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Welcome to the era of CKD and the eGFR

Steven J Chadban and Francesco L Ierino
Med J Aust 2005; 183 (3): . || doi: 10.5694/j.1326-5377.2005.tb06951.x
Published online: 1 August 2005

Estimating glomerular filtration rate using a simplified formula will lead to a vast increase in detection of chronic kidney disease in Australia

In patients with chronic kidney disease (CKD), the degree of reduction in the glomerular filtration rate (GFR) is closely linked to the development of complications of CKD, and GFR is the best index for classifying the severity of the disease. In 2002, a US working party produced a five-stage classification of CKD, with guidelines for management according to stage, based largely upon GFR (Box).1 The classification is logical and simple and has enjoyed worldwide endorsement. However, one problem has impeded widespread usage of the classification — most clinicians do not measure or calculate GFR.


  • 1 Renal Medicine, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW.
  • 2 Renal Medicine, Austin Health and University of Melbourne, Heidelberg, VIC.


Correspondence: 

  • 1. National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification and stratification. Am J Kidney Dis 2002; 39 (2 Suppl 1): S1-S266.
  • 2. Chadban SJ, Briganti E, Kerr PG, et al. Prevalence of kidney damage in Australian adults: the AusDiab Kidney Study. J Am Soc Nephrol 2003; 14 (7 Suppl 2): S131-S138.
  • 3. Zuo L, Ma Y, Zhou Y, et al. Application of GFR-estimating equations in Chinese patients with chronic kidney disease. Am J Kidney Dis 2005; 45: 463-472.
  • 4. Excell L, McDonald S. New patients commencing treatment in 2003. ANZDATA Registry Report 2004 (27th Annual Report): 8-14. Available at: http://www.anzdata.org.au/anzdata/AnzdataReport/27thReport/files/Ch02NewPatients.pdf (accessed Jun 2005).
  • 5. Keith DS, Nichols DA, Gullion CM, et al. Longitudinal follow-up and outcomes among a population with chronic kidney disease in a large managed health care organization. Arch Intern Med 2004; 164: 659-663.
  • 6. Go AS, Chertow GM, Fan D, et al. Chronic kidney disease and the risks of death, cardiovascular events and hospitalization. N Eng J Med 2004; 351: 1296-1305.
  • 7. Johnson DW. Evidence-based guide to slowing the progression of early renal insufficiency. Intern Med J 2004; 34: 50-57.
  • 8. Akbari A, Swedko PJ, Clark HD, et al. Detection of chronic kidney disease with laboratory reporting of estimated glomerular filtration rate and an educational program. Arch Intern Med 2004; 164: 1788-1792.

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