Table 1 Computable criteria for indications for nephrology referral in the KDIGO 2012 CKD guidelines
From: Evaluating the feasibility of the KDIGO CKD referral recommendations
Diagnosis | Scenario | Criteria used to identify patients |
|---|---|---|
Acute Kidney Injury | 1 | Creatinine rises by 0.3 mg/dL on most recent lab as compared to prior lab checks within last 48 h |
2 | Creatinine has risen by at least 1.5 times within past 7 days | |
3 | Estimated GFR is 50% lower as compared to the baseline eGFR, with baseline eGFR defined as the highest eGFR from the past 6 months (“abrupt sustained fall in GFR”) | |
Late Stable Chronic Kidney Disease | 4 | Recent eGFR and eGFR prior to 3 months ago are both <30 ml/min/1.73m2 |
5 | Recent eGFR and eGFR prior to 3 months ago are both <15 ml/min/1.73m2 | |
Albuminuria | 6 | Urine microalbumin/creatinine >300 μg/mg on last two consecutive checks at least 24 h apart |
Chronic Kidney Disease Progression | 7 | eGFR drop from ≥90 (CKD stage 1) to <89 ml/min/1.73m2 (CKD stage 2), accompanied by a 25% drop in eGFR on most recent lab as compared to baseline, with baseline eGFR defined as the highest eGFR from the past year |
8 | eGFR drop from 60 to 89 (CKD stage 2) to <59 ml/min/1.73m2 (CKD stage ≥3a), accompanied by a 25% drop in eGFR on most recent lab as compared to baseline, with baseline eGFR defined as the highest eGFR from the past year | |
9 | eGFR drop from 45 to 59 (CKD stage 3a) to <45 ml/min/1.73m2 (CKD stage ≥3b), accompanied by a 25% drop in eGFR on most recent lab as compared to baseline, with baseline eGFR defined as the highest eGFR from the past year | |
10 | eGFR drop from 30 to 44 (CKD stage 3b) to <30 ml/min/1.73m2 (CKD stage ≥4), accompanied by a 25% drop in eGFR on most recent lab as compared to baseline, with baseline eGFR defined as the highest eGFR from the past year | |
11 | eGFR drop from 15 to 29 (CKD stage 4) to <15 ml/min/1.73m2 (CKD stage 5), accompanied by a 25% drop in eGFR on most recent lab as compared to baseline, with baseline eGFR defined as the highest eGFR from the past year | |
High Annual GFR Decline | 12 | Mean eGFR drops ≥5 ml/min/1.73m2 per year, where the current year’s eGFR is defined by the mean eGFR for the last 365 days and the prior year’s eGFR is defined by the mean eGFR between 366 and 730 days ago |