Prognosis

A plot of the reciprocal of serum creatinine against time is often linear. In this way future renal function may be predicted.

Chronic kidney disease (CKD) is mostly progressive and leads to end-stage kidney disease and the need for kidney replacement therapy (i.e., dialysis, transplant).

Diabetes and high blood pressure (BP) are the main causes of end-stage kidney disease in adults. In the US in 2020, nearly 808,000 people were living with end-stage kidney disease: 69% on dialysis and 31% with a kidney transplant (1)

The CRIC study shows that CKD progression is correlated with cognitive decline, cardiovascular mortality, left ventricular hypertrophy, coronary artery calcification, and clinical depression, among other associations (2)

Life expectancy for patients with end-stage kidney disease is significantly reduced. Transplant confers a significant survival advantage over maintenance dialysis therapy, due mainly to reduced risk of cardiovascular death. For patients starting dialysis or receiving a kidney transplant in 2018, 5-year survival was: (3)

• 40.7% for haemodialysis patients​
• 42.5% for peritoneal dialysis patients
• 80.3% for patients receiving a deceased donor transplant
• 91.5% for patients receiving a living donor transplant.

Reference:

1. Centers for Disease Control and Prevention (CDC). Chronic kidney disease in the United States, 2023. ​May 2024 [internet publication].
2. Bundy JD et al. CRIC Study Investigators. Risk factors for progression of coronary artery calcification in patients with chronic kidney disease: The CRIC study. Atherosclerosis. 2018 Apr;271:53-60
3. United States Renal Data System. 2024 USRDS annual data report: epidemiology of kidney disease in the United States. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2024.