Chronic Kidney Disease: Evaluation of Renal Function, Albuminuria Categories, and the Risk Assessment of Kidney Failure ( Literature review)

Chronic kidney disease (CKD) is a global public health problem associated with excessive morbidity, mortality, and healthcare costs. The prevalence of CKD is steadily increasing as the population ages and the major risk factors – arterial hypertension (AH), diabetes mellitus (DM), obesity and cardiovascular disease (CVD) - continue to rise progressively. Preventing the development of CKD and its progression to the end-stage disease is of paramount importance. Albuminuria and GFR remain the main indicators of kidney function in this year’s Guidelines of the Kidney Disease: Improving Global Outcomes (KDIGO) Initiative. To determine the estimated GFR (eGFR), the KDIGO 2024 Guidelines for the Evaluation and Management of CKD suggest the use of validated equations - the CKD-EPI creatinine equation (2009), the CKD-EPI creatinine equation (2021), the CKD-EPI creatinine-cystatin C equation (2021), the EKFC equation, and others. For initial testing of albuminuria, the use of the albumin/creatinine ratio (ACR) in urine or a reagent strip urinalysis for albumin and ACR with automated reading is suggested in adults and children. In all cases, a first void in the morning midstream sample is preferred in adults and children. For physicians, the GFR calculators, the calculator of CKD risk in children, and the kidney failure risk equation, including versions for iPhones and iPads, are suggested. Evaluation of eGFR and albuminuria categories are integral components of screening, diagnosis, evaluation of the effectiveness of kidney protection measures, kidney failure risk prediction in patients with CKD, and monitoring of drug nephrotoxicity. The practical implementation of the new KDIGO 2024 Guidelines for the Evaluation and Management of CKD with the use of validated GFR calculation equations, recommendations for the assessment of albuminuria categories, and new advanced devices for creatinine/eGFR measurement facilitates the screening of kidney function and promotes the practice of early detection of CKD.