnosis and early detection of CKD, which may need a Korean estimation equation, are improving and should help to reduce the prevalence and incidence of end-stage renal disease in Korea.