[International guidelines for the assessment of chronic kidney disease].

Abstract

The new KDIGO («Kidney Disease Improving Global Outcomes») 2024 guidelines on chronic kidney disease (CKD) provide significant updates. They reaffirm the importance of the glomerular filtration rate (GFR) and of the urine albumin-to-creatinine ratio (ACR) for diagnosing and classifying CKD. CKD is defined by a GFR < 60 mL/min/1.73 m² and/or ACR > 30 mg/g and/or persistent renal abnormalities for at least three months. The main innovation is the preferential use of equations combining creatinine and cystatin C to estimate GFR, although cystatin C assay may not always be available or reimbursed. The guidelines also recommend the EKFC («European Kidney Function Consortium») equations, particularly suited to Europe and applicable to all age groups. ACR remains a key indicator for assessing the risk of CKD progression and the response to nephroprotective treatments. The use of the «Kidney Failure Risk Equation» is encouraged to estimate the risk of kidney failure and guide clinical decisions.