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Defining improvement in chronic kidney disease: regression and remission

Taal, Maarten W

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Authors



Abstract

Purpose of review: International definitions exist for chronic kidney disease (CKD) progression and kidney failure but despite evidence that kidney function may improve, there are no agreed definitions for regression and remission of CKD. In the light of recent novel kidney protective therapies and the promise of regenerative medicine to reverse kidney damage, it is time to critically examine these neglected aspects of CKD epidemiology.

Recent findings: We propose that CKD regression is viewed as a process of improvement defined as a sustained increase in glomerular filtration rate (GFR) by ≥25% and an improvement in GFR category or increase in GFR of 1≥ml/min/year, whereas remission is considered a category of improvement defined as GFR ≥60 ml/min/1.73m2 and urine albumin to creatinine ratio <30 mg/g. Several recent studies have reported improvement in kidney function in populations with CKD, even in the absence of specific therapy. Regression and remission of CKD are associated with increased likelihood of sustained improvement in kidney function as well as improved survival.

Summary: Further research is warranted to validate the proposed definitions and investigate associated mechanisms. We look to a future in which the goal of therapy is not merely to slow CKD progression but to improve kidney function and seek a cure.

Journal Article Type Article
Acceptance Date Jul 7, 2022
Online Publication Date Jul 25, 2022
Publication Date Nov 1, 2022
Deposit Date Jul 15, 2022
Publicly Available Date Jul 26, 2023
Journal Current Opinion in Nephrology and Hypertension
Print ISSN 1062-4821
Electronic ISSN 1473-6543
Publisher Ovid Technologies (Wolters Kluwer Health)
Peer Reviewed Peer Reviewed
Volume 31
Issue 6
Pages 517-521
DOI https://doi.org/10.1097/MNH.0000000000000830
Keywords Nephrology; Internal Medicine
Public URL https://nottingham-repository.worktribe.com/output/8954693
Publisher URL https://journals.lww.com/co-nephrolhypertens/Fulltext/2022/11000/Defining_improvement_in_chronic_kidney_disease_.2.aspx