Introduction

In 2012, the key international kidney guideline group KDIGO (Kidney Disease - Improving Global Outcomes), released the document “Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease (CKD)”. It is not an understatement to say this this guideline changed the world of renal practice and the role of the routine laboratory in this field.

The definition and classification of CKD in this guideline have been widely accepted around the world and used for research, epidemiology, clinical practice and education providing uniform criteria for CKD worldwide (figure 1). An additional use of the classification, for example by Kidney Health Australia, is to link the staging directly to clinical management guidelines with “colour coded” plans linked to the categories in figure 1. The diagnosis and classification are based on glomerular filtration rate (GFR) and urine albumin. These two key measurements are dependent on pathology testing, therefore placing the chemical pathology laboratory in the centre of the process. Perhaps unusually for clinical guidelines the KDIGO document provides important information on laboratory practice in this field relevant to the pre-analytical, analytical and post analytical phases of testing. Implementation of the guidelines has also stimulated close collaboration between clinicians and laboratories at local and national levels.