Chronic Kidney Disease in Primary Care: Outcomes after Five Years in a Prospective Cohort Study Interview with:
Dr. Adam Shardlow

Derby Teaching Hospitals NHS Foundation Trust
UK What is the background for this study? What are the main findings?

Response: Chronic Kidney Disease (CKD) is common in the general population, and many people are managed in primary care rather than by specialist nephrologists. This study was designed to investigate 5 year outcomes in people with mild to moderate CKD (CKD stage 3).

The main findings were that the majority of participants were stable, and progression to end stage renal disease was a rarity. Interestingly, and contrary to common thinking about CKD, we found that a significant minority no longer had evidence of CKD stage 3 at 5 years, which we have termed ‘CKD remission’. What should readers take away from your report?

Response: In our population of people with CKD stage 3 at baseline, progressive CKD was uncommon. Common clinical variables can be used to predict those at high risk of progression, allowing timely referral to secondary care. Similarly, we have shown that CKD remission may also be predicted using similar variables. This will impact upon how we explain CKD and manage patients in the primary care setting, both in reassuring those at low risk, and monitoring those at higher risk more frequently. What recommendations do you have for future research as a result of this study?

Response: The concept of CKD remission warrants further investigation in different populations. We recommend that thought is given to CKD remission in CKD diagnostic criteria in the future. Ongoing work may improve our ability to predict risk in this population. Thank you for your contribution to the community.


Chronic Kidney Disease in Primary Care: Outcomes after Five Years in a Prospective Cohort Study

Adam Shardlow ,Natasha J. McIntyre,Richard J. Fluck,Christopher W. McIntyre,
Maarten W. Taal
Published: September 20, 2016

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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