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Similar results when measuring time to renal failure in the renal failure risk equation (eGFR)
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Disclosure: Chu reports that he has received research support from Bayer HealthCare in addition to the submitted research.
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Important points:
- In patients with advanced CKD, the renal failure risk equation and eGFR gave comparable estimates.
- The estimated time to renal failure is different in patients with mild renal disease.
Recently published data show that measuring time to renal failure in advanced chronic kidney disease can aid clinical decision making and patient counseling, regardless of eGFR or renal failure risk equation-based estimates. There is a nature.
“A major challenge in the care of patients with advanced chronic kidney disease is optimally timing risk-based clinical decisions. [for] It can lead to kidney failure in the future. ” Chi D. Chu, MD, MAS, Zuckerberg San Francisco General Hospital nephrologists and their colleagues write. This multicenter study “provides an additional method of expressing prognosis that is more intuitive than cumulative incidence and may help guide time-dependent clinical decisions.”
In this retrospective cohort study, researchers used data from the CKD Outcomes and Practice Patterns Study US cohort to analyze 1,641 patients with CKD who were not undergoing maintenance dialysis and who had not undergone a kidney transplant.
Researchers constructed an accelerated time-to-failure model to estimate the association between eGFR and risk predicted by the renal failure risk equation (KFRE) and time to renal failure. KFRE estimates the 2- and 5-year risks of renal failure from CKD.
Different estimates of time to renal failure in patients with eGFR 20 mL/min/1.73 m2, according to research results. This duration was shorter in younger, male, black and nonblack patients, and in those with diabetes, hyperalbuminuria, and hypertension.
“In less advanced CKD, KFRE may provide a more consistent and unbiased estimate of time to renal failure across a range of patient characteristics, but time estimates are highly variable for both eGFR and KFRE. is inaccurate,” said the study.
Patients with eGFR <15 mL/min/1.73 m2 Alternatively, when KFRE risk was >40%, KFRE risk and eGFR showed a similar relationship with time to renal failure.
“Our results inform prognostic clinical decisions and patient counseling by estimating time to renal failure in advanced CKD, regardless of whether estimates are based on eGFR or KFRE. It shows what can be done,” Chu et al.
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