From the Guidelines
A patient with a Glomerular Filtration Rate (GFR) of 40 mL/min/1.73m² has Stage 3B Chronic Kidney Disease. This classification is based on the definition and classification of CKD stages, where Stage 3 CKD is defined as a GFR of 30-59 mL/min/1.73m², with Stage 3B specifically referring to a GFR of 30-44 mL/min/1.73m² 1. The management of Stage 3B CKD involves:
- Regular monitoring of kidney function every 3-6 months
- Blood pressure control
- Management of complications like anemia, bone disease, and cardiovascular risk factors
- Medication adjustments as necessary, considering that many drugs are cleared by the kidneys
- Nephrology referral to help manage the condition and slow progression
- Lifestyle modifications, including:
- Sodium restriction (less than 2 grams daily)
- Maintaining adequate hydration
- Avoiding nephrotoxic medications (like NSAIDs)
- Controlling diabetes and hypertension if present These measures are crucial for slowing the progression of CKD and reducing the risk of adverse outcomes, as emphasized by the National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification 1.
From the Research
CKD Stage for GFR of 40
- A Glomerular Filtration Rate (GFR) of 40 falls into the category of stage 3 Chronic Kidney Disease (CKD) 2, 3.
- Stage 3 CKD is further subdivided into two subgroups: stage 3A (eGFR 45-59 ml/min/1.73 m2) and stage 3B (eGFR 30-44 ml/min/1.73 m2) 3.
- A GFR of 40 would be classified as stage 3B CKD, which is associated with a higher risk of adverse renal and cardiovascular outcomes compared to stage 3A CKD 3.
- The progression of CKD can be influenced by various factors, including the degree of albuminuria, stage 3 subgroup, and microscopic hematuria 3.
- Early intervention and management of CKD can help slow disease progression, and a recorded diagnosis of stage 3 CKD is associated with significant improvements in CKD management and monitoring practices, as well as attenuated eGFR decline 4.