Stengel B, et al. - The determinants of prognosis and care of patients referred to nephrologists with moderate and advanced chronic kidney disease (CKD) were determined in the French Chronic Kidney Disease–Renal Epidemiology and Information Network (CKD-REIN) cohort study, by assessing their baseline risk profile and experience. Cohort members exhibited high-risk profiles. Improving blood pressure (BP) control and dietary counselling and increasing doctors’ awareness of acute kidney injury (AKI), polypharmacy and quality of life (QoL) were some of the several priorities identified in this study.

• This study included a total of 3033 outpatients with CKD and estimated glomerular filtration rates (eGFRs) of 15–60 mL/min/1.73 m² treated at 40 nationally representative public and private facilities.
• Researchers gathered the bioclinical and patient-reported information.

• Data showed that the patients’ median age was 69 (60–76) years, 65% were men.
• The mean eGFR of patients was 33 mL/min/1.73 m².
• Diabetes, a history of acute kidney injury (AKI) and uncontrolled blood pressure (BP; >140/90 mmHg) was present in 43%, 24% and 57%, respectively.
• Relative to women, men had worse risk profiles and were more likely to be past or current smokers (73% vs 34%) and have cardiovascular disease (59% vs 42%), albuminuria >30 mg/mmol (or proteinuria > 50) (40% vs 30%) (all P < 0.001) and a higher median risk of end-stage renal disease within 5 years, predicted by the kidney failure risk equation {12% [interquartile range (IQR) 3–37%] vs 9% [3–31%], P=0.008}.
• One-to-two nephrologist visits and four or more general practitioner visits were reported by 60% of patients during the previous year; a dietician was consulted by only 25% and 75% were prescribed five or more medications daily.
• Poor physical and mental quality of life (QoL) was reported, with scores <50/100.