KFRE as a criterion for referral to advanced chronic kidney disease consultations

The KDIGO guidelines recommend as a criterion for referral to ACKD consultations a risk >10% of requiring renal replacement therapy before 2 years. This risk should be assessed with externally validated prediction models. The prediction models (KFRE) and the Grams model meet these requirements. In an ACKD unit with a remission criterion of eGFR 10% as a remission criterion allows differentiation of patients according to their clinical and analytical characteristics and their evolution. 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: < 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 analyzed according to two age ranges: older and younger than 75 years. 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 < 0.05) started RRT and 45.8% vs 79.8% ( p < 0.05) remained in the clinic; at 4 years, 60.7% vs 15.6% ( p < 0.05) started RRT and 16.7% vs 52.3% ( p < 0.05) remained in the clinic. In the group with KFRE < 10% those ≥75 years vs