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Nephrol Dial Transplant (2003) 18: 1446-1451
© 2003 European Renal Association-European Dialysis and Transplant Association

Editorial Comments

The advantage of a uniform terminology and staging system for chronic kidney disease (CKD)

Adeera Levin

St Paul’s Hospital, Vancouver, Canada

Correspondence and offprint requests: A. Levin MD FRCPC, St Paul’s Hospital, 1081 Burrard Street, Room 6010A, Vancouver BC V6Z 1Y8, Canada. Email: alevin@providencehealth.bc.ca

Keywords: chronic kidney disease; glomerular filtration rate; late referral; mislabelling; terminology

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

Chronic kidney disease is an epidemic facing most western countries, with annual dialysis growth rates ~6–8% per annum. There is an increasing awareness of the immense size of the patient group with kidney disease who do not require dialysis, as derived from analysis of population databases [1]. In a recent publication, the National Kidney Foundation sponsored Kidney Disease Outcomes Quality Initiative (KDOQI) working group proposed a set of guidelines regarding the definition, classification and evaluation of chronic kidney disease [2]. Using large representative databases of both referred and non-referred patients, and evidence-based examination of the literature, five stages of kidney disease have been defined. These stages correspond to the severity of kidney function loss and the prevalence of co-morbidities associated with kidney disease. Importantly, the classification system describes the stages according to level of estimated glomerular filtration rate (GFR), not serum creatinine levels, and advocates for . . . [Full Text of this Article]

General issues: the value of precise definitions?

What is chronic kidney disease and why is it important?

Essential aspects and components of the new classification system

Details of the generation of the staging system

A few caveats, and areas of controversy

Accuracy of serum creatinine
Validation of stages
Mislabelling
Predicting outcomes
Summary

Editorial note


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