Related Experiment Video
Updated: Mar 28, 2026
Analysis of Nephron Composition and Function in the Adult Zebrafish Kidney
Published on: August 9, 2014
Renal function trajectory over time and adverse clinical outcomes
Badrul Munir Sohel1, Nahid Rumana2, Masaki Ohsawa3
1Centre for Public Health, Queen's University Belfast, Belfast, UK.
Insights
Monitoring the rate of change in kidney function, not just static eGFR levels, can identify chronic kidney disease (CKD) patients at higher risk for adverse outcomes like End Stage Renal Disease (ESRD). This dynamic approach aids targeted interventions.
Area of Science:
- Nephrology
- Public Health
- Biostatistics
Background:
- Chronic kidney disease (CKD) presents a significant global health burden, impacting morbidity, mortality, and healthcare systems.
- Current CKD staging, based on estimated glomerular filtration rate (eGFR) or kidney damage markers, identifies many patients but lacks precision for targeted interventions.
- Existing static definitions of kidney function fail to capture the progressive nature of CKD.
Purpose of the Study:
- To explore the potential of assessing the rate of change in kidney function over time to identify high-risk CKD patients.
- To summarize evidence supporting the concept of dynamic changes in kidney function and their impact on adverse outcomes.
- To discuss the feasibility of utilizing longitudinal eGFR data in the context of digital health records.
Main Methods:
- Review and synthesis of existing evidence on dynamic changes in kidney function.
- Analysis of the relationship between the magnitude of kidney function change and future adverse outcomes.
- Consideration of the role of digitalization in capturing longitudinal health data.
Main Results:
- Dynamic changes in kidney function over time are a significant factor in predicting adverse outcomes.
- The rate of decline in kidney function is a crucial metric for risk stratification.
- Digital health records facilitate the collection of longitudinal data necessary for dynamic assessment.
Conclusions:
- Assessing the rate of change in kidney function offers a more refined approach to identifying CKD patients at high risk for End Stage Renal Disease (ESRD), cardiovascular disease (CVD), and mortality.
- This dynamic perspective complements static staging, enabling more personalized and effective clinical management strategies.
- The integration of longitudinal data analysis into routine clinical practice is essential for proactive CKD management.
Abstract:
The growing burden of chronic kidney disease (CKD), with its associated morbidity and mortality, is recognized as a major public health problem globally and causing substantial load on health care systems. The current framework for the definition and staging of CKD, based on eGFR levels or presence of kidney damage, is useful for clinical classification of patients, but identifies a huge number of people as having CKD which is too many to target for intervention. The ability to identify a subset of patients, at high risk for adverse outcomes, would be useful to inform clinical management. The current staging system applies static definitions of kidney function that fail to capture the dynamic nature of the kidney disease over time. Now-a-days, it is possible to capture multiple measurements of different laboratory test results for an individual including eGFR values. A new possibility for identifying individuals at higher risk of adverse outcomes is being explored through assessment and consideration of the rate of change in kidney function over time, and this approach will be feasible in the current context of digitalization of health record keeping system. On the basis of the existing evidence, this paper summarizes important findings that support the concept of dynamic changes in kidney function over time, and discusses how the magnitude of these changes affect the future adverse outcomes of kidney disease, particularly the End Stage Renal Disease (ESRD), CVD and mortality.
Related Concept Videos
01:29Acute Kidney Injury III: Clinical Manifestations
01:22Acute Kidney Injury I: Introduction
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
01:17Factors Affecting Renal Clearance: Renal Impairment
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
01:11Renal Failure: Dose Adjustments
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
01:25Chronic Kidney Disease I: Introduction