ISSN: 1305-385X
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Chronic Kidney Disease And Failure: Definition, Stages And Epidemiology
Dr. Gültekin SÜLEYMANLARa
aNefroloji BD, Akdeniz Üniversitesi Tıp Fakültesi, ANTALYA
Chronic kidney disease (CKD) is an important public health problem in Turkey as well as in the world. CKD has been known as a nephrologic syndrome charecterized by chronic, progressive and irreversible nephron loss resulting from multiple etiologies. Definition and clasification of CKD were accepted in NKF-K/DOQI workgroup in 2002 and were modified by KDIGO controversies conference in 2004.
CKD is defined as the presence of objective kidney damage and/or the presence of a glomerular fitration rate (GFR) of <60 mL/min/1.73 m2 or less for at least 3 months irrespective of the etiology of the kidney damage. The presence of kidney damage may be defined by structural or functional abnormalities of the kidney deriving from renal histology or from abnormalities in the composition of urine or blood, or abnormalities in imaging tests. The commonest and most easily available marker of kidney damage is the presence of proteinuria including microalbuminuria.
CKD is divided into five stages based on the NFK guidelines as mentioned above. So, Stage I is defined by a normal GFR (greater than 90 mL/min per 1.73 m2) and persistent albuminuria, Stage II is a GFR between 60 to 89 mL/min per 1.73 m2 and persistent albuminuria, Stage III is a GFR between 30 and 59 mL/min per 1.73 m2, Stage IV is a GFR between 15 and 29 mL/min per 1.73 m2, Stage V is a GFR of less than 15 mL/min per 1.73 m2 or end-stage renal disease (ESRD) requiring renal replacement therapy (RRT).
The rates of incidence (2x) and prevalence (5x) of ESRD requiring RRT have been rapidly rising in Turkey based on Renal Registry Data of Turkish Society of Nephrology over the last 10 years. The major causes of ESRD are respectively diabetic nephropaty and hypertension in adults, vesicoureteral reflux and primary glomerular disease in children. CREDIT Project which is stil going on representative samples of our population will estimate the rates of prevalence of all CKD stages in Turkey.Keywords: Chronic kidney disease (CKD), definition, stage, epidemiologyTurkiye Klinikleri J Int Med Sci 2007, 3(38):1-7
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