Elsevier

Kidney International

Volume 80, Issue 1, 1 July 2011, Pages 17-28
Kidney International

Public Forum
The definition, classification, and prognosis of chronic kidney disease: a KDIGO Controversies Conference report

https://doi.org/10.1038/ki.2010.483Get rights and content
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The definition and classification for chronic kidney disease was proposed by the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-KDOQI) in 2002 and endorsed by the Kidney Disease: Improving Global Outcomes (KDIGO) in 2004. This framework promoted increased attention to chronic kidney disease in clinical practice, research and public health, but has also generated debate. It was the position of KDIGO and KDOQI that the definition and classification should reflect patient prognosis and that an analysis of outcomes would answer key questions underlying the debate. KDIGO initiated a collaborative meta-analysis and sponsored a Controversies Conference in October 2009 to examine the relationship of estimated glomerular filtration rate (GFR) and albuminuria to mortality and kidney outcomes. On the basis of analyses in 45 cohorts that included 1,555,332 participants from general, high-risk, and kidney disease populations, conference attendees agreed to retain the current definition for chronic kidney disease of a GFR <60 ml/min per 1.73 m2 or a urinary albumin-to-creatinine ratio >30 mg/g, and to modify the classification by adding albuminuria stage, subdivision of stage 3, and emphasizing clinical diagnosis. Prognosis could then be assigned based on the clinical diagnosis, stage, and other key factors relevant to specific outcomes. KDIGO has now convened a workgroup to develop a global clinical practice guideline for the definition, classification, and prognosis of chronic kidney disease.

KEYWORDS

albuminuria
chronic kidney disease
classification
definition
glomerular filtration rate
prognosis

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The Kidney Disease Improving Global Outcomes (KDIGO) Controversies Conference took place on 4–6 October 2009 in London, England.

Presented in part at the 42nd Annual Meeting of the American Society of Nephrology, 1 November 2009, San Diego, California and Spring Clinical Meetings of the National Kidney Foundation, 15 April 2010, Orlando, Florida, USA

All the authors declared no competing interests.