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In chronic kidney disease staging the use of the chronicity criterion affects prognosis and the rate of progression.
Kidney Int. 2007 Nov; 72(10):1242-8.KI

Abstract

The Kidney Disease Outcomes Quality Initiative definition and staging of chronic kidney disease (CKD) have been adopted by most nephrologists but include a criterion of chronicity that has not been investigated. This criterion specifies that renal structural damage and/or reduction in glomerular filtration rate (GFR) should be present for periods lasting longer than 3 months. We examined the effects of changing this criterion to 6, 9, or 12 months on the prognosis and the rate of progression in population-based cohorts with CKD stages 3 and 4. A 12-month chronicity criterion significantly reduced the number of CKD patients relative to the 3-month criterion for both stages 3 and 4. For both stages, there were statistically significant differences in 5-year mortality between the 6- and 9-month cohorts. For stage 4, the 5-year cumulative incidence of renal failure significantly increased from 6 to 9 months, and the rate of change in GFR significantly decreased between the same two cohorts. The 5-year cumulative incidence of improvement in GFR lasting 1 year or more was significantly higher for the 3-month cohort than for the 12-month cohort in the stage 3 group. Hence, we suggest that the chronicity criterion is an important determinant of the characteristics of the population of patients with CKD stages 3 and 4. This may have practical consequences in both research and clinical work.

Authors+Show Affiliations

Department of Nephrology, University Hospital of North Norway, Tromsø, Norway. bjorn.odvar.eriksen@unn.noNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17687256

Citation

Eriksen, B O., and O C. Ingebretsen. "In Chronic Kidney Disease Staging the Use of the Chronicity Criterion Affects Prognosis and the Rate of Progression." Kidney International, vol. 72, no. 10, 2007, pp. 1242-8.
Eriksen BO, Ingebretsen OC. In chronic kidney disease staging the use of the chronicity criterion affects prognosis and the rate of progression. Kidney Int. 2007;72(10):1242-8.
Eriksen, B. O., & Ingebretsen, O. C. (2007). In chronic kidney disease staging the use of the chronicity criterion affects prognosis and the rate of progression. Kidney International, 72(10), 1242-8.
Eriksen BO, Ingebretsen OC. In Chronic Kidney Disease Staging the Use of the Chronicity Criterion Affects Prognosis and the Rate of Progression. Kidney Int. 2007;72(10):1242-8. PubMed PMID: 17687256.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - In chronic kidney disease staging the use of the chronicity criterion affects prognosis and the rate of progression. AU - Eriksen,B O, AU - Ingebretsen,O C, Y1 - 2007/08/08/ PY - 2007/8/10/pubmed PY - 2007/12/8/medline PY - 2007/8/10/entrez SP - 1242 EP - 8 JF - Kidney international JO - Kidney Int VL - 72 IS - 10 N2 - The Kidney Disease Outcomes Quality Initiative definition and staging of chronic kidney disease (CKD) have been adopted by most nephrologists but include a criterion of chronicity that has not been investigated. This criterion specifies that renal structural damage and/or reduction in glomerular filtration rate (GFR) should be present for periods lasting longer than 3 months. We examined the effects of changing this criterion to 6, 9, or 12 months on the prognosis and the rate of progression in population-based cohorts with CKD stages 3 and 4. A 12-month chronicity criterion significantly reduced the number of CKD patients relative to the 3-month criterion for both stages 3 and 4. For both stages, there were statistically significant differences in 5-year mortality between the 6- and 9-month cohorts. For stage 4, the 5-year cumulative incidence of renal failure significantly increased from 6 to 9 months, and the rate of change in GFR significantly decreased between the same two cohorts. The 5-year cumulative incidence of improvement in GFR lasting 1 year or more was significantly higher for the 3-month cohort than for the 12-month cohort in the stage 3 group. Hence, we suggest that the chronicity criterion is an important determinant of the characteristics of the population of patients with CKD stages 3 and 4. This may have practical consequences in both research and clinical work. SN - 0085-2538 UR - https://www.unboundmedicine.com/medline/citation/17687256/In_chronic_kidney_disease_staging_the_use_of_the_chronicity_criterion_affects_prognosis_and_the_rate_of_progression_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0085-2538(15)52525-8 DB - PRIME DP - Unbound Medicine ER -