Predicting Renal Risk in the General Population: Do We Have the Right Formula?

[摘要] The widespread implementation of automated reporting of estimated GFR (eGFR) with each measurement of serum creatinine has resulted in the identification of large numbers of patients with previously undiagnosed chronic kidney disease (CKD). Epidemiologic studies have reported that CKD is relatively common, affecting up to 16.8% of the adult population (1), but it is clear that patients with CKD are a heterogeneous group with variable prognosis and only a minority progress to end-stage kidney disease (ESKD) (2). There is thus a need for methods to predict the risk for future progression of CKD. This will allow patients at high risk to be identified for treatment to slow progression and those at low risk to be reassured and spared unnecessary intervention. The need for risk stratification within CKD is particularly great among patients in the general population or primary care because the majority of patients with CKD are first identified in this setting and most are never referred to a nephrologist. Risk factors that predict CKD progression have been studied extensively in the past decade (3). Recognition that studies in disparate populations have reported similar risk factors led to the proposal that several important risk factors could be combined to develop a “renal risk score” to predict future risk for CKD progression, analogous to the Framingham risk score for predicting cardiovascular events (4). In the past 5 years, considerable progress has been made in developing such a risk score that is applicable to patients in the general population.

[学科分类] 泌尿医学

[关键词] Bone marrow necrosis;Sickle cell disease;Hyperhemolysis syndrome