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The CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) formula was first published in May 2009. It was developed in an effort to create a formula more accurate than the MDRD formula, especially when actual GFR is greater than 60 mL/min per 1.73 m 2. This is the formula currently recommended by NICE in the UK. [27]
The severity of chronic kidney disease (CKD) is described by six stages; the most severe three are defined by the MDRD-eGFR value, and first three also depend on whether there is other evidence of kidney disease (e.g., proteinuria): 0) Normal kidney function – GFR above 90 (mL/min)/(1.73 m 2) and no proteinuria
Levey is known for developing the most widely used equations to estimate GFR (renal function) globally.He pioneered work with the MDRD Study Equation, [1] led the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), which pooled measured kidney function CKD data from studies all over the world to develop equations to estimate kidney function from serum creatinine, cystatin C, and ...
CKD can be the long term consequence of irreversible acute disease or part of a disease progression. [citation needed] CKD is divided into 5 different stages (1–5) according to the estimated glomerular filtration rate (eGFR). In CKD1 eGFR is normal and in CKD5 eGFR has decreased to less than 15 ml/min. [17]
Rapidly progressive glomerulonephritis - This is a syndrome of the kidney that is characterized by rapid loss of kidney function (usually >50% decline in glomerular filtration rate (GFR) within 3 months) [23] with glomerular crescent formation frequently seen on kidney biopsy.
European guidelines classify a pre-existing decreased kidney function to be a risk factor of contrast-induced nephropathy in the following cases: [5]. Estimated glomerular filtration rate (eGFR) < 45 ml/min/1.73 m 2 of body surface area before intra-arterial administration with first-pass renal exposure (not passing lungs or peripheral circulation before kidneys), or in the intensive care unit
All people with a GFR <60 mL/min/1.73 m 2 for 3 months are defined as having chronic kidney disease. [59] Protein in the urine is regarded as an independent marker for worsening of kidney function and cardiovascular disease. Hence, British guidelines append the letter "P" to the stage of chronic kidney disease if protein loss is significant. [60]
Algorithms to estimate GFR from creatinine concentration and other parameters are discussed in the renal function article. Unfortunately, the MDRD Study equation was developed in people with chronic kidney disease, and its major limitations are imprecision and systematic underestimation of measured GFR (bias) at higher/normal values. [20]
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