GFR 57 Indicates Stage 3a Chronic Kidney Disease
A GFR of 57 mL/min/1.73 m² corresponds to Stage 3a Chronic Kidney Disease (CKD). 1
CKD Staging Based on GFR
According to the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (KDOQI) classification system, CKD is staged primarily based on glomerular filtration rate (GFR):
| Stage | GFR (mL/min/1.73 m²) | Description |
|---|---|---|
| G1 | ≥90 | Normal or high kidney function with evidence of kidney damage |
| G2 | 60-89 | Mildly decreased kidney function with evidence of kidney damage |
| G3a | 45-59 | Mildly to moderately decreased kidney function |
| G3b | 30-44 | Moderately to severely decreased kidney function |
| G4 | 15-29 | Severely decreased kidney function |
| G5 | <15 | Kidney failure |
With a GFR of 57 mL/min/1.73 m², this falls within the range of 45-59 mL/min/1.73 m², which defines Stage 3a CKD 1.
Clinical Implications of Stage 3a CKD
Stage 3a CKD represents a clinically significant reduction in kidney function that warrants attention:
- It indicates loss of approximately half of normal adult kidney function 1
- At this stage, the risk of complications begins to increase 1
- Cardiovascular risk is significantly elevated compared to those with normal kidney function 2
Important Considerations
- For definitive CKD diagnosis, this reduced GFR should be present for at least 3 months 1, 3
- According to KDIGO guidelines, patients with GFR between 45-59 mL/min/1.73 m² without other markers of kidney damage may benefit from confirmation with cystatin C measurement 1
- Albuminuria assessment is essential for comprehensive risk stratification, as it provides additional prognostic information beyond GFR alone 1
Management Implications
At Stage 3a CKD:
- Regular monitoring of kidney function is recommended
- Cardiovascular risk assessment and management become priorities as patients with CKD have a higher risk of dying from cardiovascular disease than progressing to kidney failure 2
- Medication review is important as some drugs may require dose adjustment or avoidance 1
- Blood pressure control and management of other modifiable risk factors become increasingly important
Potential Pitfalls
- A single GFR measurement of 57 mL/min/1.73 m² is insufficient for CKD diagnosis; confirmation with repeat testing over at least 3 months is required 1
- Age-related decline in GFR should be considered, but a GFR <60 mL/min/1.73 m² is still considered abnormal regardless of age 1
- Variability in GFR measurements can be an independent risk factor for mortality in Stage 3 CKD patients 4, highlighting the importance of trend monitoring rather than relying on a single value
Understanding this staging helps guide appropriate monitoring and management strategies to slow progression and reduce associated complications.