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Chronic Kidney Disease Diagnosis: Glomerular Filtration, Proteinuria, and Differential Diagnosis in Nephrology

A Hispanic physician in his 40s, wearing a white coat and stethoscope, carefully examines a renal function test graph in a modern medical office. In the background, a computer screen displays a detailed diagram of the human kidneys, relevant to chronic kidney disease (CKD) diagnosis. The environment reflects professionalism and expertise in diagnosing CKD stages, glomerular filtration, creatinine levels, and proteinuria.

Chronic Kidney Disease (CKD) is a medical condition that affects millions of people worldwide. Early CKD diagnosis is crucial to prevent progression to end-stage renal disease. In this context, glomerular filtration (GFR) and proteinuria are essential diagnostic tools that allow for the evaluation of renal function and renal damage, respectively. This article explores the importance of these markers and the differential diagnosis in nephrology practice.

Diving Deeper into CKD Diagnosis

Glomerular filtration is the best indicator of overall renal function. It is measured directly using exogenous markers or estimated through equations based on serum creatinine levels. A GFR below 60 mL/min/1.73 m² for at least three months is indicative of CKD, regardless of the underlying cause [1]. Proteinuria, on the other hand, is a marker of renal damage and is associated with an increased risk of CKD progression and mortality [2].

In patients with type 2 diabetes, albuminuria has been more closely related to endothelial dysfunction than GFR, suggesting that proteinuria could be a more sensitive indicator of vascular damage in this population [3]. Furthermore, the presence of proteinuria may influence the progression of kidney disease, even in the absence of significant dyslipidemia [4].

Conclusions

The diagnosis of chronic kidney disease requires careful evaluation of glomerular filtration and proteinuria. These markers not only help identify the presence of CKD but also provide valuable information about the risk of disease progression and associated complications. Integrating these parameters into daily clinical practice is essential for effective CKD management and improving patient outcomes.

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Created 6/1/2025