PROTEINURIC. Substaging CKD: urine protein to creatinine ratio (UP/C). NB. Any level of proteinuria or hypertension can occur at any stage of CKD i.e. at any ...
Substaging CKD: urine protein to creatinine ratio (UP/C) 0
0.1
0.2
0.3
NON-PROTEINURIC
0.4
0.5
BORDERLINE PROTEINURIC
0.6
PROTEINURIC
Substaging CKD: risk of end organ damage from hypertension Systolic blood pressure mm Hg
130
140
MINIMAL RISK
150
160
LOW RISK
170
MODERATE RISK
180
190
HIGH RISK
An adaptation of this staging system can be used for those breeds known to have higher blood pressure than average e.g. sight hounds
< 10 mm Hg
10-20 mm Hg
20-40 mm Hg
≥ 40 mm Hg
above reference range for breed involved
above reference range for breed involved
above reference range for breed involved
above reference range for breed involved
NB. Any level of proteinuria or hypertension can occur at any stage of CKD i.e. at any level of azotaemia.
IRIS A5 Cards v2 9319
3/1/07
16:18
Page 2
International Renal Interest Society
DOGS
Staging System for Chronic Kidney Disease (CKD) STEP 1. Staging is initially based on fasting plasma creatinine assessed on at least two occasions in the stable patient. STEP 2. Cases are then sub-staged based on proteinuria and blood pressure.
Plasma creatinine concentration µmol/l
50
100 125 150
180 200
250
300
350
400
440 450
500
STAGE 1
STAGE 2
STAGE 3
STAGE 4
Some other renal abnormality present e.g. inadequate concentrating ability; abnormal renal palpation
Clinical signs usually mild (e.g. PU/PD) or may be absent
Many systemic clinical signs may be present
Increasing risk of systemic clinical signs and uraemic crisis
mg/dl
1.4
2
3
Plasma creatinine concentrations apply to average size dogs – those of extreme size may vary. Supported by Novartis Animal Health Inc. Based on IRIS 2006 staging of CKD.
4
5
www.iris-kidney.com
20070003-01
1
IRIS A5 Cards v2 9319
3/1/07
16:18
Page 3
International Renal Interest Society
CATS
Substaging CKD: urine protein to creatinine ratio (UP/C) 0
0.1
0.2
NON-PROTEINURIC
0.3
0.4
BORDERLINE PROTEINURIC
0.5
0.6
PROTEINURIC
Substaging CKD: risk of end organ damage from hypertension Systolic blood pressure mm Hg
130
140
MINIMAL RISK
150
160
LOW RISK
NB. Any level of proteinuria or hypertension can occur at any stage of CKD i.e. at any level of azotaemia.
170
MODERATE RISK
180
190
HIGH RISK
IRIS A5 Cards v2 9319
3/1/07
16:18
Page 4
International Renal Interest Society
CATS
Staging System for Chronic Kidney Disease (CKD) STEP 1. Staging is initially based on fasting plasma creatinine assessed on at least two occasions in the stable patient. STEP 2. Cases are then sub-staged based on proteinuria and blood pressure.
Plasma creatinine concentration µmol/l
50
100
140 150
200
250
300
350
400
440 450
500
STAGE 1
STAGE 2
STAGE 3
STAGE 4
Some other renal abnormality present e.g. inadequate concentrating ability; abnormal renal palpation
Clinical signs usually mild (e.g. PU/PD) or may be absent
Many extra-renal clinical signs may be present
Requires intensive treatment
mg/dl
1.6
Supported by Novartis Animal Health Inc. Based on IRIS 2006 staging of CKD.
Staging System for Chronic Kidney Disease (CKD) ... severe azotaemia. Systemic signs present: e.g. bone pain, uraemic gastritis, anaemia, metabolic acidosis.
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