![]() ![]() Estimation of GFR (eGFR) is based on renally-filtered serological biomarkers, most commonly serum creatinine levels (SCr)-based equations. 1 Other more specific tests exist for characterising CKD but are beyond the scope of this review article. The two most useful biomarkers to assess the kidney health are GFR and albuminuria (or proteinuria) assessment. Therefore, blood and urine screening during routine medical care is of key importance. For subjects older than 65 years without albuminuria or proteinuria, CKD is defined by eGFR below 45 mL/min/1.73m 2.Ĭhronic kidney disease (CKD) is often described as the “silent killer” in medicine, as this pathology is seldom symptomatic until the glomerular filtration rate (GFR) is severely decreased. For patients with ages between 40 and 65 years, CKD is defined by 60 mL/min/1.73m 2. For patients younger than 40 years, CKD is defined by eGFR below 75 mL/min/1.73m 2. An age-calibrated definition of CKD has been proposed to distinguish age-related from disease-related changes in eGFR. Overestimation of the CKD prevalence in the elderly (medicalisation of senescence) and underestimation of CKD (potentially from treatable primary nephrologic diseases) in younger patients is of primary concern. However, a universal threshold does not take into account the physiologic decline in GFR with ageing nor does it account for the risk of mortality and end-stage renal disease being trivial with isolated eGFR levels just below 60 mL/min/1.73m 2 in older subjects and significantly increased with eGFR levels just above 60 mL/min/1.73m 2 among younger patients. This threshold has been defended by epidemiological studies showing that the risk of mortality or end-stage renal disease increases with an eGFR below 60 mL/min/1.73m 2. Current recommendations argue that a universal threshold of 60 mL/min/1.73m 2 should be used. The debate concerns the threshold value of estimated glomerular filtration rate (eGFR) used to make the diagnosis of CKD. Defining chronic kidney disease (CKD) is the subject of intense debate in the current nephrology literature. ![]()
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