Chronic kidney disease 10 years on

Abstract

The aim is to review in broad terms the rapid growth in knowledge and understanding of chronic kidney disease in the key areas of epidemiology, diagnosis and risk prediction in the 10 years since publication of the first formal definition and classification. Epidemiological studies that utilized the MDRD equation to estimate glomerular filtration rate (GFR) identified that chronic kidney disease (CKD) was more prevalent than previously appreciated. Considerable effort has been invested in developing more accurate formulae to estimate GFR from serum creatinine and/or cystatin C. There is a growing appreciation of the increased risk of cardiovascular disease and death associated with even small reductions in GFR or mild albuminuria. Risk prediction equations have been developed to assess risk of progression of CKD but these require further validation, and equations to predict the cardiovascular risk associated with CKD are urgently required. The first 10 years of 'CKD' have been characterized by an unprecedented growth in knowledge and understanding but over the next decade efforts should focus on translating this enhanced knowledge into improved outcomes for the many people now living with this diagnosis.