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Dtsch Med Wochenschr 2025; 150(03): 77-82
DOI: 10.1055/a-2265-9422
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Chronische Nierenkrankheiten: Epidemiologie, Bedeutung für die Praxis und Formeln zur Diagnose

Chronic Kidney Disease: epidemiology, implications for clinical practice and equations for diagnosis
Elke Schaeffner
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Die chronische Nierenerkrankung gehört zu den häufigsten chronischen Erkrankungen. Die Diagnose hat auch in Bezug auf die Patientenprognose große Bedeutung. Und neben der Schätzung der glomerulären Filtrationsrate ist die Bestimmung der Albuminurie ein wichtiges prädikatives Werkzeug. Sich an der KDIGO-Leitlinie orientierend, werden diagnostische Formeln zur Schätzung der Nierenfunktion und Formeln zur individuellen Risikoabschätzung eines Nierenversagens werden diskutiert [1].

Abstract

The article is based, among other things, on the updated KDIGO guideline for the evaluation and management of chronic kidney disease, which was published in Kidney International in March 2024. Chronic kidney disease is one of the most common chronic diseases, with a prevalence of around 10%, not least due to demographic ageing. The incidence of chronic kidney disease is approximately twice that of diabetes and approximately 20 times higher than that of cancer. Chronic kidney disease is classified using glomerular filtration rate and albuminuria. The definition of CKD may also include markers other than GFR and ACR. Patients with diabetes or hypertension should have GFR and ACR tested regularly. The individual risk of kidney failure requiring dialysis can be determined using a prediction equation. A better understanding of age- and gender-specific differences means that personalized therapy approaches are becoming increasingly important. Clinicians should be aware of the limitations of the endogenous biomarkers creatinine and cystatin C for determining GFR. For Germany, the equations of the European Kidney Function Consortium (EKFC) are recommended for estimating GFR.

Kernaussagen

  • Die Häufigkeit chronischer Nierenerkrankungen ist ca. doppelt so hoch wie die für Diabetes und ca. 20-mal höher als die für Krebs.

  • Die chronische Nierenerkrankung wird mithilfe der glomerulären Filtrationsrate und der Albuminurie klassifiziert.

  • Die Definition von CKD kann auch andere Marker als GFR und ACR beinhalten.

  • Bei Patienten mit Diabetes oder Bluthochdruck sollten regelmäßig GFR und ACR getestet werden.

  • Das individuelle Risiko für ein dialysepflichtiges Nierenversagen kann mittels Prädiktionsgleichung bestimmt werden.

  • Ein besseres Verständnis für alters- und geschlechtsspezifische Unterschiede lässt personalisierte Therapieansätze immer wichtiger werden.

  • Kliniker sollten sich über die Limitationen der endogenen Biomarker Kreatinin und Cystatin C zur Bestimmung der GFR bewusst sein.

  • Für Deutschland werden für die Schätzung der GFR die Gleichungen des European Kidney Function Consortiums (EKFC) empfohlen.

Schlüsselwörter

chronische Nierenkrankheit - Klassifikation - Prädiktion - glomeruläre Filtrationsrate - Schätzformel

Keywords

chronic kidney disease - classification - prediction - glomerular filtration rate - estimation equation


Publication History

Article published online:
14 January 2025

© 2025. Thieme. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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