KDOQI and KDIGO Issue Joint Position Statement on CKD Classification

(New York, NY) – May 5, 2009 – The KDOQI definitions of CKD and its stages, having been globally adopted over the past seven years, should be reexamined using outcomes data from patients with CKD. Defining the prognosis of patients with chronic kidney disease (CKD) is the critical next step in determining the validity of the current CKD classification system, according to the KDOQI and KDIGO leadership.

The National Kidney Foundation’s Kidney Disease Outcomes Quality Initiative (KDOQI™) and the global non-profit foundation, Kidney Disease: Improving Global Outcomes (KDIGO®) released a joint position statement in the June issue of the American Journal of Kidney Diseases.The statement reviews the ongoing debate about how and whether to modify the current CKD definition and classification and proposes a structured review of recent data to resolve controversy.

KDOQI’s Clinical Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification, and Stratification established terminology which was adopted throughout the world and provided a new conceptual framework for diagnosis and classification of CKD based upon markers of damage and estimated glomerular filtration rate (GFR). The 2002 guideline heightened global awareness of CKD as a public health problem, spawned new research, and expanded the CKD database.

“We have witnessed an exponential increase in the amount of research performed on non-dialysis CKD patients, resulting in an upsurge in comparative studies in the common definition of CKD,” said Dr. Michael Rocco, a nephrologists at Wake Forest University School of Medicine in Winston-Salem, North Carolina and chair of KDOQI.

“KDIGO believes that re-examining the outcomes of CKD patients is necessary and represents the appropriate strategy to test the validity of the current system,” said Dr. Kai-Uwe Eckardt of the University Clinic Erlangen in Germany. “Although the current CKD system was created by KDOQI in the United States, the KDIGO leadership has chosen to host the conference as these issues should be addressed by an international clinical practice guideline group.”

A KDIGO Controversies Conference will be held in October 2009 to facilitate a review of the current CKD staging system and a thorough analysis of the prognosis of patients fulfilling criteria for CKD. The purpose of the conference is to address five topics:

  • What are the key outcomes of CKD?
  • What progress has been made in CKD testing (eGFR and albuminuria)?
  • What are the key factors determining prognosis (eGFR, albuminuria, others)?
  • Should the current CKD classification (based on eGFR) be modified to include additional factors associated with prognosis?
  • Should the current CKD definition be modified?

“The results of the conference will be summarized, and publication of a conference report, together with technical reports concerning the analysis is presented, is being planned. Following the conference KDIGO will appoint a workgroup to develop a revised global guideline on the definition, staging and management of CKD,” continued Dr. Eckardt. “The update process is a vital part of both KDOQI and KDIGO and is designed to determine if current guideline statements are still supported by current literature and if recommendations need to be added or revised.”

About the National Kidney Foundation
The National Kidney Foundation is dedicated to preventing kidney and urinary tract diseases, improving the health and well being of individuals and families affected by these diseases, influencing public policy in support of the kidney community and increasing the availability of all organs for transplantation. For more information visit www.kidney.org

About KDOQI
The Kidney Disease Outcomes Quality Initiative or (NKF KDOQI)™ provides evidence-based clinical practice guidelines developed by volunteer physicians and health care providers for all stages of chronic kidney disease and related complications, from diagnosis to monitoring and management. For more information visit www.kdoqi.org

About KDIGO
KDIGO, a global non-profit foundation managed by the National Kidney Foundation, is dedicated to improving the care and outcomes of kidney disease patients worldwide through promoting coordination, collaboration, and integration of initiatives to develop and implement clinical practices guidelines. For more information visit www.kdigo.org