Similar results in the measurement of time to kidney failure for the kidney failure risk equation, eGFR

Key points to remember:

• In patients with advanced CKD, the kidney failure risk equation and eGFR showed comparable estimates.
• The estimated time to renal failure varied in patients with less severe renal failure.

According to recently published data, measuring time to kidney failure in advanced chronic kidney disease can inform clinical decisions and patient counseling, regardless of estimates based on eGFR or the risk equation for kidney failure. ‘renal failure.

“A major challenge in the management of patients with advanced chronic kidney disease is the optimal timing of clinical decisions based on their risk [for] future kidney failure, Chi D. Chu, MD, MAS, in the division of nephology at Zuckerberg San Francisco General Hospital, and colleagues, wrote. The multicenter study “provides an additional way of expressing prognosis that may be more intuitive than cumulative incidence and could help guide clinical decisions over time.”

In the retrospective cohort study, researchers used data from the US CKD Outcomes and Practice Patterns Study cohort to analyze 1,641 patients with CKD who were not receiving maintenance dialysis and had not undergone transplantation anterior kidney.

The researchers constructed accelerated time-to-failure models to estimate the association between eGFR and risk predicted by the kidney failure risk equation (KFRE) and time to onset of kidney failure. The KFRE estimates the risk of kidney failure at 2 and 5 years with CRF.

The estimated time to renal failure varied in patients with an eGFR of 20 mL/min/1.73 m², according to the results of the study. It was shorter for younger, male, black patients compared to non-black patients, and for patients with diabetes, higher albuminuria, and high blood pressure.

“In less advanced cases of CKD, KFRE may provide more consistent and fair estimates of time to onset of renal failure for different patient characteristics, but time estimates are largely imprecise for eGFR and KFRE,” according to the research.

Patients with an eGFR less than 15 mL/min/1.73 m² or a KFRE risk greater than 40%, KFRE risk and eGFR showed similar relationships with time to renal failure.

“Our results demonstrate that estimating the time to renal failure in cases of advanced CKD can inform clinical decisions and patient counseling on prognosis, whether the estimates are based on eGFR or KFRE,” said writes Chu and his colleagues.