Contribution of the glomerular filtration rate slope to the kidney hierarchical composite endpoint

IF 14.8 1区医学 Q1 UROLOGY & NEPHROLOGY

Kidney international Pub Date : 2025-03-24 DOI:10.1016/j.kint.2025.03.011

Dustin J. Little , Niels Jongs , Meike Brinker , Samvel B. Gasparyan , Patrick Schloemer , Hiddo J.L. Heerspink

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引用次数: 0

Abstract

Introduction

A recent chronic kidney disease (CKD) progression hierarchical composite endpoint (HCE) utilizes the glomerular filtration rate (GFR) slope for participants without a dichotomous event. Here, we evaluated clinical interpretations when HCE analyses are driven by GFR slope comparisons.

Methods

Using CKD trial data, we calculated win odds using only GFR slope; dichotomous kidney events and GFR slope; all-cause mortality, dichotomous kidney events, and GFR slope; and all-cause mortality with dichotomous kidney events.

Results

Win odds (95% confidence interval) calculated from pairwise GFR slope only comparisons were 1.44 (1.34–1.55), 1.60 (1.49–1.72), 1.19 (1.10–1.28), and 0.82 (0.78–0.86) in the DAPA-CKD, CREDENCE, SONAR, and ALTITUDE trials, respectively. Win odds were similar for the GFR slope only and full kidney HCE with and without mortality.

Conclusions

These results support incorporation of GFR slope into the CKD progression HCE and help to interpret the magnitude of treatment effect on kidney HCE estimated with win odds.

查看原文本刊更多论文

肾小球滤过率斜率对肾脏分级复合终点的贡献。

最近的一项慢性肾脏疾病（CKD）进展分层复合终点（HCE）利用肾小球滤过率（GFR）斜率来评估无二分事件的参与者。在这里，我们评估了由GFR斜率比较驱动的HCE分析的临床解释。方法：使用CKD试验数据，仅使用GFR斜率计算获胜几率；二分类肾事件和GFR斜率；全因死亡率、双肾事件和GFR斜率；两种肾事件的全因死亡率。结果：在DAPA-CKD、CREDENCE、SONAR和ALTITUDE试验中，仅GFR斜率的成对比较计算出的获胜几率（95%置信区间）分别为1.44（1.34-1.55）、1.60（1.49-1.72）、1.19（1.10-1.28）和0.82（0.78-0.86）。仅GFR斜率和全肾HCE的死亡率相似。结论：这些结果支持GFR斜率与CKD进展HCE的关联，并有助于解释治疗对肾脏HCE的影响程度。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Kidney international 医学-泌尿学与肾脏学

CiteScore

23.30

自引率

3.10%

发文量

490

审稿时长

3-6 weeks

期刊介绍： Kidney International (KI), the official journal of the International Society of Nephrology, is led by Dr. Pierre Ronco (Paris, France) and stands as one of nephrology's most cited and esteemed publications worldwide. KI provides exceptional benefits for both readers and authors, featuring highly cited original articles, focused reviews, cutting-edge imaging techniques, and lively discussions on controversial topics. The journal is dedicated to kidney research, serving researchers, clinical investigators, and practicing nephrologists.