NEW YORK—An updated, global version of the groundbreaking National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-KDOQI) guideline Chronic Kidney Disease: Evaluation, Classification, Stratification, will be released tomorrow by the Kidney Disease: Improving Global Outcomes (KDIGO). The new guideline, published in Kidney International Supplements, retains the current chronic kidney disease (CKD) definition but augments the classification system to include albuminuria, or protein in the urine, and cause of disease, as well as GFR stage.
“The original guideline provided a common language for communication among providers, patients and their families, investigators, and policy-makers and a framework for developing a public health approach to affect care and improve outcomes of CKD. The definition of CKD remains the same so the prevalence in the U.S. using that definition is still 26 million,” said Andrew S. Levey, MD, co-chair of the NKF KDOQI workgroup that developed the 2002 CKD Guideline and Dr. Gerald J. and Dorothy R. Professor of Medicine at Tufts Medical Center in Boston. “That guideline led to a paradigm change in the approach to CKD, shifting from an uncommon disease often culminating in kidney failure and treatment by nephrologists to a common condition leading to death from cardiovascular disease. As a result, CKD is now accepted as a worldwide public health problem and the global guideline was developed to address this issue.”
The updated guideline enables more accurate risk prediction and management by subdividing the GFR stages based on the level of albuminuria, providing a more precise picture of each patient’s condition. The albuminuria level helps physicians stratify risk and evaluate likely outcomes which ultimately make a difference for management and treatment.
“The new staging predicts meaningful outcomes for patients more accurately based on both blood and urine tests instead of one or the other test alone,” said Joseph Vassalotti, MD, NKF chief medical officer. “When you put together a patient’s level of kidney function as assessed by the blood test to estimate glomerular filtration rate (eGFR) and the extent of kidney damage based on urine albumin level, you improve prediction of risk for future chronic kidney failure and subsequent cardiovascular events. The updated guideline also guides doctors on the appropriate frequency of monitoring based on GFR and albuminuria categories. ”