Researchers from Johns Hopkins Bloomberg School of Public Health have developed an online tool that can determine how likely it is that a patient with chronic kidney disease will experience kidney failure in the next two to five years. The research was published in the Journal of the American Medical Association

More than 661,000 Americans have kidney failure and of them, 468,000 individuals are on dialysis and approximately 193,000 live with a functioning kidney transplant, according to the National Kidney Foundation.

The tool was built on another tool developed by Canadian researchers that studied Canadian patients, and added data from over 721,000 patients from 30 countries. It will help patients who are at high risk for kidney failure prepare for dialysis or transplant and will give patients who have chronic kidney disease but are not at high risk of kidney failure peace of mind.
"While the tool can aid in management of a patient's disease and prepare them for the worst, many more patients will find the results reassuring," Dr. Josef Coresh, one of the researchers and the George W. Comstock Professor of Epidemiology at the Bloomberg School, said in a statement. "You can reassure a lot of worried people with the fact that their risk is actually very low. The vast majority of patients will not need dialysis."

The online tool works by essentially combining the results of common medical tests. The researchers discovered that a four-variable risk calculator can accurately predict the risk of kidney failure in two or five years, and that an eight-variable calculator can do even better.

The four-variable risk calculator uses age, sex, and an estimate of kidney function from blood and urine tests; the eight-variable risk calculator includes those things as well as blood calcium, phosphate, bicarbonate, and albumin levels.

The researchers found the results in the U.S were similar to the results in the original Canadian study. They also found that the tool needed slight adjustments in countries outside of North America to account for the lower risk of kidney failure in those regions.

The researchers assume that there is lower risk in those countries because the physicians in those areas might be less likely to refer patients for dialysis, or because they might be better at treating kidney disease.

The tool may help serve as a wake-up call for some to better comply with medication, diet and other lifestyle changes, and it will give clinicians and patients time to plan for dialysis and/or transplant if needed.

"Dialysis and transplantation are expensive and complicated and take planning," Dr. Morgan E. Grams, the study's co-author and a nephrologist, and assistant professor of epidemiology at the Bloomberg School, said in statement. "Knowing ahead of time allows people to consider their options."

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