美国肾脏协会慢性肾脏疾病诊疗指南（英文）.pdfVIP

Clinical Guidelines National Kidney Foundation Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification, and Stratification Andrew S. Levey, MD; Josef Coresh, MD, PhD; Ethan Balk, MD, MPH; Annamaria T. Kausz, MD, MS; Adeera Levin, MD; Michael W. Steffes, MD, PhD; Ronald J. Hogg, MD; Ronald D. Perrone, MD; Joseph Lau, MD; and Garabed Eknoyan, MD Chronic kidney disease is a worldwide public health problem with dure outlined by the Agency for Healthcare Research and Quality. an increasing incidence and prevalence, poor outcomes, and high This paper presents the definition and five-stage classifica- cost. Outcomes of chronic kidney disease include not only kidney tion system of chronic kidney disease and summarizes the major failure but also complications of decreased kidney function and recommendations on early detection in adults. Recommendations cardiovascular disease. Current evidence suggests that some of include identifying persons at increased risk (those with diabetes, these adverse outcomes can be prevented or delayed by early those with hypertension, those with a family history of chronic detection and treatment. Unfortunately, chronic kidney disease is kidney disease, those older than 60 years of age, or those with underdiagnosed and undertreated, in part as a result of lack of U.S. racial or ethnic minority status), detecting kidney damage by agreement on a definition and classification of its stages of pro- measuring the albumin–creatinine ratio in untimed (“spot”) urine gression. specimens, and estimating the glomerular filtration rate from se- Recent clinical practice