According to the defining method suggested by K/DOQI working team of American
National Kidney Disease(NKF): Chronic Kidney Disease(CKD) means that there is
renal injury confirmed by renal biopsy or detective injury indicator, or means
that the duration time is no less than 3 months on the level of GFR is less than
60ml per minute in 1.73m². The renal injury indicators include proteinuria,
inspection abnormality in urinal test strip or urinary sediment or in kidney
imageology. GFR could be calculated according to the formula of body surface
area basing on serum creatinine and other variables such as age, gender, race,
etc.
The stages of Chronic Renal Insufficiency(CRI) in our country include the
following four phases, which is determined generally according to the standard
for evaluation established in a symposium on primary glomerulus disease
classification, treatment and assessment of its therapeutic effect, which is
held in Taiping City, Anhui province in June, 1992 by Kidney Disease Group of
Chinese Journal of Internal Medicine Editorial Committee:
Phase 1: Compensatory Stage of Chronic Renal Function(CRF)Insufficiency. When
the degree of damage to the nephron is no more than the normal 50%(
GFR50~80ml/min), there can’t go so far as to the appearance of metabolities
retentions such as Blood Urea Nitrogen(BUN) and so on as a result of the
compensation of renal function. Meanwhile, Serum Creatinine(Scr) could maintain
the normal level(133~177ummol/l,1.5~2.0mg/dl). Generally there are no symptoms
in clinical in this phase.
Phase 2: Decompensatory Stage of CRF Insufficiency: When the remaining renal
function is less than the normal 50%(GFR20~50ml/min) and Scr reaches the level
of 177~442umol/l(2~5mg/dl), and also, the rise of BUN exceeds
7.1mmol/l，(20mg/dl), such phase can see the general symptoms such as
hypodynamia, mild anemia and poor appetite, etc.
Phase 3: Stage of Renal Failure: Scr reaches up to 442~707ummol/l(5~8mg/dl),
Creatinine Clearance Rate(Ccr) decreases into 10~20ml/min, BUN rises up to
17.9~28.6mmol(50~80mg/dl). Such phase can see the severe anemia, metabolic
acidosis, metabolic disorder on Calcium and Phosphorus, metabolic disorder on
water and electrolyte, etc.
Phase 4: Stage of Uremia. Scr reaches over 707ummol/l(8mg/dl), Ccr decreases
below 10ml/min. NUN increases over 28.6mmol/l(80mg/dl). Such phase can see the
obvious symptom on acidosis as well as the severe symptoms on all
syImmunotherapys of the body.
NKF divides the CKD into five phases according to the GFR:
CKD Phase 1: Impair on kidney, and GRF is normal or increasing and lies less
than 90(ml/min/1.73m²)(Ellipsis in the below);
CKD Phase 2: Impair on kidney, GRF decreases slightly and lies between
between 60~80;
CKD Phase 3: GFR decreases moderately and lies between 30~59;
CKD Phase 4: GFR decreases moderately and lies between 15~29;
CKD Phase 5: Renal Failure, GFR decreases below 15 or to be dialyzed.
