WHAT’S NEW IN CHRONIC KIDNEY DISEASE Thomas G. Ferguson, MD State Lead, CKD 4/30/13

HOW DO PATIENTS BECOME INCLUDED IN THE REGISTRY? Lab with GFR ≤ 60 from any source Wait ≥ 90 days Repeat GFR GFR ≤ 60 included in the database

NEW GUIDELINES CHANGES IN THE CLASSIFICATION SYSTEM OLD CLASSIFICATION Stage 1 GFR ≥ 90 Stage 2 GFR Stage 3 GFR Stage 4 GFR Stage 5 GFR < 15 NEW CLASSIFICATION Stage 1 GFR ≥ 90 Stage 2 GFR 60 – 89 Stage 3a GFR 45 – 59 Stage 3b GFR 30 – 44 Stage 4 GFR 15 – 29 Stage 5 GFR < 15

NEW GUIDELINES CHANGES IN THE eGFR EQUATION OLD EQUATION MDRD EQUATION Unable to give a value for GFR > 60 NEW EQUATION EPI EQUATION Able to give values of GFR > 60 Needed for new classification system

NEW GUIDELINES URINE PROTEIN (ALBUMIN) / CREATININE New classification system recognizes risk with abnormal urine protein (albumin) / creatinine ratio—increased proteinuria Appropriate actions required for abnormal ratio

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