Tangri Navdeep, Ferguson Thomas, Komenda Paul
Department of Medicine and Community Health Sciences, University of Manitoba, Seven Oaks General Hospital, Winnipeg, Manitoba, Canada.
Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Nephrol Dial Transplant. 2017 May 1;32(5):748-751. doi: 10.1093/ndt/gfx067.
Accurate risk prediction for chronic kidney disease (CKD) progression can inform the patient-provider dialogue, and provide actionable thresholds for key clinical decisions. In 2011, we developed the kidney failure risk equations (KFREs) to predict the risk of kidney failure requiring dialysis or transplant in patients with CKD. Subsequently, the KFREs have been extensively validated, and have now been proven accurate in multiple continents, ethnicities and disease-specific subpopulations. They can discriminate progressors from non-progressors, and are well calibrated and easy to use. We believe that current and future studies should now focus on clinical implementation of the KFREs, through quality improvement initiatives and cluster randomized trials. A risk-based care paradigm for CKD care can be achieved through knowledge translation and implementation research.
对慢性肾脏病（CKD）进展进行准确的风险预测，可为医患沟通提供依据，并为关键临床决策提供可操作的阈值。2011年，我们开发了肾衰竭风险方程（KFREs），以预测CKD患者需要透析或移植的肾衰竭风险。随后，KFREs得到了广泛验证，现已在多个大洲、不同种族和特定疾病亚人群中被证明是准确的。它们能够区分病情进展者和非进展者，校准良好且易于使用。我们认为，当前和未来的研究现在应通过质量改进计划和整群随机试验，专注于KFREs的临床应用。通过知识转化和实施研究，可以实现基于风险的CKD护理模式。
