A new online tool may help predict whether someone with chronic kidney disease will develop kidney failure in the next two to five years.
Using results from kidney function tests, the tool helps those at high risk for kidney failure prepare for dialysis or kidney transplant. It also provides reassurance to those who likely won’t progress to kidney failure, said lead researcher Dr. Navdeep Tangri, an associate professor of nephrology at the University of Manitoba in Winnipeg, Canada.
“This study sets the stage for the tool to be used globally for all patients with kidney disease. The tool helps patients plan their lives by knowing what their risk is for dialysis,” Tangri said.
To find out the risk of kidney failure, patients need blood and urine test results from their doctor to enter into the online calculator, along with their age and sex, Tangri explained.
Tangri said that, working with their doctor, patients can use the tool’s findings to help lower their risk of kidney failure by better controlling their blood pressure and blood sugar, along with eating a healthy diet and exercising.
“In nine out of 10 cases, patients think their risk is higher than it actually is,” Tangri said. “Most of the time, the information provides them with peace of mind.”
The report was published Jan. 12 in the Journal of the American Medical Association.
For the study, researchers tested the accuracy of the online tool in more than 700,000 people with chronic kidney disease in 30 countries. The investigators found that the risk calculator accurately predicted the risk of kidney failure in two or five years.
Tangri said that results in the United States were similar to those in the original Canadian study. However, in countries outside North America, the tool needed adjustment to account for the lower kidney failure risk in these countries, he said.
Doctors in some of these countries may be less likely to refer patients for dialysis or they may be better at treating kidney disease, Tangri said.
According to the researchers, the original Canadian tool was criticized because there was little data from black patients with kidney disease. Blacks have the highest rates of kidney disease in the United States. However, including more black patients didn’t change the accuracy of the tool, the researchers found.
In the United States, about 26 million people have kidney disease, the National Kidney Foundation says. Kidney failure occurs when approximately 85 to 90 percent of your kidney function is gone, according to the foundation.
In 2013, more than 117,000 patients developed kidney failure, the study authors said. About 1 percent of those with chronic kidney disease develop kidney failure every two years, they added.
The tool can help patients in several ways, Tangri said. It can help patients and doctors plan for potential dialysis or transplant. Because patients who need dialysis require an operation to create a fistula to connect them to the machine and it takes months of healing before the fistula can be used, the surgery can take place long before dialysis begins.
For patients who need a kidney transplant, the tool allows them to get on a transplant list earlier.
Kidney specialist Dr. Maria DeVita, of Lenox Hill Hospital in New York City, said, “Since chronic kidney disease is well known to progress at various rates in individual patients — even amongst those with the same diagnosis — it has been a clinical problem on how best to advise patients preparing for kidney failure or to allocate resources for those at the highest risk.”
This report is good news for those with chronic kidney disease and their doctors, she said.
“This study gives all clinicians hope that we will be able to better predict which patients are at the greatest risk of progressing to end-stage kidney disease,” DeVita said.
For more on kidney disease, visit the National Kidney Foundation.
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