Mañana, JUEVES, 24 DE ABRIL, el sistema se apagará debido a tareas habituales de mantenimiento a partir de las 9 de la mañana. Lamentamos las molestias.
Clarifying the concept of chronic kidney disease for non-nephrologists
Entidad
UAM. Departamento de Medicina; Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD)Editor
Oxford University Press on behalf of ERA-EDTAFecha de edición
2019-02-14Cita
10.1093/ckj/sfz007
Clinical Kidney Journal 12.2 (2019): 258–261
ISSN
2048-8505 (print); 2048-8513 (online)DOI
10.1093/ckj/sfz007Financiado por
This research was supported by FIS PI16/02057, ISCIII-RETIC REDinREN RD016/0009 FEDER funds, Sociedad Española de Nefrología, Fundación Renal Iñigo Ávarez de Toledo (FRIAT), ISCIII Rio Hortega (MVPG) and Comunidad de Madrid Biomedicina B2017/BMD-3686 CIFRA2-CM.Proyecto
Gobierno de España. PI16/02057; Gobierno de España. RD016/0009; Comunidad de Madrid. B2017/BMD-3686/CIFRA2Versión del editor
https://doi.org/10.1093/ckj/sfz007Materias
Albuminuria; Chronic kidney disease; Creatinine clearance; Definition; Glomerular filtration rate; Urate; MedicinaDerechos
© 2019 The AuthorsResumen
Chronic kidney disease (CKD) expands the prior concept of chronic renal insufficiency by including patients with relatively
preserved renal function, as assessed by the estimated glomerular filtration rate (eGFR), as even these early CKD stages are
associated with an increased risk for all-cause death and cardiovascular death, CKD progression and acute kidney injury.
A decreased eGFR (<60 mL/min/1.73m2) is by itself diagnostic of CKD when persisting for >3 months. However, when eGFR
is 60 mL/min/1.73m2, an additional criterion is required to diagnose CKD. In a recent clinical trial published in The New
England Journal of Medicine, all 6190 participants were reported to have CKD: 47% had Stages 1 and 2 CKD and 53% had Stage 3
CKD. This illustrates a widespread misunderstanding of the concept of CKD. Moreover, CKD categories in this study were
assigned based on the estimated creatinine clearance. Since both estimated creatinine clearance and creatinine clearance
overestimate eGFR, this illustrates another frequent misunderstanding: equating GFR with creatinine clearance. In this
commentary, we clarify the concept of CKD and of CKD categories for non-nephrologists. Assigning a diagnosis of CKD to a
patient with normal renal function and absence of other evidence of CKD may have negative consequences for the
individual (e.g. insurance and others) as well as for the medical community at large by creating confusion about the concept.
Lista de ficheros
Google Scholar:Pérez-Gómez, Maria Vanessa
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Bartsch, Lorenz-Alexander
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Castillo-Rodríguez, Esmeralda
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Fernández-Prado, Raúl
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Fernández-Fernández, Beatriz
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Martín-Cleary, Catalina
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Gracia-Iguacel, Carolina
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Ortiz Arduán, Alberto
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