July 15, 2003Annals of Internal Medicine
National Kidney Foundation Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification, and Stratification
Population
Adults at risk for or with chronic kidney disease
Design
Guideline
Authors
Discussion
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Member takes
Implication
Facilitates earlier CKD identification and targeted CVD prevention in routine practice; confirms foundational classification for ongoing clinical research.
Key Points
- To establish a standardized definition, five-stage classification system, and clinical practice guidelines for the early evaluation and risk stratification of chronic kidney disease.
- Developed clinical practice guidelines using evidence-based procedures established by the Agency for Healthcare Research and Quality.
- Assessed laboratory methods for evaluating kidney damage and function across populations to define disease progression and complication risks.
- Defined chronic kidney disease and created a five-stage classification system based on estimated glomerular filtration rate and markers of kidney damage, regardless of underlying etiology.
- Identified that early-stage chronic kidney disease affects approximately 11% of adults and recommended targeted screening for high-risk individuals—including those with diabetes, hypertension, older age, or minority status—using spot urine albumin-to-creatinine ratios and serum creatinine-based prediction equations.
Structured PICO
P
Population
Adults at risk for or with chronic kidney disease (including those with diabetes, hypertension, family history of CKD, older than 60 years, or U.S. racial/ethnic minority status)
I
Intervention
Early detection and classification of chronic kidney disease using albumin-creatinine ratio in untimed urine specimens and estimated glomerular filtration rate
These guidelines establish the standard definition and five-stage classification system for chronic kidney disease to improve early detection, risk stratification for cardiovascular disease, and management.
Cite This Study
Levey et al. (2003) studied this question.