What is the Chronic Kidney Disease (CKD) stage for a patient with an estimated Glomerular Filtration Rate (EGFR) of 69?

CKD Stage Classification for eGFR 69 mL/min/1.73 m²

An eGFR of 69 mL/min/1.73 m² corresponds to CKD Stage 2 (mildly decreased kidney function), but ONLY if there is evidence of kidney damage present for at least 3 months. 1, 2

Critical Diagnostic Requirement

• Stage 2 CKD requires BOTH eGFR 60-89 mL/min/1.73 m² AND evidence of kidney damage - the eGFR alone is insufficient for diagnosis 1, 3
• You must measure urinary albumin-to-creatinine ratio (UACR) immediately on a random spot urine sample to confirm kidney damage 1, 3
• If UACR is <30 mg/g with no other markers of kidney damage (hematuria, structural abnormalities on imaging, or pathologic findings), this patient does NOT have CKD despite the eGFR of 69 3

Confirming Chronicity

• Proof of chronicity requires abnormalities persisting for at least 3 months, which can be established by reviewing past eGFR measurements, past albuminuria measurements, imaging findings showing reduced kidney size or cortical thinning, or repeat measurements within and beyond the 3-month point 1
• Do not assume chronicity based on a single abnormal eGFR, as this could represent acute kidney injury or acute kidney disease 1

If CKD Stage 2 is Confirmed

• The patient has mildly decreased kidney function (eGFR 60-89 mL/min/1.73 m²) with evidence of kidney damage 2, 3
• Target blood pressure <130/80 mmHg, initiating antihypertensive therapy if BP ≥130/80 mmHg 3
• If UACR ≥30 mg/g and hypertension is present, initiate ACE inhibitor or ARB therapy 3
• Monitor eGFR and UACR at least annually, or every 6-12 months depending on albuminuria severity 3

Common Pitfall to Avoid

• The most critical error is diagnosing CKD based on eGFR alone - Stage 2 CKD absolutely requires documented kidney damage in addition to the mildly decreased eGFR 1, 3