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NDT Advance Access originally published online on December 22, 2008
Nephrology Dialysis Transplantation 2009 24(3):698-700; doi:10.1093/ndt/gfn704
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


A critical evaluation of chronic kidney disease—should isolated reduced estimated glomerular filtration rate be considered a ‘disease’?

Emilio D. Poggio1 and Andrew D. Rule2

1 Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH 2 Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA

Correspondence and offprint requests to: Emilio D. Poggio, Renal Function Laboratory, Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic, 9500 Euclid Avenue-Desk A51, Cleveland, OH 44195, USA. Tel: +1-216-444-5383; Fax: +1-216-444-9378; E-mail: poggioe@ccf.org

Keywords: CKD; glomerular filtration rate; MDRD

The first 150 words of the full text of this article appear below.



   Introduction
 
The definition and classification of chronic kidney disease (CKD) as adopted by the National Kidney Foundation and by the Kidney Disease: Improving Global Outcomes [1,2] has generated new interest in nephrology. A consistent classification is necessary to develop a coherent literature on the natural history, risk factors and outcomes of a disease. A primary goal with CKD classification has been to identify an earlier, often asymptomatic stage where interventions may prevent the progression to end-stage renal disease. Interventions only at late stages of disease are not desirable given the high morbidity, mortality and societal costs associated with dialysis and transplantation. The current classification of CKD is based on three fundamental components: (1) damaged renal parenchyma for stages 1 and 2 (e.g. proteinuria or polycystic kidneys); (2) decreased function as determined by glomerular filtration rate (GFR) regardless of damaged renal parenchyma for stages 3 and higher; and (3) chronicity . . . [Full Text of this Article]


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