Chronic Renal Failure:

Stage 3a 3b 4 5
Normal CKD 8 yrs 4 yrs 4 yrs 1 yrs
Uncontrolled DM 2 yrs 1.5 - 0.1
HTN 6 yrs 3 - 0.2

CKD Definition:
 Irreversible structural & functional damage
 >3 months
 GFR <60 ml/min/1.73 m2

CKD stages:
Stage 5= <15%
Stage 4= 15-30
Stage 3b= 30-45
Stage 3a= 45-60

What is the importance in Staging:

 CKD is irreversible.
But Stage 3 is crucial.
Up to Stage 3 can be delay in progression.
 Stage 4 & 5:
Delay in progression not possible.
Prepare for dialysis

Creatinine to E GFR: Schwartz Equation:

GFR= k X (Height in cm/ Creatinine)
K in female, children 0.55
K in male 0.7

Cockcroff- Gault Formula:

for Creatinine clearance measurement from creatinine

Drugs avoided:
 ACE, ARB
 Analgesics
 Aminoglycosides
 Acyclovir
 Dr. Ahmed Tanjimul Islam
 MBBS, MSc (Leeds, England),
 PGD (UNSW, Australia) MD (Neurology)
 Medical Officer of Neurology,
 Rajshahi Medical College Hospital, Bangladesh