Body system: Genitourinary SystemRegulation: 38 CFR § 4.115b
DC 7539 covers renal amyloid disease (deposition of misfolded amyloid protein in the kidney, causing nephrotic-range proteinuria and progressive renal failure) PLUS a much broader set of conditions per the CFR Note: all glomerulonephritis types, all vasculitis types, and renal involvement from systemic diseases including lupus and lupus nephritis, Henoch-Schönlein purpura, scleroderma (especially scleroderma renal crisis), hemolytic uremic syndrome, polyarthritis, Wegener's granulomatosis, Goodpasture's syndrome, and sickle cell disease. The VA rates all of these conditions under the renal dysfunction ladder (38 CFR § 4.115a) from 0% to 100% based on GFR sustained over 3 consecutive months in the past 12 months.
Rating levels
- 100% — You qualify for 100% if your renal amyloid disease (or other systemic-disease-related renal involvement covered by the Note) has progressed to end-stage renal disease — GFR under 15 mL/min/1.73 m² sustained for 3+ consecutive months, OR routine dialysis dependence, OR transplant eligibility.
- 80% — You qualify for 80% if the condition has progressed to Stage 4 CKD — GFR 15-29 mL/min/1.73 m² sustained for 3+ consecutive months.
- 60% — You qualify for 60% if the condition is at Stage 3b CKD — GFR 30-44 mL/min/1.73 m² sustained for 3+ consecutive months.
- 30% — You qualify for 30% if the condition is at Stage 3a CKD — GFR 45-59 mL/min/1.73 m² sustained for 3+ consecutive months.
- 0% — You qualify for 0% if your GFR is 60-89 mL/min/1.73 m² (Stage 2 CKD) AND you have one of three additional markers sustained for 3+ consecutive months: recurrent urinary casts, structural kidney abnormalities, or proteinuria with ACR ≥ 30 mg/g. Proteinuria is particularly common in renal amyloid disease and in lupus nephritis.
- -1% — The scope of DC 7539 is much broader than the literal 'renal amyloid disease' title suggests. The CFR Note explicitly extends this code to cover renal involvement from ALL glomerulonephritis types, ALL vasculitis types, and many other systemic diseases that affect the kidney as a downstream complication. Examples named in the Note include: lupus erythematosus and lupus nephritis (immune-complex glomerular damage), Henoch-Schönlein purpura (IgA-mediated small-vessel vasculitis with kidney involvement), scleroderma (renal crisis with malignant hypertension and microangiopathic hemolytic anemia), hemolytic uremic syndrome (HUS — thrombotic microangiopathy of the kidney), polyarthritis (chronic inflammatory joint disease with renal complications), Wegener's granulomatosis / granulomatosis with polyangiitis (ANCA-associated small-vessel vasculitis), Goodpasture's syndrome (anti-GBM antibodies attacking both lung and kidney basement membrane), and sickle cell disease (sickle cell nephropathy with papillary necrosis and progressive CKD). All of these get rated under the renal dysfunction ladder above. If the systemic disease itself is also separately rateable under another DC, both ratings may apply per 38 CFR § 4.14 anti-pyramiding rules — the rater determines whether the disabilities are truly distinct or constitute the same disability.