Relationship between estimated glomerular filtration rate and kidney disease

Relationship between estimated glomerular filtration rate (eGFR) and stages of chronic kidney disease (CKD):

• Stage 1: Normal GFR; GFR >90 mL/min/1.73 m2 with other evidence of chronic kidney damage*
• Stage 2: Mild impairment; GFR 60-89 mL/min/1.73 m2 with other evidence of chronic kidney damage*
• Stage 3: Moderate impairment; GFR 30-59 mL/min/1.73 m2
• Stage 4: Severe impairment: GFR 15-29 mL/min/1.73 m2
• Stage 5: Established renal failure (ERF): GFR < 15 mL/min/1.73 m2 or on dialysis

* “other evidence of chronic kidney damage” may be one of the following:

• persistent microalbuminuria
• persistent proteinuria
• persistent haematuria (after exclusion of other causes, e.g. urological disease)
• structural abnormalities of the kidneys demonstrated on ultrasound scanning or other radiological tests, e.g. polycystic kidney disease, reflux nephropathy
• biopsy-proven chronic glomerulonephritis (most of these patients will have microalbumuria or proteinuria, and/or haematuria)

Note that patients found to have a GFR of 60-89 mL/min/1.73 m2 without one of these markers should not be considered to have CKD and should not be subjected to further investigation unless there are additional reasons to do so.

Reference:

1. The Renal Association (May 2006).UK CKD Guidelines
2. Doctor (June 28th 2005):23.