Overview
Kidney Function Is More Than eGFR
Chronic kidney disease (CKD) is present when an abnormality of kidney structure or function persists for more than 3 months and has implications for health.
Chronic kidney disease (CKD) is present when an abnormality of kidney structure or function persists for more than 3 months and has implications for health. The abnormality may be a reduced GFR, albuminuria, abnormal urine sediment, structural disease on imaging, or another established marker of kidney injury. A single low eGFR does not by itself establish CKD; it may represent acute kidney injury, an acute illness, or an inaccurate estimate. CKD risk is described on two independent axes: - GFR category: G1 is at least 90, G2 is 60–89, G3a is 45–59, G3b is 30–44, G4 is 15–29, and G5 is below 15 mL/min/1.73 m². - Albuminuria category: A1 is below 30, A2 is 30–300, and A3 is above 300 mg/g urinary albumin-to-creatinine ratio (ACR). A patient with G3b A3 has a very different kidney-failure and cardiovascular risk profile from a patient with G3b A1. Reporting only “eGFR 38” loses clinically decisive information. Obtain a random urine ACR, confirm persistent abnormalities when appropriate, and interpret both axes together. Diabetes Canada uses serum creatinine with eGFR and random urine ACR as...