2014
DOI: 10.1053/j.ajkd.2013.09.016
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Estimated GFR Decline as a Surrogate End Point for Kidney Failure: A Post Hoc Analysis From the Reduction of End Points in Non–Insulin-Dependent Diabetes With the Angiotensin II Antagonist Losartan (RENAAL) Study and Irbesartan Diabetic Nephropathy Trial (IDNT)

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Cited by 59 publications
(37 citation statements)
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“…This rate of decline may be a predictive factor [8] and has also been used as a criterion for evaluating the efficacy of renoprotective agents. In addition to increases in the serum creatinine level of 1.5- and 2-fold, a 40% or 30% decline in the estimated glomerular filtration rate (eGFR) from baseline have recently been proposed as new surrogate endpoints [911]. …”
Section: Introductionmentioning
confidence: 99%
“…This rate of decline may be a predictive factor [8] and has also been used as a criterion for evaluating the efficacy of renoprotective agents. In addition to increases in the serum creatinine level of 1.5- and 2-fold, a 40% or 30% decline in the estimated glomerular filtration rate (eGFR) from baseline have recently been proposed as new surrogate endpoints [911]. …”
Section: Introductionmentioning
confidence: 99%
“…Attenuation of the hazard ratio of the treatment effect for lesser eGFR declines compared to the hazard ratio for the clinical endpoint can outweigh the benefit of an increased number of endpoint events. 11,22 Third, since the number and type of trials in CKD are limited, particularly with respect to length of follow-up and number of ESRD events reached, simulation studies are necessary to assess a wide range of potential scenarios to evaluate the utility, robustness and power of lesser eGFR declines. 23 In particular, simulation studies can address the impact of short-term (acute) effects on kidney function in the same or opposite direction from the long term (chronic) effect of a treatment, such as lower blood pressure or renin-angiotensin system inhibition.…”
Section: Discussionmentioning
confidence: 99%
“…6 Other studies focused on mortality and cardiovascular disease since these outcomes occur more commonly than ESRD and showed a strong relationship with various definitions for CKD progression. 7-11 A systematic evaluation across studies using a uniform analytic approach is needed to provide a more rigorous basis for determining the prognosis associated with specific declines in eGFR. Clinical trials with doubling of serum creatinine or ESRD as an end-point typically have follow-up of approximately 5 years.…”
Section: Introductionmentioning
confidence: 99%
“…With regard to the change in eGFR, studies have consistently demonstrated that one-year change in eGFR is strongly related to the risks of ESRD, 56 cardiovascular disease, 78 and mortality 5710 among NDD-CKD patients. Recently, not only declining eGFR but also increasing eGFR has been shown to be independently associated with higher mortality.…”
Section: Discussionmentioning
confidence: 99%
“…Several studies have demonstrated strong associations between change in estimated glomerular filtration rate (eGFR) over one year and risk of ESRD, 56 cardiovascular disease, 78 and mortality 5710 among NDD-CKD patients. However, these studies have focused primarily on patients with relatively preserved kidney function, and only a few studies have examined the association between increasing eGFR trajectory and risk of adverse outcomes.…”
Section: Introductionmentioning
confidence: 99%