Chronic Kidney Disease

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Author: Kelly Wilhelms, PhD, DABCC
Reviewers: Peter Platteborze, PhD, DABCC, FAACC; Alexandru Casapu, MBA, MLS(ASCP)CM, PBT(ASCP)CM

This course provides essential background on Chronic Kidney Disease (CKD) for the practicing clinical laboratorian. Emphasis is placed on the National Kidney Foundation-Kidney Disease Outcomes Quality Initiative (NKF-KDOQI) review and commentary of the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines, with focus on the laboratory testing associated with diagnosis and monitoring of the disease.

Continuing Education Credits

Objectives

  • Describe the frequency, risk factors, classification, and public health implications of chronic kidney disease (CKD)
  • Name and describe the use of common serum and urinary biomarkers used to diagnose and evaluate CKD
  • Describe the use and limitations of major calculations employed in estimating glomerular filtration rate (GFR)
  • List treatment options to control progression of CKD.

Course Outline

  • Chronic Kidney Disease
      • Introduction
      • Renal Anatomy & Function
      • The Nephron
      • Chronic Kidney Disease
      • Epidemiology
      • Risk Factors
      • Match the respective:
      • What disease or factor is the current leading cause of CKD worldwide?
      • According to 2012 KDIGO guidelines, CKD may be diagnosed if chronic abnormalities in kidney function are present for more than 3 months.
  • Laboratory Testing
      • Diagnostic Tests for Chronic Kidney Disease (CKD)
    • Glomerular Filtration Rate
      • Glomerular Filtration Rate
      • Direct Measurement of the GFR (1 of 2)
      • Direct Measurement of the GFR (2 of 2)
      • Calculated Estimates of GFR
      • Creatinine
      • Demographic Effects on Creatinine Generation
      • Effects of Age on GFR
      • Measurement of Creatinine
      • Measurement of Creatinine, continued
      • Creatinine Assay Standardization
      • Which of the following factors may influence creatinine concentration in individuals?
      • Which type of creatinine assay may exhibit interference in testing of patients with liver disease (increased bilirubin)?
      • Cystatin C
      • Creatinine Clearance
      • Cockcroft-Gault Equation
      • Modification of Diet in Renal Disease (MDRD) Equation
      • Chronic Kidney Disease - Epidemiology (CKD-EPI) Equation
      • eGFR in Children
      • Which eGFR equation is currently recommended for use by international experts?
    • Urine Albumin
      • Urine Albumin
      • Urine Albumin / Creatinine Ratio
      • Categories of Albuminuria
      • The term "microalbumin" is currently recommended for use to describe urine albumin.
      • Patients with a urine albumin/creatinine ratio < 30 mg/g are considered to have severe albuminuria.
    • Clinical Assessment and Treatment
      • Clinical Assessment of Risk
      • Treatment / Therapy
      • Summary
  • References
      • References

Additional Information

Level of Instruction:  Intermediate
 
Intended Audience: Medical laboratory scientists, medical technologists, and technicians. This course is also appropriate for medical laboratory science students and pathology residents.
 
Course Information: This course provides essential background on Chronic Kidney Disease (CKD) for the practicing clinical laboratorian. Emphasis is placed on the National Kidney Foundation-Kidney Disease Outcomes Quality Initiative (NKF-KDOQI) review and commentary of the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines, with focus on the laboratory testing associated with diagnosis and monitoring of the disease.
 
Author information: Kelly Wilhelms, PhD, DABCC has over 15 years of diverse clinical laboratory experience in hospital and reference laboratories, ranging from various levels of general management to CLIA Laboratory Director. He is a veteran of over 10 years in the United States Army as a Biochemistry Officer and currently holds a high level technical position at a major non-profit hospital system in the Southwestern US. Kelly holds a PhD in Toxicology from Iowa State University and is board certified by the American Board of Clinical Chemistry.
 
Reviewer Information: Peter Platteborze, PhD, DABCC, FAACC has over ten years of experience as a medical laboratory scientist, forensic toxicology expert witness and laboratory director. He served over 20 years in the Army as a biochemist. He is currently a Program Director and Assistant Professor at St. Mary's University in San Antonio, TX. He holds a BS degree in Biochemistry from the University of Tampa and a PhD in Biochemistry from the University of South Carolina.
 
Reviewer Information: Alexandru Casapu, MBA, MLS(ASCP)CM, PBT(ASCP)CM has over 20 years of experience as a medical laboratory scientist, section supervisor, and laboratory manager. He is the former Director of Clinical Laboratory Technology and Phlebotomy Programs at Georgia Piedmont Technical College. He is currently a Program Director at MediaLab, Inc. 

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