dialysis and/or renal transplantation indicating other heritable causes of CKD. A CKD patient should be questioned for a history of abnormal bladder emptying, constipation, recurrent urinary tract infections, vesicoureteral reflux, or meningomyelocele any of which could suggest obstructive uropathy as a cause for CKD. The patient should be evaluated for a history of proteinuria, hematuria, flank pain, or edema consistent with chronic glomerulonephritis (GN) and for previous episodes of skin rashes, fever, adenopathy, or arthralgias consistent with systemic lupus erythematosus (SLE) or a vasculitis. Many times the absence of a previous history of symptoms or renal disease is indicative of CKD due to congenital anomalies of the kidneys such as hypoplasia/dysplasia or medullary cystic disease.
TABLE 23-1 Classification of Chronic Kidney Disease