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A 65-year old man with a history of gouty arthritis and long-standing hypertension presents to clinic with a painful right great toe.You prescribe him a short course of steroids and initiate allopurinol for his gout flare.
His labs demonstrate that his e GFR is stable at 35 m L/min/1.73 m A 44-year old woman has a history of chronic back pain for which she regularly takes non-steroidal anti-inflammatory drugs.
Unfortunately as a result, she has developed chronic kidney disease.
Her e GFR remains stable at 92 ml/min/1.73 m, and her ACR remains elevated at 416 mg/g despite ACE-inhibitor therapy.
Based on the “CKD Risk Map,” you know that: 1) her CKD can be classified as G1/A3; 2) her risk of progressing to kidney failure is high; 3) referral to a nephrologist is recommended; and 4) she should be monitored at least twice per year.
His labs results from that visit showed that his e GFR and ACR remained stable at 18 ml/min/1.73 m and 25 mg/g, respectively.
Based on the “CKD Risk Map,” you know that: 1) his CKD can be classified as G4/A1; 2) his risk of progression is very high; 3) referral to a nephrologist is recommended; and 4) he should be monitored at least three times per year.
The grid below is a “Risk Map” for chronic kidney disease (CKD) that reflects prognosis, recommended frequency of monitoring, and indications for nephrology referral.
To see case studies, click on a colored box in the grid below.
A 44-year old woman with autosomal dominant polycystic kidney disease presents to your clinic for routine follow-up.
Since her last follow-up six months ago, she has had some back discomfort. Her e GFR has remained stable at 110 ml/min/1.73 m, and her ACR shows 20 mg/g of albuminuria.