IRIS CKD Stages
| IRIS Stage | Creatinine | SDMA | Comments |
|---|---|---|---|
| At Risk | <1.4 mg/dL (dog) <1.6 mg/dL (cat) |
<14 μg/dL | Clinical history may suggest increased risk for CKD development |
| Stage 1 | <1.4 mg/dL (dog) <1.6 mg/dL (cat) |
<14 μg/dL | Nonazotemic. Some other renal abnormality present |
| Stage 2 | 1.4-2.0 mg/dL (dog) 1.6-2.8 mg/dL (cat) |
14-25 μg/dL | Mild renal azotemia. Clinical signs usually mild or absent. |
| Stage 3 | 2.1-5.0 mg/dL (dog) 2.9-5.0 mg/dL (cat) |
≥25 μg/dL | Moderate renal azotemia. Extrarenal clinical signs may be present. |
| Stage 4 | >5.0 mg/dL (dog) >5.0 mg/dL (cat) |
≥45 μg/dL | Severe renal azotemia |
Substaging by Arterial Blood Pressure
| Systolic BP mm Hg | BP Substage | Risk of Organ Damage* |
|---|---|---|
| <150 | Normotensive | Minimal |
| 150-159 | Borderline hypertensive | Low |
| 160-179 | Hypertensive | Moderate |
| ≥180 | Severely Hypertensive | High |
*Some breeds, particularly sight hounds, tend to have higher blood pressure than other breeds. It is preferable to use breed-specific reference ranges if available. The classification of risk of future target organ damage in “high-pressure breeds” might be adjusted as follows:
- Minimal risk
- systolic pressure <10 mm Hg above the breed-specific reference range
- Low risk
- systolic pressure 10-20 mm Hg above the breed-specific reference range
- Moderate risk
- systolic pressure 20-40 mm Hg above the breed-specific reference range
- High risk
- systolic pressure >40 mm Hg above the breed-specific reference range.
Substaging by Proteinuria
| UP/C Value | Substage |
|---|---|
| Dogs <0.2 Cats <0.2 |
Non-proteinuric |
| Dogs 0.2 to 0.5 Cats 0.2 to 0.4 |
Borderline proteinuric |
| Dogs >0.5 Cats >0.4 |
Proteinuric |