Health Information Management

Tip: Know stages of chronic kidney disease

APCs Insider, December 7, 2012

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Glomerular filtration rate (GFR) measures the ­creatinine level of the blood and how well the kidneys ­function. Physicians generally look at GFR during a patient's annual physical, Lawson says. Kidneys that are not functioning optimally do not filter waste correctly, ­causing the creatinine level in the blood to rise.

Muscles generate creatinine as a waste product. Because people have different amounts of muscle, they produce different amounts of creatinine. GFR ­allows ­physicians to compare kidney function across the ­population because it accounts for age, race, and ­gender, factors that impact how much muscle someone has.
 
A patient with CKD progresses through as many as six stages, according to the National Kidney Foundation. Stage I CKD is a GFR greater than or equal to 90.
 
 Stage II CKD is a GFR of 60-90. This is mild kidney disease. At this stage, most people don't even realize they have a problem.
 
A GFR of 30-59 is Stage III CKD, or moderate ­kidney disease. These patients may still be symptom free.
Stage IV CKD is a GFR of 15-29. This is severe kidney damage, and a physician will start preparing a patient at this stage for kidney replacement therapy.
 
A GFR of less than 15 is Stage V CKD and is ­considered kidney failure. Patients who have a GFR of less than 15 and are receiving dialysis have Stage VI CKD and are diagnosed with end-stage renal disease . The difference between Stages V and VI is dialysis.
 
The tip is adapted from “Simplify chronic kidney disease outpatient coding” in the October Briefings on APCs.



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