The concept of chronic kidney disease and chronic renal insufficiency installments

According to the American Kidney Disease Foundation (NKF) definition method K / DOQI Working Group: Chronic kidney disease is detected through biopsy or injury markers of kidney damage or confirmed glomerular filtration rate (GFR) sustained <60ml / min/1.73m ² ≥ 3 months. Markers of kidney damage include proteinuria, urine test strip or urinary sediment abnormalities or renal imaging abnormalities. GFR can be calculated by serum creatinine and based on a number of other variables including age, gender, race, and body surface area formula.
Phase I: chronic renal insufficiency compensatory deadline: when impaired renal units do not exceed the normal 50% (GFR50 ~ 80ml/min) renal decompensation and can not appear due to urea nitrogen (BUN) and other metabolites retention, serum creatinine (Scr) to maintain normal levels (serum creatinine 133 ~ 177ummol / l, 1.5 ~ 2.0mg/dl), usually clinically asymptomatic.
Phase II: chronic renal failure decompensation: nephron impaired renal function remaining below the normal 50% (GFR20 ~ 50ml/min) serum creatinine of 177 ~ 442umol / l (2 ~ 5mg/dl), urea nitrogen, increased by more than 7.1mmol / l, (20mg/dl), clinical fatigue, mild anemia, loss of appetite and other symptoms.
Phase III: renal failure: serum creatinine of 442 ~ 707ummol / l (5 ~ 8mg/dl), creatinine clearance rate dropped to 10 ~ 20ml/min, urea nitrogen increased to 17.9 ~ 28.6mmol (50 ~ 80mg/dl ). Patients with severe anemia, metabolic acidosis, calcium and phosphorus metabolism, water and electrolyte metabolism disorders.
Phase IV: uremia: serum creatinine of 707ummol / l (8mg/dl) above, at 10ml/min creatinine clearance less urea nitrogen 28.6mmol / l (80mg/dl) above, acidosis symptoms, systemic Each system symptoms are severe.
American Kidney Disease Foundation glomerular filtration rate is usually based on the chronic kidney disease is divided into five:
CKD1 period: renal impairment, GFR normal or elevated, GFR ≥ 90 (ml/min/1.73m ²) (hereinafter province);
CKD2 period: renal impairment, GFR decreased slightly, GFR 60 to 80;
CKD3 period: GFR moderate decline, GFR is located 30 to 59;
CKD4 period: GFR moderate decline, GFR 15 to 29;

CKD5 period: renal failure, GFR <15 or dialysis