335 Ch 334. Chronic Kidney Disease (CKD) — Diagnosis, Staging, and Complications

CKD = eGFR < 60 OR kidney damage (albuminuria, hematuria, abnormal imaging, biopsy) for ≥ 3 months；台灣 ~ 12% 成人盛行率（global ~ 10%）；最常見原因：DM (diabetic kidney disease, DKD) > HTN > GN > PKD；KDIGO 2012 + 2024 staging：(1) G stage by eGFR：G1 (≥ 90), G2 (60-89), G3a (45-59), G3b (30-44), G4 (15-29), G5 (< 15)；(2) A stage by UACR：A1 < 30, A2 30-300, A3 > 300 mg/g；combined risk of progression + CV events；complications：(1) cardiovascular (top cause of death in CKD — CHD risk equivalent); (2) anemia (low EPO + iron deficiency); (3) CKD-MBD (mineral bone disorder: hyperphosphatemia + ↓ vit D + ↑ PTH + ↑ FGF-23 + vascular calcification); (4) fluid + electrolyte (Na, K, acid-base); (5) uremia (encephalopathy, neuropathy, GI); (6) nutrition (protein-energy wasting); (7) endocrine (insulin resistance, infertility, hypothyroid)；2024 HIF-PHI (roxadustat, vadadustat, daprodustat) for renal anemia; etelcalcetide for secondary hyperPTH; bardoxolone withdrawn (CV concerns)。