When it comes to chronic kidney disease (CKD), the grading system can feel confusing, especially when you see a term like "CKD Stage 2" associated with an estimated glomerular filtration rate (eGFR) of 60 or higher. Wait, isn't that normal kidney function? Let’s break down the history of CKD grading, clear up the confusion, and help you understand what it really means.
A Brief History of CKD Grading
The CKD grading system was first introduced by the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI) in 2002. Its purpose was simple: provide a framework for diagnosing and managing kidney disease. The system divides CKD into five stages based on eGFR, which estimates how well your kidneys filter waste from your blood.
Here’s a quick refresher:
Stage 1: eGFR ≥90 with signs of kidney damage
Stage 2: eGFR 60–89 with signs of kidney damage
Stage 3: eGFR 30–59
Stage 4: eGFR 15–29
Stage 5: eGFR <15 (kidney failure)
Notice something? Stage 2 includes eGFR values that fall within the normal range. So, why does it get labeled as CKD?
The Key Factor: Kidney Damage, Not Just eGFR
An eGFR of 60–89 is not a standalone diagnosis of CKD. For Stage 2 CKD to apply, there must also be evidence of kidney damage. This could mean the presence of protein in the urine (proteinuria), blood in the urine (hematuria), or imaging abnormalities suggesting structural kidney issues.
If you have an eGFR of 60 or higher and no signs of kidney damage, congratulations—your kidneys are functioning normally! The CKD Stage 2 label doesn’t apply in this case.
Why the System Can Be Misleading
The inclusion of eGFR 60–89 in CKD Stage 2 has caused unnecessary worry for many patients. This overlap exists because the CKD system was designed to identify at-risk populations. It emphasizes early detection of kidney damage, even when kidney function (eGFR) remains in the normal range.
Context Matters
eGFR naturally declines with age—this is part of the normal aging process, not necessarily a sign of disease. For example, an eGFR of 65 in a 70-year-old might be perfectly normal, whereas the same value in a young adult could prompt further investigation.
Takeaway
If your eGFR is 60 or higher and there are no other signs of kidney damage, you do not have chronic kidney disease. Understanding this context can save you unnecessary anxiety and lead to better conversations with your healthcare provider.
At Access Urology, we’re here to demystify medical jargon and empower you with accurate, actionable information. If you have questions about your kidney health, don’t hesitate to reach out—we’ve got your back!
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