Kidney disease is defined as an abnormality of kidney structure or function with implications for the health of an individual [1].
The onset of kidney disease can occur suddenly (e.g. Acute Kidney Injury), and either resolve or become chronic [1]. A duration of greater than three months delineates ‘chronic’ kidney disease (CKD) [1].
CKD is a general term for a heterogeneous group of disorders with respect to cause, severity and the rate of progression [1] and is classified into five stages of severity according to the level of kidney function, or evidence of damage indicated by biological markers [2].
Classification is based on cause (‘C’) of CKD, Glomerular Filtration Rate (GFR) category (‘G’) and albuminuria category (‘A’), respectively referred to as ‘CGA’ staging [1]. CGA staging is used to inform the need for referral, general medical management and therapeutic interventions [1].
Stage five kidney disease
Kidney failure is considered the most serious outcome of CKD [1] occurring in stage five of the disease. Stage five is the most symptomatic form of CKD, and is referred to as End Stage Kidney Disease (ESKD). People with ESKD require dialysis, a kidney transplant or end of life management. The two former pathways of care are called renal replacement therapy (RRT). ESKD is the most severe manifestation of CKD, presenting the greatest level of symptom burden to patient communities and the Australian healthcare system [2].
References:
- KDIGO, KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Vol. 3. 2012, Kidney International Supplement 2013.
- Australian Institute of Health and Welfare, Cardiovascular disease, diabetes and chronic kidney disease – Australian facts: Prevalence and incidence. Cardiovascular, diabetes and chronic kidney disease. 2014: Canberra.