NDT Advance Access originally published online on August 3, 2006
Nephrology Dialysis Transplantation 2006 21(9):2358-2361; doi:10.1093/ndt/gfl195
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© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Editorial Comment
Screening for early chronic kidney disease—what method fits best?
University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
Correspondence and offprint requests to: Paul E. de Jong, Division of Nephrology, Department of Medicine, University Medical Center Groningen, Groningen University, Hanzeplein 1, 9713 EZ Groningen, The Netherlands. Email: p.e.de.jong@int.umcg.nl
Keywords: albuminuria; cardiovascular disease; chronic kidney disease; eGFR; renal function; screening
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Introduction |
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Much attention is presently focused on the detection of early chronic kidney disease (CKD). This interest is related to the fact that it is becoming more and more accepted that an impaired kidney function and elevated albuminuria are associated with progressive cardiovascular disease. It is thus important that easy-to-apply and reliable techniques be available to properly define the presence of renal damage. In this comment, we will describe what methods are available to define the presence of CKD, and we will discuss how these methods should be used in daily practice.
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Changing clinical nephrology practice over the decades |
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Nephrology practice has dramatically changed since the early sixties of the previous century. In the early years of nephrology, most attention was directed towards setting up dialysis and transplant programmes. In those years, little attention was paid to the prevention of progressive renal function loss. In the nineties, practice started to change, as it became clear that progressive CKD
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How can we detect patients not known with a specific renal disease, but at risk for progressive CKD? |
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Limitations of estimated GFR measurements |
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The creatinine measurement |
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The calculation of estimated GFR |
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The bias introduced by the estimates |
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The use of fixed cut-off levels for CKD definitions |
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An impaired GFR or progressive renal function impairment? |
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What is the role for the nephrologist? |
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