- To have a more precise picture of each patient’s condition
- To guide decisions for testing and treatment
- Because neither the category of GFR nor the category of albuminuria alone can fully capture prognosis of CKD
- To evaluate patient’s risk of progression and complications
- Recognize that small fluctuations in GFR are common and are not necessarily indicative of progression
- Understand that prognosis will vary depending on:
- Cause
- GFR
- Degree of albuminuria; and
- Other comorbid conditions
| Examples of CGA Staging | |||
|---|---|---|---|
| Cause | GFR category | Albuminuria category | Criterion for CKD |
| Diabetic kidney disease | G5 | A3 | Decreased GFR, Albuminuria |
| Idiopathic focal sclerosis | G2 | A3 | Albuminuria |
| Kidney transplant recipient | G2 | A1 | History of kidney transplantation |
| Polycystic kidney disease | G2 | A1 | Imaging abnormality |
| Vesicoureteral reflex | G1 | A1 | Imaging abnormality |
| Distal renal tubular acidosis | G1 | A1 | Electrolyte abnormalities |
| Hypertensive kidney disease | G4 | A2 | Decreased GFR, Albuminuria |
| CKD presumed due to diabetes and hypertension | G4 | A1 | Decreased GFR |
| CKD presumed due to diabetes and hypertension | G2 | A3 | Albuminuria |
| CKD presumed due to diabetes and hypertension | G3a | A1 | Decreased GFR |
| CKD cause unknown | G3a | A1 | Decreased GFR |
| Abbreviations: CGA, Cause, GFR category and albuminuria category; CKD, chronic kidney disease; GFR, glomerular filtration rate. Note: Patients above the thick horizontal line are likely to be encountered in nephrology practice. Patients below the thick horizontal line are likely to be encountered in primary care practice and in nephrology practice. | |||