View in EDS PDF Full Text

El KFRE como criterio de remisión a las consultas de enfermedad renal crónica avanzada.

Saved in:
Bibliographic Details
Title: El KFRE como criterio de remisión a las consultas de enfermedad renal crónica avanzada.
Alternate Title: KFRE as a criterion for referral to advanced chronic kidney disease consultations.
Authors: Gallego-Valcarce, Eduardo1 egallegov@telefonica.net, Rey-Cárdenas, Angela1, López-Melero, Eva1, María Tato-Ribera, Ana1, Roldan, Deborah1, San Román, Sofía López1, Méndez Abreu, Ángel1, Cases-Corona, Clara1, Gruss, Enrique1
Source: Nefrologia. Jan2026, Vol. 46 Issue 1, p1-9. 9p.
Subjects: RENAL replacement therapy, PREDICTION models, CHRONIC kidney failure, GLOMERULAR filtration rate, TREATMENT effectiveness, AGE differences, KIDNEY disease diagnosis
Abstract (English): Background and objective: The KDIGO guidelines recommend as a criterion for referral to ACKD consultations a risk > 10% of requiring renal replacement therapy (RRT) before 2 years. This risk should be assessed with externally validated prediction models. The prediction model KFRE and the Grams model meet these requirements. In an ACKD unit with a remission criterion of eGFR < 30 mL/min, we proposed a retrospective cohort study to evaluate whether the application of a KFRE > 10% as a remission criterion allows differentiation of patients according to their clinical and analytical characteristics and their evolution. Patients and methods: We studied 573 patients followed in the ACKD clinic for at least 4 years. In the first consultation we classified them into two groups according to their 2-year KFRE: < 10% or = 10%. We compared their clinical and analytical characteristics and whether the prognoses made by Grams' model at baseline matched the observed evolution. Both groups were analysed according to two age ranges: older and younger than 75 years. Results: Patients with KFRE = 10% (53.4%), with respect to those with KFRE < 10%, were significantly younger and their annual eGFR loss was greater. They had different evolution: at 2 years, 38.9% vs 3% (P < .05) started RRT and 45.8% vs 79.8% (P < .05) remained in the clinic; at 4 years, 60.7% vs 15.6% (P < .05) started RRT and 16.7% vs 52.3% (P < .05) remained in the clinic. In the group with KFRE< 10% those = 75 years vs < 75 years initiated RRT and died previously in a significantly different proportion at 2 years: 1.2 vs 6.1% and 23.7 vs 6.1% respectively (P < .05). In the group with KFRE = 10% those = 75 years and those < 75 years initiated RRT and previously died in a significantly different proportion at 2 years: 25.9 vs 46.4% and 32.1 vs 5.7%, respectively (P < .05). Prediction models predicted all these differences quite accurately. Conclusions: A KFRE = 10% at 2 years would be an appropriate criterion for referral to ACKD consultations, since it would select a group of patients who are really going to require RRT in the medium term, regardless of their age, and would avoid the referral of patients at low risk of requiring RRT, mainly elderly patients. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Antecedentes y objetivo: Las guías KDIGO recomiendan como criterio de remisión a las consultas de ERCA un riesgo > 10% de precisar tratamiento renal sustitutivo (TRS) antes de 2 años. Este riesgo se debe evaluar con modelos de predicción validados externamente. El modelo de predicción KFRE y el modelo de Grams cumplen estos requisitos. En una unidad de ERCA con un criterio de remisión de FGe < 30 ml/min, planteamos un estudio de cohortes retrospectivo para evaluar si la aplicación de un KFRE > 10% como criterio de remisión permite diferenciar a los pacientes según sus características clínicas y analíticas y su evolución. Pacientes y métodos: Estudiamos 573 pacientes seguidos en la consulta de ERCA al menos durante 4 años. En la primera consulta los clasificamos en dos grupos según su KFRE a 2 años: < 10% o = 10%. Comparamos sus características clínicas y analíticas y si los pronósticos efectuados por el modelo de Grams al inicio se ajustan a la evolución observada. Ambos grupos se han analizado según dos rangos de edad: mayores y menores de 75 años. Resultados: Los pacientes con KFRE = 10% (53,4%), con respecto a los que tenían KFRE < 10%, eran significativamente más jóvenes y su pérdida anual de FGe fue mayor. Tuvieron diferente evolución: a los 2 años iniciaron TRS el 38,9% vs el 3% (p < 0,05) y permanecieron en la consulta el 45,8% vs el 79,8% (p < 0,05), a los 4 años iniciaron TRS el 60,7% vs el 15,6% (p < 0,05), permanecieron en la consulta el 16,7% vs el 52,3% (p < 0,05). En el grupo con KFRE< 10% los = 75 años frente a los < 75 años iniciaron TRS y fallecieron previamente en una proporción significativamente diferente a los 2 años: 1,2 vs 6,1% y 23,7 vs 6,1%, respectivamente (p < 0,05). En el grupo con KFRE = 10% los = 75 años y los < 75 años iniciaron TRS y fallecieron previamente en una proporción significativamente diferente a los 2 años: 25,9 vs 46,4% y 32,1 vs 5,7%, respectivamente (p < 0,05). Los modelos de predicción pronosticaron todas estas diferencias con bastante exactitud. Conclusiones: Un KFRE = 10% a 2 años sería un adecuado criterio de remisión a las consultas de ERCA, ya que seleccionaría un grupo de pacientes que realmente van a precisar TRS a medio plazo, independientemente de su edad, y evitaría la remisión de enfermos con escaso riesgo de precisar TRS, fundamentalmente pacientes de edad avanzada. [ABSTRACT FROM AUTHOR]
Copyright of Nefrologia is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: MedicLatina
FullText Links:
  – Type: pdflink
Text:
  Availability: 0
Header DbId: lth
DbLabel: MedicLatina
An: 191001598
AccessLevel: 6
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: El KFRE como criterio de remisi&#243;n a las consultas de enfermedad renal cr&#243;nica avanzada.
– Name: TitleAlt
  Label: Alternate Title
  Group: TiAlt
  Data: KFRE as a criterion for referral to advanced chronic kidney disease consultations.
– Name: Author
  Label: Authors
  Group: Au
  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Gallego-Valcarce%2C+Eduardo%22&quot;&gt;Gallego-Valcarce, Eduardo&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;i&gt; egallegov@telefonica.net&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Rey-C&#225;rdenas%2C+Angela%22&quot;&gt;Rey-C&#225;rdenas, Angela&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22L&#243;pez-Melero%2C+Eva%22&quot;&gt;L&#243;pez-Melero, Eva&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Mar&#237;a+Tato-Ribera%2C+Ana%22&quot;&gt;Mar&#237;a Tato-Ribera, Ana&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Roldan%2C+Deborah%22&quot;&gt;Roldan, Deborah&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22San+Rom&#225;n%2C+Sof&#237;a+L&#243;pez%22&quot;&gt;San Rom&#225;n, Sof&#237;a L&#243;pez&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22M&#233;ndez+Abreu%2C+&#193;ngel%22&quot;&gt;M&#233;ndez Abreu, &#193;ngel&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Cases-Corona%2C+Clara%22&quot;&gt;Cases-Corona, Clara&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Gruss%2C+Enrique%22&quot;&gt;Gruss, Enrique&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;
– Name: TitleSource
  Label: Source
  Group: Src
  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Nefrologia%22&quot;&gt;Nefrologia&lt;/searchLink&gt;. Jan2026, Vol. 46 Issue 1, p1-9. 9p.
– Name: Subject
  Label: Subjects
  Group: Su
  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22RENAL+replacement+therapy%22&quot;&gt;RENAL replacement therapy&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22PREDICTION+models%22&quot;&gt;PREDICTION models&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22CHRONIC+kidney+failure%22&quot;&gt;CHRONIC kidney failure&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22GLOMERULAR+filtration+rate%22&quot;&gt;GLOMERULAR filtration rate&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22TREATMENT+effectiveness%22&quot;&gt;TREATMENT effectiveness&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22AGE+differences%22&quot;&gt;AGE differences&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22KIDNEY+disease+diagnosis%22&quot;&gt;KIDNEY disease diagnosis&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract (English)
  Group: Ab
  Data: Background and objective: The KDIGO guidelines recommend as a criterion for referral to ACKD consultations a risk &gt; 10% of requiring renal replacement therapy (RRT) before 2 years. This risk should be assessed with externally validated prediction models. The prediction model KFRE and the Grams model meet these requirements. In an ACKD unit with a remission criterion of eGFR &lt; 30 mL/min, we proposed a retrospective cohort study to evaluate whether the application of a KFRE &gt; 10% as a remission criterion allows differentiation of patients according to their clinical and analytical characteristics and their evolution. Patients and methods: We studied 573 patients followed in the ACKD clinic for at least 4 years. In the first consultation we classified them into two groups according to their 2-year KFRE: &lt; 10% or = 10%. We compared their clinical and analytical characteristics and whether the prognoses made by Grams&#39; model at baseline matched the observed evolution. Both groups were analysed according to two age ranges: older and younger than 75 years. Results: Patients with KFRE = 10% (53.4%), with respect to those with KFRE &lt; 10%, were significantly younger and their annual eGFR loss was greater. They had different evolution: at 2 years, 38.9% vs 3% (P &lt; .05) started RRT and 45.8% vs 79.8% (P &lt; .05) remained in the clinic; at 4 years, 60.7% vs 15.6% (P &lt; .05) started RRT and 16.7% vs 52.3% (P &lt; .05) remained in the clinic. In the group with KFRE&lt; 10% those = 75 years vs &lt; 75 years initiated RRT and died previously in a significantly different proportion at 2 years: 1.2 vs 6.1% and 23.7 vs 6.1% respectively (P &lt; .05). In the group with KFRE = 10% those = 75 years and those &lt; 75 years initiated RRT and previously died in a significantly different proportion at 2 years: 25.9 vs 46.4% and 32.1 vs 5.7%, respectively (P &lt; .05). Prediction models predicted all these differences quite accurately. Conclusions: A KFRE = 10% at 2 years would be an appropriate criterion for referral to ACKD consultations, since it would select a group of patients who are really going to require RRT in the medium term, regardless of their age, and would avoid the referral of patients at low risk of requiring RRT, mainly elderly patients. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label: Abstract (Spanish)
  Group: Ab
  Data: Antecedentes y objetivo: Las gu&#237;as KDIGO recomiendan como criterio de remisi&#243;n a las consultas de ERCA un riesgo &gt; 10% de precisar tratamiento renal sustitutivo (TRS) antes de 2 a&#241;os. Este riesgo se debe evaluar con modelos de predicci&#243;n validados externamente. El modelo de predicci&#243;n KFRE y el modelo de Grams cumplen estos requisitos. En una unidad de ERCA con un criterio de remisi&#243;n de FGe &lt; 30 ml/min, planteamos un estudio de cohortes retrospectivo para evaluar si la aplicaci&#243;n de un KFRE &gt; 10% como criterio de remisi&#243;n permite diferenciar a los pacientes seg&#250;n sus caracter&#237;sticas cl&#237;nicas y anal&#237;ticas y su evoluci&#243;n. Pacientes y m&#233;todos: Estudiamos 573 pacientes seguidos en la consulta de ERCA al menos durante 4 a&#241;os. En la primera consulta los clasificamos en dos grupos seg&#250;n su KFRE a 2 a&#241;os: &lt; 10% o = 10%. Comparamos sus caracter&#237;sticas cl&#237;nicas y anal&#237;ticas y si los pron&#243;sticos efectuados por el modelo de Grams al inicio se ajustan a la evoluci&#243;n observada. Ambos grupos se han analizado seg&#250;n dos rangos de edad: mayores y menores de 75 a&#241;os. Resultados: Los pacientes con KFRE = 10% (53,4%), con respecto a los que ten&#237;an KFRE &lt; 10%, eran significativamente m&#225;s j&#243;venes y su p&#233;rdida anual de FGe fue mayor. Tuvieron diferente evoluci&#243;n: a los 2 a&#241;os iniciaron TRS el 38,9% vs el 3% (p &lt; 0,05) y permanecieron en la consulta el 45,8% vs el 79,8% (p &lt; 0,05), a los 4 a&#241;os iniciaron TRS el 60,7% vs el 15,6% (p &lt; 0,05), permanecieron en la consulta el 16,7% vs el 52,3% (p &lt; 0,05). En el grupo con KFRE&lt; 10% los = 75 a&#241;os frente a los &lt; 75 a&#241;os iniciaron TRS y fallecieron previamente en una proporci&#243;n significativamente diferente a los 2 a&#241;os: 1,2 vs 6,1% y 23,7 vs 6,1%, respectivamente (p &lt; 0,05). En el grupo con KFRE = 10% los = 75 a&#241;os y los &lt; 75 a&#241;os iniciaron TRS y fallecieron previamente en una proporci&#243;n significativamente diferente a los 2 a&#241;os: 25,9 vs 46,4% y 32,1 vs 5,7%, respectivamente (p &lt; 0,05). Los modelos de predicci&#243;n pronosticaron todas estas diferencias con bastante exactitud. Conclusiones: Un KFRE = 10% a 2 a&#241;os ser&#237;a un adecuado criterio de remisi&#243;n a las consultas de ERCA, ya que seleccionar&#237;a un grupo de pacientes que realmente van a precisar TRS a medio plazo, independientemente de su edad, y evitar&#237;a la remisi&#243;n de enfermos con escaso riesgo de precisar TRS, fundamentalmente pacientes de edad avanzada. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: &lt;i&gt;Copyright of Nefrologia is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=lth&AN=191001598
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1016/j.nefro.2025.501412
    Languages:
      – Code: spa
        Text: Spanish
    PhysicalDescription:
      Pagination:
        PageCount: 9
        StartPage: 1
    Subjects:
      – SubjectFull: RENAL replacement therapy
        Type: general
      – SubjectFull: PREDICTION models
        Type: general
      – SubjectFull: CHRONIC kidney failure
        Type: general
      – SubjectFull: GLOMERULAR filtration rate
        Type: general
      – SubjectFull: TREATMENT effectiveness
        Type: general
      – SubjectFull: AGE differences
        Type: general
      – SubjectFull: KIDNEY disease diagnosis
        Type: general
    Titles:
      – TitleFull: El KFRE como criterio de remisión a las consultas de enfermedad renal crónica avanzada.
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Gallego-Valcarce, Eduardo
      – PersonEntity:
          Name:
            NameFull: Rey-Cárdenas, Angela
      – PersonEntity:
          Name:
            NameFull: López-Melero, Eva
      – PersonEntity:
          Name:
            NameFull: María Tato-Ribera, Ana
      – PersonEntity:
          Name:
            NameFull: Roldan, Deborah
      – PersonEntity:
          Name:
            NameFull: San Román, Sofía López
      – PersonEntity:
          Name:
            NameFull: Méndez Abreu, Ángel
      – PersonEntity:
          Name:
            NameFull: Cases-Corona, Clara
      – PersonEntity:
          Name:
            NameFull: Gruss, Enrique
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 01
              Text: Jan2026
              Type: published
              Y: 2026
          Identifiers:
            – Type: issn-print
              Value: 02116995
          Numbering:
            – Type: volume
              Value: 46
            – Type: issue
              Value: 1
          Titles:
            – TitleFull: Nefrologia
              Type: main
ResultId 1