McMahon GM, et al. - This trial intended to estimate the residual lifetime risk of chronic kidney disease (CKD). The findings revealed the possibility that 4 out of 10 individuals without CKD at age 50 years would eventually develop CKD. This risk appeared to be altered due to the presence of hypertension, diabetes and obesity at baseline. Hence, this study illustrated the significance of early detection of CKD risk factors, which would assist in patient education, and potentially lower the future risk of disease.

Methods

• This Framingham Offspring Study recruited individuals if they were free of CKD (estimated glomerular filtration rate <60 mL/min/1.73 m²) at age 50 years and who displayed a minimum of two serum creatinine measures during follow-up (mean 16 years, 49506 person-years).
• The lifetime risk of CKD to age 90 years was computed, adjusting for the competing risk of death in the overall cohort and in population subgroups with known CKD risk factors encompassing hypertension, obesity and diabetes.

Results

• 3362 individuals (52% women) were enrolled. Mean age at study baseline was 54 years.
• 729 patients (21.7%) developed CKD and 618 (18.4%) died at the end of this research.
• The cumulative lifetime risk of CKD was 41.3% [95% confidence interval (CI) 38.5-44.0], at age 50 years.
• Increased risk was noted among those with risk factors at baseline including diabetes (52.6%, 95% CI 44.8–60.4), hypertension (50.2%, 95% CI 46.1–54.3) and obesity (46.5%, 95% CI 41.1–52.0).
• Those patients without any risk factors at baseline displayed lower lifetime risk of CKD (34.2%, 95% CI 29.4–39.0) relative to those with 1, 2 or 3 risk factors (45.0, 51.5 and 56.1% respectively, P < 0.01 for all compared with those with no risk factors).