Abstract
BackgroundChronic kidney disease (CKD) is a public health challenge; however, evidence-based, optimal follow-up intervals for patients with CKD have not been identified. This study aimed to identify appropriate follow-up intervals for different stages of CKD.MethodsWe studied 2682 patients with CKD. The number of patients experiencing a 50% increase in creatinine and those reaching end-stage renal failure were examined on the basis of their CKD stage. The renal function testing interval was defined as the estimated time for 0.1% of the patients with CKD to have a composite renal outcome, after adjusting for clinical risk factors. Transitions from CKD stage-based subgroups were analyzed using parametric cumulative incidence models. Other sensitivity analyses involved estimation of the time to renal event occurrence for 1% of patients.ResultsOf the 913 patients (34%) who had a composite renal event, 29 had stage 3A (10.5%), 151 had stage 3B (16.3%), 429 had stage 4 (41.0%), and 304 had stage 5 CKD (70.9%). The estimated renal function testing intervals for patients with CKD were 6.0 months for stage 3A, 3.4 months for stage 3B, 2.0 months for stage 4, and 1.2 months for stage 5.ConclusionsThe optimal follow-up intervals were longer for patients with lower CKD stages. These estimates are longer than those recommended by the current guidelines and serve as a reference for nephrologists in selecting an appropriate follow-up interval for each patient.Trial registrationUMIN clinical trial registry number: UMIN000020038.
Highlights
In 2002, the National Kidney Foundation of the United States proposed the concept of chronic kidney disease (CKD) with the objectives of comprehensively covering a wide range of kidney diseases, including various underlying1 3 Vol.:(0123456789)Clinical and Experimental Nephrology (2019) 23:613–620 diseases, and developing measures for continuous management of this chronic condition [1]
The international guidelines by Kidney Disease: Improving Global Outcomes (KDIGO) provide guidance on the frequency of renal function assessment according to disease staging based on the glomerular filtration rate (GFR), and the severity of Chronic kidney disease (CKD) based on the presence of albuminuria [8]
On the basis of previous researches [10,11,12], we aimed to identify appropriate followup intervals for different stages of CKD by defining these optimal intervals according to the time to occurrence of a composite renal event in 0.1% of the patients in respective CKD subgroups
Summary
In 2002, the National Kidney Foundation of the United States proposed the concept of chronic kidney disease (CKD) with the objectives of comprehensively covering a wide range of kidney diseases, including various underlying1 3 Vol.:(0123456789)Clinical and Experimental Nephrology (2019) 23:613–620 diseases, and developing measures for continuous management of this chronic condition [1]. The international guidelines by Kidney Disease: Improving Global Outcomes (KDIGO) provide guidance on the frequency of renal function assessment according to disease staging based on the glomerular filtration rate (GFR), and the severity of CKD based on the presence of albuminuria [8]. Chronic kidney disease (CKD) is a public health challenge; evidence-based, optimal follow-up intervals for patients with CKD have not been identified. The renal function testing interval was defined as the estimated time for 0.1% of the patients with CKD to have a composite renal outcome, after adjusting for clinical risk factors. Conclusions The optimal follow-up intervals were longer for patients with lower CKD stages These estimates are longer than those recommended by the current guidelines and serve as a reference for nephrologists in selecting an appropriate follow-up interval for each patient.
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