Current CKD Definition Takes into Account Both Relative and Absolute Risk

Abstract

Delanaye et al. now reopen the discussion, suggesting that the GFR threshold for the CKD definition should be determined only by relative risks for mortality. They cite data from the CKD Prognosis Consortium, the largest meta-analysis, showing that the relative hazard of mortality for eGFR 45–59 versus 75–89 ml/min per 1.73 m² with albumin-creatinine ratio3 Absolute risk is more important than relative risk to patients and providers. The threshold for CKD should also take into account outcomes beyond mortality such as ESKD, AKI, heart failure, and hospitalization which are often more specific and sensitive consequences of CKD, and have substantial excess risk in older age.