Tonelli et al combined estimated glomerular filtration rate and level of proteinuria to improve the classification for risk in patients with chronic kidney disease. Knowing the risk can help to identify a patient who may benefit from more aggressive management. The authors are from the Alberta Kidney Disease Network in Canada.
Patient selection: chronic kidney diseaes (CKD) with estimated glomerular filtratio rate >= 15 mL per min per 1.73 aquare meter BSA (with < 15 indicating end-stage renal disease or ESRD)
Parameters:
(1) estimated glomerular filtration rate (eGFR) using the MDRDS equation, expressed as mL per minute per 1.73 square meter BSA
(2) level of proteinuria
|
Protein on Urine Dipstick |
Albumin to Creatinine Ratio |
Proteinuria |
|
negative |
< 30 mg/g |
normal |
|
trace or 1+ |
30 to 300 mg/g |
mild |
|
2+ or higher |
> 300 mg/g |
heavy |
|
eGFR |
Proteinuria |
Risk Category |
Ranking |
|
>= 60 |
none |
0 (none) |
1 |
|
|
mild |
1 |
3 |
|
|
heavy |
3 |
7 |
|
45 to 59.9 |
none |
1 |
2 |
|
|
mild |
2 |
5 |
|
|
heavy |
4 |
10 |
|
30 to 49.9 |
none |
2 |
4 |
|
|
mild |
3 |
6 |
|
|
heavy |
4 |
11 |
|
15 to 29.9 |
none |
3 |
8 |
|
|
mild |
4 |
9 |
|
|
heavy |
4 |
12 |
where:
• Risk category 1 corresponds to rankings 2 and 3; risk category 2 to rankings 4 and 5; risk category 3 to rankings 6 to 8; risk category 4 to rankings 9 to 12 (Appendix, Figure 2)
Specialty: Nephrology, Clinical Laboratory
ICD-10: ,
