Findings seen for patients with advanced chronic kidney disease<\/p>\n<\/h3>\n
By Lori Solomon HealthDay Reporter<\/b>
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WEDNESDAY, Nov. 12, 2025 (HealthDay News) — A new tool can predict individualized probability of survival with conservative management (CM) versus dialysis transition among individuals with advanced chronic kidney disease (CKD), according to a study presented at Kidney Week, the annual meeting of the American Society of Nephrology, held from Nov. 5 to 9 in Houston.<\/p>\n
Connie Rhee, M.D., from the University of California, Los Angeles, and colleagues developed a mortality risk prediction tool using data from 61,118 veterans with advanced CKD (at least two estimated glomerular filtration rates [eGFRs] <25 separated by \u226590 days) treated with CM versus dialysis (nonreceipt versus receipt of dialysis within two years of first eGFR <25 [index eGFR]) from 2010 to 2019. This tool was validated in 76,687 patients with advanced CKD treated with CM versus dialysis, identified from the OptumLabs Data Warehouse.<\/p>\n
The researchers found that in the veterans cohort (43,197 receiving CM versus 17,921 receiving dialysis), characteristics associated with death included older age; higher index eGFR, urine albumin-creatinine ratio, and Veteran Affairs frailty index; faster eGFR decline; lower albumin and body mass index; prior one-year hospitalization; heart disease; sepsis; and dialysis transition. In the development and internal validation veterans cohort, discrimination yielded C-statistics of 0.70 and 0.69, respectively. Similarly, in the OptumLabs external validation cohort, the risk score had a C-statistic of 0.69. <\/p>\n
“Our objective is to establish a stronger evidence base for conservative non-dialytic management in the advanced CKD population,” Rhee said in a statement. “By rigorously studying the comparative effectiveness of conservative management versus dialysis transition, findings from our and others\u2019 research have the potential to expand viable, patient-centric treatment options for CKD.”<\/p>\n