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Kidney function for the non-nephrologist: an emerging tool for predicting mortality risk
1Norwegian University of Science and Technology, Institute of Cancer Research and Molecular Biology, Trondheim, Norway. stein.hallan@ntnu.no
Kidney International
|December 16, 2010
Summary
New research suggests higher thresholds for estimated glomerular filtration rate (eGFR) and albumin-to-creatinine ratio (ACR) may better predict mortality risk. These findings offer refined cardiovascular risk assessment using kidney function markers.
Area of Science:
- Nephrology
- Cardiology
- Epidemiology
Background:
- Cardiovascular disease (CVD) risk assessment frequently incorporates kidney function markers like estimated glomerular filtration rate (eGFR) and albuminuria.
- Current thresholds for defining chronic kidney disease (CKD) may not be optimal for predicting all-cause mortality.
Discussion:
- This study utilized classification tree methodology on NHANES III data to identify optimal cutoff values for eGFR and albumin-creatinine ratio (ACR) in mortality prediction.
- The analysis aimed to determine if established CKD diagnostic cutoffs align with those most predictive of adverse outcomes.
Key Insights:
- Optimal cutoff for eGFR predicting mortality was identified as 94 ml/min per 1.73 m(2).
- Optimal cutoff for albumin-creatinine ratio (ACR) predicting mortality was identified as 9 mg/g.
- These identified optimal cutoffs are 'healthier' or 'more normal' than current thresholds used for CKD diagnosis.
Outlook:
- Further validation of these proposed eGFR and ACR cutoffs in diverse populations is warranted.
- These findings could lead to revised guidelines for cardiovascular risk stratification in clinical practice.
- Future research may explore the mechanistic links between these refined kidney function parameters and mortality.
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