Skip to Main Content

++

  • Image not available. The stage of chronic kidney disease (CKD) should be determined for all individuals based on the level of kidney function, independent of etiology, according to the National Kidney Foundation (NKF) Kidney Disease/Dialysis Outcome Quality Initiative CKD classification system.
  • Image not available. Persistent proteinuria indicates the presence of CKD.
  • Image not available. Quantitation of urine protein excretion, such as the measurement of a spot urine albumin-to-creatinine ratio, is recommended for determining the severity of CKD and monitoring the rate of disease progression.
  • Image not available. The glomerular filtration rate (GFR) is the single best indicator of kidney function.
  • Image not available. Measurement of the GFR is most accurate when performed following the exogenous administration of inulin, iothalamate, or radioisotopes such as technetium 99m diethylenetriamine pentaacetic acid (99mTc-DTPA).
  • Image not available. Equations to estimate creatinine clearance or GFR are commonly used in ambulatory and inpatient settings and incorporate patient laboratory and demographic variables, such as serum creatinine, cystatin C, age, gender, weight, and ethnicity.
  • Image not available. Longitudinal assessment of GFR and proteinuria is important for monitoring the efficacy of therapeutic interventions, such as angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, which are used to slow or halt the progression of kidney disease.
  • Image not available. The measurement of Scr alone, evaluation of a plot of the reciprocal of Scr versus time, and serum cystatin C concentration should be used with caution to estimate the rate of decline in renal function in patients with CKD, as these indices do not consider patient age, lean body mass, gender, diet, concomitant diseases and drug therapy, circadian rhythm, stability of kidney function, or tubular secretion of creatinine.
  • Image not available. Other assessments of the kidney, such as radiography, computed tomography, magnetic resonance imaging, sonography, and biopsy, are mainly used for determining the diagnosis of a given condition, as they provide evidence of the functional and structural changes associated with kidney disease.

++

Upon completion of the chapter, the reader will be able to:

++

  • 1. Understand basic renal physiology and the role of the kidney in maintaining homeostasis.
  • 2. Describe the most recent NKF K/DOQI guidelines relating to CKD classification.
  • 3. Understand the role of urinalysis (chemical and microscopic) in detecting and monitoring renal disease.
  • 4. Understand the importance of quantifying renal function and its role in the identification, monitoring, and classification of CKD.
  • 5. Compare and contrast various methods to estimate and measure creatinine clearance and GFR in patients with CKD and acute renal failure.
  • 6. Determine the most appropriate method for assessing renal function in patients with CKD, liver disease as well as pediatrics and the elderly.
  • 7. Compare and contrast the available methods to evaluate proteinuria in patients with CKD.
  • 8. Identify the most common methods to quantify renal blood flow and renal tubular function.
  • 9. Describe the appropriate use of creatinine clearance and estimated GFR equations for renal drug dose adjustments.
  • 10. Understand the limitations of using serum cystatin C as a quantitative index of kidney function.
  • 11 Discuss the role of qualitative tests such as CT, MRI, ultrasonography, ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.