Classifying Risk in Patients With Chronic Kidney Disease
Authors: Marcello Tonelli, Paul Muntner, Brenda Hemmelgarn
Journal: Annals of Internal Medicine (2011)

Letters19 July 2011Classifying Risk in Patients With Chronic Kidney DiseaseMarcello Tonelli, MD, SM, Paul Muntner, PhD, and Brenda Hemmelgarn, PhD, MDMarcello Tonelli, MD, SMFrom University of Alberta, Edmonton, Alberta T6B 2G3, Canada; University of Alabama at Birmingham, Birmingham, AL 35294; and University of Alberta, Calgary, Alberta T2N 2T9, Canada.Search for more papers by this author, Paul Muntner, PhDFrom University of Alberta, Edmonton, Alberta T6B 2G3, Canada; University of Alabama at Birmingham, Birmingham, AL 35294; and University of Alberta, Calgary, Alberta T2N 2T9, Canada.Search for more papers by this author, and Brenda Hemmelgarn, PhD, MDFrom University of Alberta, Edmonton, Alberta T6B 2G3, Canada; University of Alabama at Birmingham, Birmingham, AL 35294; and University of Alberta, Calgary, Alberta T2N 2T9, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-155-2-201107190-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We agree with Dr. Thorp that it is always preferable to use the most accurate equation available and to use repeated measures of eGFR to classify persons with respect to kidney function. The incremental benefit of using the CKD Epidemiology Collaboration eGFR equation (1) and multiple eGFR measurements spaced at least 3 months apart (2) is worthy of consideration but would be unlikely to affect our conclusion—that incorporating information on proteinuria would improve the prognostic power of the current staging system for CKD.Marcello Tonelli, MD, SMUniversity of AlbertaEdmonton, Alberta T6B 2G3, CanadaPaul Muntner, PhDUniversity of Alabama ...References1. Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF, Feldman HI, et al; CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration). A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150:604-12. [PMID: 19414839] LinkGoogle Scholar2. NKF KDOQI clinical practice guidelines for chronic kidney disease. Am J Kidney Dis. 2002;39 Suppl 1 76. [PMID: 11904577] MedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Marcello Tonelli, MD, SM; Paul Muntner, PhD; Brenda Hemmelgarn, PhD, MDAffiliations: From University of Alberta, Edmonton, Alberta T6B 2G3, Canada; University of Alabama at Birmingham, Birmingham, AL 35294; and University of Alberta, Calgary, Alberta T2N 2T9, Canada.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M10-0837. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoA New Equation to Estimate Glomerular Filtration Rate Andrew S. Levey , Lesley A. Stevens , Christopher H. Schmid , Yaping (Lucy) Zhang , Alejandro F. Castro III , Harold I. Feldman , John W. Kusek , Paul Eggers , Frederick Van Lente , Tom Greene , Josef Coresh , and Using Proteinuria and Estimated Glomerular Filtration Rate to Classify Risk in Patients With Chronic Kidney Disease Marcello Tonelli , Paul Muntner , Anita Lloyd , Braden J. Manns , Matthew T. James , Scott Klarenbach , Robert R. Quinn , Natasha Wiebe , Brenda R. Hemmelgarn , and Classifying Risk in Patients With Chronic Kidney Disease Micah L. Thorp Metrics 19 July 2011Volume 155, Issue 2Page: 134KeywordsChronic kidney diseaseConflicts of interestDisclosureEpidemiologyEstimated glomerular filtration rateInformation technologyKidneysProteinuria ePublished: 19 July 2011 Issue Published: 19 July 2011 Copyright & PermissionsCopyright © 2011 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...