skip to main content

eGFR Variability Threshold KDIGO — ESENeph MCQ

Instant feedback + full explanation. One question, done properly.

HardChronic Kidney DiseaseeGFR Variability Threshold KDIGOESENeph

A stable patient with CKD has eGFR fall from 40 to 31 mL/min/1.73m² on a repeat test without an obvious acute illness. How should the change be interpreted?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Evaluate this fall for reversible causes or progressive kidney disease

The best answer is “Evaluate this fall for reversible causes or progressive kidney disease”. A change exceeding 20% is beyond expected variability and should prompt confirmation and assessment of haemodynamics, obstruction, medicines and kidney-disease activity. “Interpret any eGFR decline as confirmed irreversible CKD progression” is less appropriate because smaller changes can reflect biological and analytical variability “Interpret changes below 30% using clinical context and repeat measurement” is less appropriate because KDIGO uses a lower variability threshold for repeat eGFR change “Investigate a sustained fall after confirming timing and measurement conditions” is less appropriate because that would delay evaluation of a clinically important decline “Assess eGFR variability using serial standardized creatinine measurements” is less appropriate because serial change is central to CKD monitoring

Reference: KDIGO 2024 CKD guideline: https://kdigo.org/wp-content/uploads/2024/03/KDIGO-2024-CKD-Guideline.pdf