Abstract: SA-PO0514
CKD Remission at Two Years and Long-Term Kidney, Cardiovascular, and Mortality Outcomes
Session Information
- CKD: Clinical - Therapies, CKM Health, Special Populations, and More
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2202 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Verma, Ashish, Boston Medical Center, Boston, Massachusetts, United States
- Claudel, Sophie E., Boston Medical Center, Boston, Massachusetts, United States
- Schmidt, Insa Marie, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, United States
- Zhao, Runqi, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, United States
- Waikar, Sushrut S., Boston Medical Center, Boston, Massachusetts, United States
- Tangri, Navdeep, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada
Background
Recent advances in SGLT2 inhibitors, nonsteroidal MRAs, GLP-1 receptor agonists, and targeted therapies have shifted CKD management from slowing progression to achieving remission. However, the extent to which CKD remission is achievable and whether achieving it yields clinically significant, long-lasting improvements in long-term outcomes remains unclear.
Methods
We analyzed 3,011 CRIC participants who were event-free at Year 2. CKD remission was defined by three criteria: proteinuric CKD G2 with UPCR decline to <150 mg/g; CKD G3a improving to G2 with UPCR <150 mg/g; or CKD G3b with annualized eGFR decline <1 mL/min/1.73m2. Primary outcomes were CKD progression (>50% eGFR decline or ESKD), ESKD, and all-cause mortality; secondary outcomes were composite CVD and incident heart failure, assessed over a median follow-up of 12.5 years from Year 2. Site-stratified multivariable Cox and Fine-Gray competing-risk models estimated hazard ratios; G-formula direct standardization estimated adjusted cumulative incidence, absolute risk difference, and restricted mean survival time.
Results
Of the 3011 patients with available data, 668 achieved remission within the next 2 years.CKD remission was associated with a 61% lower risk of CKD progression (HR 0.39, 95% CI 0.32-0.48), a 53% lower risk of ESKD (HR 0.47, 95% CI 0.38–0.59), and a 17% lower risk of all-cause mortality (HR 0.83, 95% CI 0.70–0.97) than no remission (Table 1). At 10 years of follow-up, those who achieved remission had a 17.4% lower absolute risk of CKD progression, a 12.1% lower risk of ESKD, and a 4.1% lower risk of death (Table 1). At 10 years of follow-up, CKD remission increased event-free survival from CKD progression by 1.17 years, for ESKD by 0.77 years, and for death by 0.21 years (all p < 0.03) (Table 1), with no heterogeneity by sex, diabetes, prior CVD, or RAASi use.
Conclusion
CKD remission is independently associated with markedly lower long-term risk of CKD progression, ESKD, and mortality, as well as with meaningfully longer event-free time, supporting recognition of CKD remission as an attainable, durable clinical target.