Summary of KDIGO 2012 CKD Guideline

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Summary of KDIGO 2012 CKD Guideline

Chapter 2: Definition, Identification, and Prediction Of CKD Progression

2.1: Definition and Identification of CKD Progression


2.1.1: Assess GFR and albuminuria at least annually in people with CKD. Assess GFR and albuminuria more often for individuals at higher risk of progression, and/or where measurement will impact therapeutic decisions (see grid on next page). (Not graded)

2.1.2: Recognize that small fluctuations in GFR are common and are not necessarily indicative of progression. (Not graded)

2.1.3: Define CKD progression based on one or more of the following (not graded):

  • Decline in GFR category (≥90 (G1), 60–89 (G2), 45–59 (G3a), 30–44 (G3b), 15–29 (G4), <15 (G5) ml/min per 1.73 m). A certain drop in eGFR is defined as a drop in GFR category accompanied by a 25% or greater drop in eGFR from baseline.

  • Rapid progression is defined as a sustained decline in eGFR of >5 ml/min per 1.73 m/year.

  • The confidence in assessing progression is increased with increasing number of serum creatinine measurements and duration of follow-up.

2.1.4: In people with CKD progression, as defined in Recommendation 2.1.3, review current management, examine for reversible causes of progression, and consider referral to a specialist. (Not graded)

2.2: Predictors of Progression


2.2.1: Identify factors associated with CKD progression to inform prognosis. These include cause of CKD, level of GFR, level of albuminuria, age, sex, race/ethnicity, elevated blood pressure (BP), hyperglycemia, dyslipidemia, smoking, obesity, history of cardiovascular disease, ongoing exposure to nephrotoxic agents, and others. (Not graded)

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