Blog entry by Meguid El Nahas

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by Meguid El Nahas - Wednesday, 13 April 2016, 6:00 AM
Anyone in the world

http://www.ncbi.nlm.nih.gov/pubmed/27057075

This excellent paper proposes an age-sensitive CKD classification:

<40 years: CKD threshold = 75 ml/min

40-65years: CKD threshold = 60 ml/min

>65 years: CKD threshold =45 ml/min

this in the absence of other corroborating signs of kidney damage.

It is high time we move away from one classification and one CKD threshold (60 ml/min) for all...

It is also high time to appreciate that CKD is not a single disease...with a single definition...and a single classification...

A GFR of 60 ml/min in a 25 year old patient with glomerulonephritis is a very different proposition than a GFR of 60 in a 75 year old with longstanding hypertension...

GFR thresholds are therefore meaningless in isolation as they serve no medical or clinical purpose...in fact, they have not changed clinical practice of referred patients with kidney damage...they only generated interest and research by "epidemiologists" that created a "Disease" to generate interest in a small subspecialty that looked for a way to enhance its significance by claiming that 1 in 4 of the general population, 1 in 3, 1 in 2 in a lifetime, is or will...suffer from CKD...

In my opinion, it is high time to drop CKD thresholds all together and define referred kidney damage patients by their medical condition, as to the general population define those affected by their underlying condition (hypertension, diabetes) and detail the degree and nature of their kidney damage.

 

 

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