Tracking changes in average eGFR over time from the eGFR slope among people enrolled in cardiovascular outcome trials of new treatments is found to be beneficial to gauge the progression of chronic kidney disease (CKD).

A review recently published in 'JAMA Cardiology’ which evaluated the potential role and limitations of eGFR slope in cardiovascular trials revealed that eGFR slope may serve as a valuable marker to determine progression of CKD in cardiovascular trials.

According to the authors, eGFR slope has demonstrated strong association with subsequent progression to end-stage kidney disease (ESKD). With adequate sample size, treatment effects in the range of 0.5 to 1.00 mL/min/1.73 m2/y had 96% probability of predicting CKD progression, defined as doubling of serum creatinine, eGFR less than 15 mL/min/1.73 m2, or ESKD. eGFR slope can be used in patients with higher baseline values and may provide CKD progression insights when few hard kidney events are observed, especially in trials with limited follow-up. The researchers also pointed out the multiple challenges in computing eGFR slope in cardiovascular trials that includes accounting for initial eGFR dip, nonlinearity, and heteroscedasticity

Further work is required to standardize data collection, follow-up duration, time points for kidney function assessment, and analytic methods to compute eGFR slope in cardiovascular trials.