2014年10月27日星期一

Concept of Chronic Kidney Disease and Phases of Chronic Renal Insufficiency

According to the defining method suggested by K/DOQI working team of American National Kidney Disease(NKF): Chronic Kidney Disease(CKD) means that there is renal injury confirmed by renal biopsy or detective injury indicator, or means that the duration time is no less than 3 months on the level of GFR is less than 60ml per minute in 1.73m². The renal injury indicators include proteinuria, inspection abnormality in urinal test strip or urinary sediment or in kidney imageology. GFR could be calculated according to the formula of body surface area basing on serum creatinine and other variables such as age, gender, race, etc.
The stages of Chronic Renal Insufficiency(CRI) in our country include the following four phases, which is determined generally according to the standard for evaluation established in a symposium on primary glomerulus disease classification, treatment and assessment of its therapeutic effect, which is held in Taiping City, Anhui province in June, 1992 by Kidney Disease Group of Chinese Journal of Internal Medicine Editorial Committee:
Phase 1: Compensatory Stage of Chronic Renal Function(CRF)Insufficiency. When the degree of damage to the nephron is no more than the normal 50%( GFR50~80ml/min), there can’t go so far as to the appearance of metabolities retentions such as Blood Urea Nitrogen(BUN) and so on as a result of the compensation of renal function. Meanwhile, Serum Creatinine(Scr) could maintain the normal level(133~177ummol/l,1.5~2.0mg/dl). Generally there are no symptoms in clinical in this phase.
Phase 2: Decompensatory Stage of CRF Insufficiency: When the remaining renal function is less than the normal 50%(GFR20~50ml/min) and Scr reaches the level of 177~442umol/l(2~5mg/dl), and also, the rise of BUN exceeds 7.1mmol/l,(20mg/dl), such phase can see the general symptoms such as hypodynamia, mild anemia and poor appetite, etc.
Phase 3: Stage of Renal Failure: Scr reaches up to 442~707ummol/l(5~8mg/dl), Creatinine Clearance Rate(Ccr) decreases into 10~20ml/min, BUN rises up to 17.9~28.6mmol(50~80mg/dl). Such phase can see the severe anemia, metabolic acidosis, metabolic disorder on Calcium and Phosphorus, metabolic disorder on water and electrolyte, etc.
Phase 4: Stage of Uremia. Scr reaches over 707ummol/l(8mg/dl), Ccr decreases below 10ml/min. NUN increases over 28.6mmol/l(80mg/dl). Such phase can see the obvious symptom on acidosis as well as the severe symptoms on all syImmunotherapys of the body.
NKF divides the CKD into five phases according to the GFR:
CKD Phase 1: Impair on kidney, and GRF is normal or increasing and lies less than 90(ml/min/1.73m²)(Ellipsis in the below);
CKD Phase 2: Impair on kidney, GRF decreases slightly and lies between between 60~80;
CKD Phase 3: GFR decreases moderately and lies between 30~59;
CKD Phase 4: GFR decreases moderately and lies between 15~29;

CKD Phase 5: Renal Failure, GFR decreases below 15 or to be dialyzed.

Leave a Message

Full Name:
Country:
Email:
Phone Number:
Whatsapp:
Medical Report:
Disease Description:
 

24-hour doctor online, free consultation on kidney disease related issues