Chronic renal failure definition

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


Chronic kidney disease (CKD) defines a broad spectrum of disorders that disturb the structural or functional integrity of the kidney. Given the variety of underlying etiologies, varying severity, and different rates of progression the term only loosely outlines a very complex group of diseases. In 2000, a new definition of chronic kidney disease was introduced that ushered a shift from considering the disease an end-stage life threatening entity to a more prevalent entity of variable stages requiring early detection and preventative measures, in addition to management. [1] CKD was defined as: [2]

  1. Kidney damage for ≥3 months as defined by structural or functional abnormalities of the kidney, with or without decreased GFR, manifest by either:
* Pathological abnormalities
* Markers of kidney damage including abnormalities in the composition of the blood or urine or imaging abnormalities
  1. GFR <60 mL/min/1.73 m2 for ≥3 months with or without kidney damage

The KDOQI work group also recognized persons with a GFR between 60 to 89 mL/min/1.73 m2 without any evidence of kidney damage as having decreased GFR with several possible etiologies: [2]

  • Age (infants and older adults)
  • Vegetarian diet
  • Unilateral nephrectomy
  • Extracellular volume depletion
  • Reduced kidney perfusion (heart failure and cirrhosis)


  1. Levey AS, Coresh J (2012). "Chronic kidney disease". Lancet. 379 (9811): 165–80. doi:10.1016/S0140-6736(11)60178-5. PMID 21840587.
  2. 2.0 2.1 Levey AS, Coresh J, Balk E, Kausz AT, Levin A, Steffes MW; et al. (2003). "National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification". Ann Intern Med. 139 (2): 137–47. PMID 12859163.

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