DIAGNOSTIC CRITERIA USED TO CLASSIFY KIDNEY DISEASES LEADING TO
CHRONIC RENAL FAILURE TAKING INTO ACCOUNT THE STRUCTURAL
GLOMERULONEPHRITIS (primary and secondary)
a) Renal biopsy required
b) Nephrotic syndrome: proteinuria higher than 3.5 g/24 h, albuminemia lower than
4 g/dl and/or total proteinemia lower than 6 g/dl.
Insulin-dependent diabetes mellitus, proliferative retinopathy, proteinuria higher than
3.5 g/24 h.
CYSTIC KIDNEY DISEASE
Multiple bilateral cysts diagnosed by any of the following techniques:
ultrasonography, urography, pyelography, computed tomography (CT), nuclear
magnetic resonance (NMR), digital intravenous angiography substraction (DIVAS),
a) Vesico-ureteric reflux diagnosed by cystography or intravenous urography.
b) Bilateral hydronephrosis diagnosed by renal ultrasonography, intravenous
urography or pyelography, renal computer tomography or magnetic resonance.
c) Two or more of the following criteria observed with any of the above mentioned
techniques or in laboratory analysis:
1. Cortical scars.
2. Calix distortion due to scars.
3. Calyceal ampullar deformation.
4. Papillary necrosis.
5. Organic calcifications.
6. Longitudinal renal diametre lower than 8 cm measured by ultrasonography
with plasmatic creatinine lower than 6 mg/dl.
7. Serum potassium higher than 5.5 mEq/l with plasmatic creatinine lower than 6
8. Plasma bicarbonate below 22 mEq/l and anion gap below 15 mEq/l.
a) Hypertension diagnosed prior to chronic renal failure, and without any of the
above mentioned criteria indicating that the patient belongs to any other group.
Hypertension is defined by maintained systolic blood pressure higher than 140
mm Hg and diastolic blood pressure higher than 90 mm Hg.
Chronic renal failure is defined as maintained values of serum creatinine higher
than 1.5 mg/dl (men) and 1.3 mg/dl (women).
b) Vascular damage diagnosed by DIVAS, arteriography or renal biopsy.
c) The patient cannot be classified in any group and presents or has presented any
of the following diseases or interventions before or coincidental with a serum
creatinine below 2.5 mg/dl:
1. Severe hypertension defined by hypertensive heart disease and/or ocular
fundi with haemorrhages, exudates and /or edema.
2. Intermittent claudication, ischaemic damage in legs, vascular bridges or
amputation due to ischaemia.
3. Cerebral vascular accident, cerebral infarction or haemorrhage diagnosed
by CT or MNR.
4. Ischaemic heart disease documented by electrocardiogram, radionuclide
perfusion imaging or coronary angiography.
5. Supraaortic trunks damage diagnosed through Doppler ultrasonography or
6. Aortic aneurism diagnosed by DIVAS, CT or arteriography.
It fulfils criteria to be classified in two groups.
NEPHROPATHY OF UNKNOWN ETIOLOGY (UNK)
It could not be classified in any of the above mentioned groups.