• Clin Med (Lond) · Dec 2016

    Review

    Chronic kidney disease: towards a risk-based approach.

    • Maarten W Taal.
    • Royal Derby Hospital, Derby, UK maarten.taal1@nhs.net.
    • Clin Med (Lond). 2016 Dec 1; 16 (Suppl 6): s117s120s117-s120.

    AbstractChronic kidney disease (CKD) affects 8-16% of adults worldwide and is associated with multiple adverse outcomes. It includes a heterogeneous group of conditions with widely varied associated risks; risk stratification is therefore vital for clinical management. Use of the CKD Epidemiology Collaboration (CKD-EPI) equation to estimate glomerular filtration rate (GFR) instead of the Modification of Diet in Renal Disease (MDRD) equation will reduce, though not eliminate, over-diagnosis of CKD. Cystatin C is recommended as an alternative measure of GFR but is not yet widely used. A new classification system for CKD, which includes GFR and albuminuria, has been endorsed by the National Institute for Health and Care Excellence to aid risk stratification and a recently validated formula, requiring only age, gender, eGFR and albuminuria, is useful to predict risk of end-stage kidney disease (ESKD). A risk-based approach will facilitate appropriate treatment for people at high risk of developing ESKD while sparing the majority, who are at low risk, from unnecessary intervention.© Royal College of Physicians 2016. All rights reserved.

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