From the Guidelines
A GFR of 52 mL/min/1.73m² indicates Stage 3a chronic kidney disease (CKD), and according to the Canadian Society of Nephrology commentary on the KDIGO clinical practice guideline for CKD evaluation and management 1, patients with this level of kidney function should have their eGFR determined when there is an important change in health status and when considering prescribing a medication affected by eGFR.
Key Management Strategies
- Controlling blood pressure is crucial, but the target blood pressure is not explicitly stated in the provided evidence, however, it is generally recommended to be less than 130/80 mmHg.
- Managing diabetes if present is important, but the target HbA1c level is not specified in the provided evidence.
- Following a kidney-friendly diet that limits sodium, potassium, and phosphorus is recommended, but specific details are not provided in the evidence.
- Avoiding nephrotoxic medications like NSAIDs (ibuprofen, naproxen) and certain antibiotics when possible is a general recommendation.
- Staying well-hydrated but avoiding excessive fluid intake is also important.
Monitoring and Follow-up
- The evidence suggests that for people with CKD but without diabetes, eGFR should be determined when there is an important change in health status and when considering prescribing a medication affected by eGFR, and that albuminuria be assessed initially and reassessed to assess the etiology of new edema and whenever knowledge of albuminuria will affect management 1.
- After the first 2 eGFR values have established the diagnosis of CKD and provided initial information about trajectory, eGFR should be reassessed at clinically relevant intervals, more often the lower the eGFR, the more rapid the decrease in eGFR, and the higher the albuminuria at baseline 1.
Lifestyle Modifications
- Regular exercise, weight management, smoking cessation, and limited alcohol consumption are important components of the treatment plan, but specific details are not provided in the evidence.
From the Research
GFR 52 Overview
- A GFR (Glomerular Filtration Rate) of 52 mL/min/1.73 m2 is considered to be a stage 3 chronic kidney disease (CKD) according to the National Kidney Foundation's guidelines 2.
- CKD is a common disorder that requires close collaboration between the primary care physician and nephrologist, with most aspects of early CKD managed in the primary care setting with nephrology input 3.
Management and Referral
- Optimal management of CKD includes cardiovascular risk reduction, treatment of albuminuria, avoidance of potential nephrotoxins, and adjustments to drug dosing 2.
- Patients with a GFR of 52 may not require immediate referral to a nephrologist, but should be closely monitored for complications of CKD, such as hyperkalemia, metabolic acidosis, and anemia 2, 3.
- The Kidney Failure Risk Equation (KFRE) is a novel tool that can guide wiser nephrology referrals and impact patients, taking into account the risk of CKD progression and cardiovascular complications 4.
Treatment and Medications
- ACE inhibitors and ARBs are commonly used to slow the progression of renal insufficiency and may be beneficial for patients with proteinuric kidney disease, especially in the early and middle stages of renal insufficiency 5.
- The use of ACE inhibitors and ARBs may also have a cardio-protective effect, reducing proteinuria and delaying progression of CKD 5.