Chapter 2: Definition, identification, and prediction of CKD progression

Abstract

RATIONALE The statement is worded this way to remind the practitioner to use both GFR and albuminuria in order to assess progression and is consistent with the definition offered in Chapter 1 regarding definitions of CKD which include both parameters. There is increasing evidence which supports that both parameters are valuable. Lower GFR and greater albuminuria are both associated with an increased rate of progression and are synergistic. More frequent measures of eGFR and albuminuria should be considered in patients with a lower GFR and greater albuminuria as these people are more likely to progress. Frequency of measurement should also be individualized based on the patient history and underlying cause of kidney disease. In specific conditions (e.g., GN or increased levels of albuminuria), frequent (every 1–3 months) assessment may guide therapeutic decisions. Regular monitoring of stable patients may include more frequent monitoring than annually, but will be dictated by underlying cause, history, and estimates of GFR and ACR values obtained previously.