Abstract: SA-PO1190
Rate of GFR Loss: A 50-Year Analysis
Session Information
- CKD: Biomarkers and Emerging Tools for Diagnosis and Monitoring
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Cohen, Eric P., New York University, New York, New York, United States
- Mehta, Mansi, New York University, New York, New York, United States
Background
CKD is usually progressive with loss of kidney function over time. Rate of loss of kidney function (GFR) is a clinical trial metric. That use can be complicated by non-linear progression rates, and may differ between clinic compared to study populations.
Methods
Our PubMed search used ("Renal Insufficiency, Chronic" OR chronic renal insufficiency OR Chronic progressive renal disease OR chronic renal disease OR chronic renal failure) AND "Creatinine/blood" AND "Regression Analysis" AND ("Humans") NOT dialysis OR hemodialysis) and found added references without exclusion by cause of CKD. We included only studies reporting numerical rates of progression. Means or medians were recorded, as per the study. Individual data were averaged for studies showing those. Linearity was recorded. Use of RAA (renin-angiotensin antagonists) was recorded and those data assigned to the RAA group. Group comparisons were possible for clinic versus study and no RAA versus RAA, because other comparisons would be between overlapping groups.
Results
70 references were identified from 1976 to 2025. Of those 85% reported linear rates of loss of GFR or eGFR over time. Loss of GFR in the 70 studies was at a mean rate of 5.4 ml/min/year. Progression rates have fallen over time as shown below. Studies using RAA show slower rates of progression than those not using them. Studies using RAA with SGLT2i have an average progression rate of 1.9 ± 1.2 ml/min/year, which approaches the age-related rate of loss of GFR. 3 of the 70 articles report that the rate of loss of GFR in CKD may slow in association with more frequent Nephrology clinic care.
Conclusion
The variable of office visit frequency has not been controlled for in recent large intervention studies. Along with better adherence, frequency of office visits in a study setting may account for part of the benefit of both RAA and SGLT2i, and for the lesser rates of progression in recent intervention studies compared to usual in-practice experience.
| All, ml/min/year | Clinic only | Study only | No RAA | RAA | SGLT2i |
| 5.4 ± 4.4 | 7.6 ± 4.1 | 4.5 ± 2.1 | 7.6 ± 5.3 | 3.6 ± 2.7 | 1.9 ± 1.2 |
Delta GFR / year ± sd
Funding
- Veterans Affairs Support