Chronic Kidney Disease – Where Next? Predicting Outcomes and Planning Care Pathways

*Angharad Marks,1 Nicholas Fluck,2 Corri Black3

1. Clinician Scientist Fellow and Honorary Consultant Nephrologist, University of Aberdeen and NHS Grampian, Aberdeen, UK
2. Consultant Nephrologist, Acute Sector Clinical Lead and Honorary Senior Clinical Lecturer, NHS Grampian and University of Aberdeen, Aberdeen, UK
3. Senior Clinical Lecturer and Honorary Consultant in Public Health, University of Aberdeen and NHS Grampian, Aberdeen, UK *Correspondence to a.marks@abdn.ac.uk

Disclosure: No potential conflict of interest.
Received: 13.03.14 Accepted: 09.04.14
Citation: EMJ Neph. 2014;1:67-75.

Abstract

With the introduction of the National Kidney Foundation Kidney Disease Outcomes Quality Initiative chronic kidney disease (CKD) guidelines, CKD has been identified as common, particularly in the elderly. The outcomes for those with CKD can be poor: mortality, initiation of renal replacement therapy, and progressive deterioration in kidney function, with its associated complications. In young people with CKD, the risk of poor outcome is high and the social cost substantial, but the actual number of patients affected is relatively small. In the elderly, the risk of poor outcome is substantially lower, but due to the high prevalence of CKD the actual number of poor outcomes attributable to CKD is higher. Predicting which patients are at greatest risk, and being able to tailor care appropriately, has significant potential benefits. Risk prediction models in CKD are being developed and show promise but thus far have limitations. In this review we describe the pathway for developing and evaluating risk prediction tools, and consider what models we have for CKD prediction and where next.

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