Subtle variations in estimated glomerular filtration rate (eGFR) measurements, even within accepted clinical ranges, can signal significantly poorer outcomes for individuals with chronic kidney disease (CKD), according to recent research.
The findings, presented in a large-scale meta-analysis by the Chronic Kidney Disease Prognosis Consortium (CKD-PC), highlight the importance of consistent eGFR assessment. EGFR is a key metric used to evaluate kidney function, estimating how well the kidneys filter waste from the blood. Traditionally, eGFR is calculated using creatinine levels, a waste product from muscle metabolism. Though, cystatin C, another substance filtered by the kidneys, is increasingly used as an alternative marker.
The CKD-PC analysis revealed substantial discordance between eGFR values derived from creatinine and cystatin C. This discrepancy, researchers found, is associated with increased risk of adverse events in CKD patients. The study did not specify the magnitude of increased risk, but emphasized the clinical significance of the difference.
Currently, a standard blood test measuring creatinine levels is the primary method for estimating GFR. Healthcare professionals utilize formulas to estimate GFR because directly measuring it (mGFR) is a complex and time-consuming process. Early detection of CKD is crucial, as the disease often presents no symptoms in its initial stages, affecting an estimated 37 million adults in the United States, with nearly 90% unaware of their condition.
Recent studies have also explored the efficacy of dapagliflozin, a medication, in managing CKD. A study involving 94 CKD patients, both diabetic and non-diabetic, treated with 10mg of dapagliflozin daily for 12 months, showed improvements in several key health indicators, including body mass index, blood pressure, uric acid levels, and hemoglobin. Notably, the study demonstrated a significant increase in the eGFR slope – the rate at which kidney function changes over time – in all patients, including those with rapidly declining kidney function and those with highly low baseline eGFR levels (below 25 mL/min/1.73 m2). The positive effect of dapagliflozin was further amplified when combined with multidisciplinary care.
Separate research indicates dapagliflozin can lower the risk of eGFR decline and negative renal outcomes in patients with advanced CKD (stages 4 and 5) with eGFR rates between 10 and 30 mL/min/1.73m2 compared to placebo.
The National Kidney Foundation emphasizes the uniqueness of each patient’s kidney health and advocates for personalized treatment approaches. Further research is ongoing to refine eGFR estimation methods and optimize treatment strategies for CKD.
