Study: 30% Decline in eGFR Over 2 Years Strongly Predicts ESRD

Baseline eGFR, higher phosphorus, proteinuria, and male gender, also are associated with an elevated risk of end-stage renal disease in patients with chronic kidney disease.
Baseline eGFR, higher phosphorus, proteinuria, and male gender, also are associated with an elevated risk of end-stage renal disease in patients with chronic kidney disease.

The future incidence of end-stage renal disease (ESRD) among patients with chronic kidney disease is best predicted by a 30% decline in estimated glomerular filtration rate (eGFR) over 2 years, new findings suggest.

In a study of 701 patients with chronic kidney disease (CKD), a team led by Shunya Uchida, MD, of Tianjin First Central Hospital in Tianjin, China, found that this magnitude of decline was associated with a significant 31.6 times increased risk of ESRD compared with a 0% to 10% decline over 2 years (reference), according to an online report in PLOS One (10;e0132927).

Baseline eGFR and proteinuria were the most important risk factors for predicting ESRD. Serum phosphorus levels and male sex also predicted an elevated risk of ESRD. Each 1 mg/dL increment in serum phosphorus during follow-up was associated with a 2.7 times increased risk of ESRD. Male sex was associated with a significant 2.6 times increased risk compared with female sex.

Baseline eGFR and proteinuria were the most important risk factors for predicting ESRD, according to the investigators. Results showed that higher albumin and hemoglobin levels were associated with a lower risk of ESRD.

Of the 701 subjects, 83 progressed to ESRD during a mean follow-up of 4.5 years (maximum 6 years).

The new findings corroborate those of a study by Josef Coresh, MD, and colleagues, who reported in the Journal of the American Medical Association (2014;311:2518-2531) that a 30% decline in eGFR over 2 years showed that highest percentage of population attributable risk.

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