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Stage 4 chronic kidney disease

MedGen UID:
389224
•Concept ID:
C2317473
•
Disease or Syndrome
Synonyms: Chronic kidney disease stage 4; Chronic Kidney Disease, Stage 4; CKD stage 4; Severe Kidney Disease; Severe Renal Disease
SNOMED CT: Chronic kidney disease stage 4 (431857002); CKD stage 4 (431857002)
 
HPO: HP:0012626

Definition

A type of chronic kidney disease with severely reduced glomerular filtration rate (GFR 15-29 mL/min/1.73 m2). [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVStage 4 chronic kidney disease

Conditions with this feature

Familial juvenile hyperuricemic nephropathy type 1
MedGen UID:
1645893
•Concept ID:
C4551496
•
Disease or Syndrome
Autosomal dominant tubulointerstitial kidney disease – UMOD (ADTKD-UMOD) is characterized by normal urinalysis and slowly progressive chronic kidney disease (CKD), usually first noted in the teen years and progressing to end-stage renal disease (ESRD) between the third and seventh decades. Hyperuricemia is often present from an early age, and gout (resulting from reduced kidney excretion of uric acid) occurs in the teenage years in about 8% of affected individuals and develops in 55% of affected individuals over time.
See: Condition Record
Familial juvenile hyperuricemic nephropathy type 1

Professional guidelines

PubMed

Heart Failure Outcomes With Volume-Guided Management.
Strobeck JE, Feldschuh J, Miller WL
JACC Heart Fail 2018 Nov;6(11):940-948. Epub 2018 Oct 10 doi: 10.1016/j.jchf.2018.06.017. PMID: 30316941
Management of hepatitis C viral infection in chronic kidney disease patients on hemodialysis in the era of direct-acting antivirals.
Ko SY, Choe WH
Clin Mol Hepatol 2018 Dec;24(4):351-357. Epub 2018 Mar 16 doi: 10.3350/cmh.2017.0063. PMID: 29544240Free PMC Article
New treatment for hepatitis C in chronic kidney disease, dialysis, and transplant.
Fabrizi F, Martin P, Messa P
Kidney Int 2016 May;89(5):988-994. Epub 2016 Mar 11 doi: 10.1016/j.kint.2016.01.011. PMID: 27083277

Curated

UK NICE Guideline NG203, Chronic kidney disease: assessment and management, 2021

Recent clinical studies

Etiology

Chlorthalidone for Hypertension in Advanced Chronic Kidney Disease.
Agarwal R, Sinha AD, Cramer AE, Balmes-Fenwick M, Dickinson JH, Ouyang F, Tu W
N Engl J Med 2021 Dec 30;385(27):2507-2519. Epub 2021 Nov 5 doi: 10.1056/NEJMoa2110730. PMID: 34739197Free PMC Article
Vascular calcification progression in patients with end-stage chronic kidney disease.
San Norberto EM, Revilla Á, Fernández-Urbón A, Gómez-Giralda B, Taylor JH, Vaquero C
Int Angiol 2021 Dec;40(6):528-536. Epub 2021 Sep 13 doi: 10.23736/S0392-9590.21.04698-8. PMID: 34515450
Effects of Dapagliflozin in Stage 4 Chronic Kidney Disease.
Chertow GM, Vart P, Jongs N, Toto RD, Gorriz JL, Hou FF, McMurray JJV, Correa-Rotter R, Rossing P, Sjöström CD, Stefánsson BV, Langkilde AM, Wheeler DC, Heerspink HJL; DAPA-CKD Trial Committees and Investigators
J Am Soc Nephrol 2021 Sep;32(9):2352-2361. Epub 2021 Jul 16 doi: 10.1681/ASN.2021020167. PMID: 34272327Free PMC Article
Chronic Kidney Disease and Related Long-Term Complications After Liver Transplantation.
Sharma P, Bari K
Adv Chronic Kidney Dis 2015 Sep;22(5):404-11. doi: 10.1053/j.ackd.2015.06.001. PMID: 26311603Free PMC Article
The kidney and bisphosphonates.
Miller PD
Bone 2011 Jul;49(1):77-81. Epub 2011 Jan 11 doi: 10.1016/j.bone.2010.12.024. PMID: 21232648

Diagnosis

Insulinoma mimic: methadone-induced hypoglycaemia.
Kanbour S, Balaji A, Chae K, Mathioudakis N
BMJ Case Rep 2022 Jul 26;15(7) doi: 10.1136/bcr-2021-245890. PMID: 35882435Free PMC Article
Vascular calcification progression in patients with end-stage chronic kidney disease.
San Norberto EM, Revilla Á, Fernández-Urbón A, Gómez-Giralda B, Taylor JH, Vaquero C
Int Angiol 2021 Dec;40(6):528-536. Epub 2021 Sep 13 doi: 10.23736/S0392-9590.21.04698-8. PMID: 34515450
Effects of Dapagliflozin in Stage 4 Chronic Kidney Disease.
Chertow GM, Vart P, Jongs N, Toto RD, Gorriz JL, Hou FF, McMurray JJV, Correa-Rotter R, Rossing P, Sjöström CD, Stefánsson BV, Langkilde AM, Wheeler DC, Heerspink HJL; DAPA-CKD Trial Committees and Investigators
J Am Soc Nephrol 2021 Sep;32(9):2352-2361. Epub 2021 Jul 16 doi: 10.1681/ASN.2021020167. PMID: 34272327Free PMC Article
Chronic Kidney Disease and Related Long-Term Complications After Liver Transplantation.
Sharma P, Bari K
Adv Chronic Kidney Dis 2015 Sep;22(5):404-11. doi: 10.1053/j.ackd.2015.06.001. PMID: 26311603Free PMC Article
The kidney and bisphosphonates.
Miller PD
Bone 2011 Jul;49(1):77-81. Epub 2011 Jan 11 doi: 10.1016/j.bone.2010.12.024. PMID: 21232648

Therapy

Insulinoma mimic: methadone-induced hypoglycaemia.
Kanbour S, Balaji A, Chae K, Mathioudakis N
BMJ Case Rep 2022 Jul 26;15(7) doi: 10.1136/bcr-2021-245890. PMID: 35882435Free PMC Article
Chlorthalidone for Hypertension in Advanced Chronic Kidney Disease.
Agarwal R, Sinha AD, Cramer AE, Balmes-Fenwick M, Dickinson JH, Ouyang F, Tu W
N Engl J Med 2021 Dec 30;385(27):2507-2519. Epub 2021 Nov 5 doi: 10.1056/NEJMoa2110730. PMID: 34739197Free PMC Article
Effects of Dapagliflozin in Stage 4 Chronic Kidney Disease.
Chertow GM, Vart P, Jongs N, Toto RD, Gorriz JL, Hou FF, McMurray JJV, Correa-Rotter R, Rossing P, Sjöström CD, Stefánsson BV, Langkilde AM, Wheeler DC, Heerspink HJL; DAPA-CKD Trial Committees and Investigators
J Am Soc Nephrol 2021 Sep;32(9):2352-2361. Epub 2021 Jul 16 doi: 10.1681/ASN.2021020167. PMID: 34272327Free PMC Article
Chronic Kidney Disease and Related Long-Term Complications After Liver Transplantation.
Sharma P, Bari K
Adv Chronic Kidney Dis 2015 Sep;22(5):404-11. doi: 10.1053/j.ackd.2015.06.001. PMID: 26311603Free PMC Article
The kidney and bisphosphonates.
Miller PD
Bone 2011 Jul;49(1):77-81. Epub 2011 Jan 11 doi: 10.1016/j.bone.2010.12.024. PMID: 21232648

Prognosis

The ICD-9 to ICD-10 transition has not improved identification of rapidly progressing stage 3 and stage 4 chronic kidney disease patients: a diagnostic test study.
Jalal K, Charest A, Wu X, Quigg RJ, Chang S
BMC Nephrol 2024 Feb 14;25(1):55. doi: 10.1186/s12882-024-03478-1. PMID: 38355500Free PMC Article
Insulinoma mimic: methadone-induced hypoglycaemia.
Kanbour S, Balaji A, Chae K, Mathioudakis N
BMJ Case Rep 2022 Jul 26;15(7) doi: 10.1136/bcr-2021-245890. PMID: 35882435Free PMC Article
Vascular calcification progression in patients with end-stage chronic kidney disease.
San Norberto EM, Revilla Á, Fernández-Urbón A, Gómez-Giralda B, Taylor JH, Vaquero C
Int Angiol 2021 Dec;40(6):528-536. Epub 2021 Sep 13 doi: 10.23736/S0392-9590.21.04698-8. PMID: 34515450
Thromboembolism and bleeding in patients with atrial fibrillation and stage 4 chronic kidney disease: impact of biomarkers.
Matusik PT, Leśniak WJ, Heleniak Z, Undas A
Kardiol Pol 2021;79(10):1086-1092. Epub 2021 Aug 15 doi: 10.33963/KP.a2021.0088. PMID: 34392517
Chronic Kidney Disease and Related Long-Term Complications After Liver Transplantation.
Sharma P, Bari K
Adv Chronic Kidney Dis 2015 Sep;22(5):404-11. doi: 10.1053/j.ackd.2015.06.001. PMID: 26311603Free PMC Article

Clinical prediction guides

Vascular calcification progression in patients with end-stage chronic kidney disease.
San Norberto EM, Revilla Á, Fernández-Urbón A, Gómez-Giralda B, Taylor JH, Vaquero C
Int Angiol 2021 Dec;40(6):528-536. Epub 2021 Sep 13 doi: 10.23736/S0392-9590.21.04698-8. PMID: 34515450
Thromboembolism and bleeding in patients with atrial fibrillation and stage 4 chronic kidney disease: impact of biomarkers.
Matusik PT, Leśniak WJ, Heleniak Z, Undas A
Kardiol Pol 2021;79(10):1086-1092. Epub 2021 Aug 15 doi: 10.33963/KP.a2021.0088. PMID: 34392517
Effects of Dapagliflozin in Stage 4 Chronic Kidney Disease.
Chertow GM, Vart P, Jongs N, Toto RD, Gorriz JL, Hou FF, McMurray JJV, Correa-Rotter R, Rossing P, Sjöström CD, Stefánsson BV, Langkilde AM, Wheeler DC, Heerspink HJL; DAPA-CKD Trial Committees and Investigators
J Am Soc Nephrol 2021 Sep;32(9):2352-2361. Epub 2021 Jul 16 doi: 10.1681/ASN.2021020167. PMID: 34272327Free PMC Article
Bisphosphonates to reduce bone fractures in stage 3B+ chronic kidney disease: a propensity score-matched cohort study.
Robinson DE, Ali MS, Strauss VY, Elhussein L, Abrahamsen B, Arden NK, Ben-Shlomo Y, Caskey F, Cooper C, Dedman D, Delmestri A, Judge A, Javaid MK, Prieto-Alhambra D
Health Technol Assess 2021 Mar;25(17):1-106. doi: 10.3310/hta25170. PMID: 33739919Free PMC Article
The kidney and bisphosphonates.
Miller PD
Bone 2011 Jul;49(1):77-81. Epub 2011 Jan 11 doi: 10.1016/j.bone.2010.12.024. PMID: 21232648

Recent systematic reviews

Acute Kidney Injury Following Transcatheter Edge-to-Edge Mitral Valve Repair: A Systematic Review and Meta-Analysis.
Doulamis IP, Tzani A, Kampaktsis PN, Kaneko T, Tang GHL
Cardiovasc Revasc Med 2022 May;38:29-35. Epub 2021 Jul 23 doi: 10.1016/j.carrev.2021.07.021. PMID: 34334337

Supplemental Content

Table of contents

    Clinical resources

    Practice guidelines

    • PubMed
      See practice and clinical guidelines in PubMed. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.

    Curated

    • NICE, 2021
      UK NICE Guideline NG203, Chronic kidney disease: assessment and management, 2021

    Consumer resources

    Reviews

    Related information

    • PMC Articles
      Related information in PubMed Central Links
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      Related literature resources in PubMed

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