Kidney Disease (Renal Dysfunction)
Kidney disease (renal dysfunction) is rated based on GFR (glomerular filtration rate) under the genitourinary rating schedule. This covers a wide range of conditions including nephropathy, glomerulonephritis, interstitial nephritis, polycystic kidney disease, and renal involvement from systemic diseases like diabetes or lupus. Conditions can be rated under the kidney failure schedule or the urinary rating system, whichever provides the higher rating. The GFR must be documented for at least 3 consecutive months during the past 12 months (meaning at least two abnormal readings 3 or more months apart). GFR, eGFR, and creatinine-based approximations are all accepted when calculated by a medical professional.
VA Rating Levels
GFR from 60-89 mL/min/1.73m2 with albumin/creatinine ratio of 30 mg/g or greater, OR with recurrent RBC/WBC/granular casts, OR with structural kidney abnormalities, all documented for at least 3 consecutive months in the past 12 months.
Chronic kidney disease with GFR from 45-59 mL/min/1.73m2 for at least 3 consecutive months during the past 12 months.
Chronic kidney disease with GFR from 30-44 mL/min/1.73m2 for at least 3 consecutive months during the past 12 months.
Chronic kidney disease with GFR from 15-29 mL/min/1.73m2 for at least 3 consecutive months during the past 12 months.
Chronic kidney disease with GFR less than 15 mL/min/1.73m2 for at least 3 consecutive months, OR requires regular routine dialysis, OR eligible kidney transplant recipient.
Exam Tips & Key Evidence
- →Kidney disease is a presumptive condition if diagnosed within one year of separation at a compensable level. It is also commonly secondary to diabetes, hypertension, or long-term NSAID use for service-connected pain.
- →The 3 consecutive months requirement does not mean continuous testing. It means at least two abnormal readings separated by 3 or more months within a 12-month period. If only one abnormal reading exists but chronic disease is suspected, the VA can order a follow-up exam 3 months later.
- →If you have a single condition affecting both kidney and urinary functions, you can only receive one rating for whichever is higher. However, if you have separate conditions affecting each, you can receive ratings for both.
- →Kidney transplant recipients get 100% for one year following surgery, then rated on residuals. Removal of one kidney has a minimum 30% rating.
- →Common secondary conditions include gout and heart disease. Each GFR stage reduction corresponds to a significantly higher rating, so request regular kidney function testing.
Commonly Related Conditions
38 CFR Reference
38 CFR 4.115a-b, Diagnostic Code 7530