title: Chronic kidney disease: towards a risk-based approach.
abstract: Chronic 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.
authors.affiliation: Royal Derby Hospital, Derby, UK maarten.taal1@nhs.net.
authors.forename: Maarten W
authors.initials: MW
authors.lastname: Taal
mesh_terms: D000328:Adult; D055316:Cystatin C; D005919:Glomerular Filtration Rate; D006801:Humans; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D012306:Risk
chemical_list: D055316:Cystatin C
keywords: Chronic kidney disease; KFRE (kidney failure risk equation); cystatin C; estimated GFR; risk prediction