The fourth wave in chronic kidney disease (CKD) classification: taking into account the aging kidney
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2023
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Springer Nature
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CKD affects more than 10% of the population worldwide, is
strongly associated with accelerated cardiovascular morbimortality,
and its prevalence is exponentially higher among
older individuals, although this prevalence is just based on
estimated GFR (eGFR) and albuminuria [1]. The first CKD
classification (2002) was proposed by the KDOQI group;
it divided CKD into five categories based on eGFR. This
classification was subsequently endorsed by the KDIGO
organization. The second CKD classification (2008) subdivided
stage 3 into stages 3a and 3b (45–59 and 30–44 ml/
min/1.73 m2,
respectively), and incorporated the presence
or absence of albuminuria [2]. The third and currently used
KDIGO CKD classification (2012) added the albuminuria
level: normal (A1), moderate (A2), and severe (A3) [3]. The
positive impact that implementation of the current classification
has had is not debatable, however it does not take into
consideration the age of the patient. Experts in nephrogeriatrics
have long suggested that eGFR declines as we age.
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Musso, C.G., Ricardo, A.C. & Aroca-Martinez, G. The fourth wave in chronic kidney disease (CKD) classification: taking into account the aging kidney. Int Urol Nephrol (2023). https://doi.org/10.1007/s11255-023-03642-w
