Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.
Duke Clinical Research Institute, Durham, NC, USA.
Curr Heart Fail Rep. 2024 Aug;21(4):407-416. doi: 10.1007/s11897-024-00668-8. Epub 2024 May 25.
End stage kidney disease can be a slow process and it may be challenging to achieve required follow-up for sufficient events. Therefore, a surrogate kidney endpoint, such as estimated glomerular filtration rate (eGFR) slope maybe attractive to assess the kidney in cardiovascular trials, especially heart failure (HF).
eGFR slope can generate informative results in a shorter follow-up period, has decreased risk of type-2 error, and is less sensitive to eGFR shifts compared with other surrogate kidney endpoints (eGFR decline≥40% or doubling creatinine). However, eGFR slope has its limitations with acute effects, heterogeneity in slope calculation/reporting, and deviations from linearity. eGFR slope is a kidney endpoint which may be well-suited for HF trials. Cross-collaborated guideline recommendations are needed to optimize the use of eGFR slope as a kidney endpoint in patients with HF.
终末期肾病可能是一个缓慢的过程，为了获得足够的事件随访，可能具有挑战性。因此，替代肾脏终点，如估计肾小球滤过率（eGFR）斜率，可能具有吸引力，可用于评估心血管试验中的肾脏，特别是心力衰竭（HF）。
eGFR 斜率可以在较短的随访期内产生有意义的结果，降低了 2 型错误的风险，并且与其他替代肾脏终点（eGFR 下降≥40%或肌酐加倍）相比，对 eGFR 变化的敏感性较低。然而，eGFR 斜率具有急性效应、斜率计算/报告的异质性以及线性偏离的局限性。eGFR 斜率是一个肾脏终点，可能非常适合 HF 试验。需要交叉协作的指南建议来优化 eGFR 斜率作为 HF 患者肾脏终点的使用。
