30-Second Takeaway
- Age- and sex-specific eGFR percentiles with ACR may better flag high-risk CKD than a fixed 60 ml/min/1.73 m² cutoff.
- Point-of-care transdermal GFR closely tracks nuclear GFR across kidney function and skin tones, outperforming creatinine eGFR benchmarks.
- High ESA dosing on dialysis is linked to higher incident cancer risk, especially in older patients, supporting conservative hemoglobin targets.
Week ending February 28, 2026
New evidence refining CKD detection, dialysis practice, and renoprotective therapy across the kidney disease spectrum
Age- and sex-specific eGFR percentiles plus ACR to refine CKD detection
This editorial argues that a fixed eGFR threshold of 60 mL/min/1.73 m² is potentially misleading for CKD diagnosis. Yang et al. used age- and sex-adjusted eGFR percentiles to better identify individuals at high risk of kidney failure and death. The model reinforces urine albumin-to-creatinine ratio as a central, currently underused, component of CKD detection and risk stratification. Percentile-based eGFR interpretation could reduce labeling age-appropriate decline as CKD while highlighting younger, high-risk patients currently overlooked.
Transdermal fluorescent GFR provides accurate point-of-care GFR across skin tones
This multicenter pivotal study compared transdermal fluorescent GFR (tGFR) using relmapirazin with plasma-derived nuclear GFR (nGFR) in 182 participants spanning normal function to CKD stage 4. Overall P30 for tGFR versus nGFR was 94% (95% CI 89%-97%), exceeding typical creatinine-based eGFR performance reported in the literature. Accuracy remained high both above and below 60 mL/min/1.73 m² and across all Fitzpatrick skin types, with P30 values in the KDIGO optimal range. These findings support tGFR as a feasible point-of-care alternative when precise individual GFR is needed, such as chemotherapy or transplant dosing decisions.
Statin initiation in CKD: modest renoprotection and lower mortality in emulated trial
This target-trial emulation used Hong Kong electronic records to compare statin initiators with matched non-initiators among adults with CKD and eGFR ≥15 mL/min/1.73 m². Statin initiation was associated with lower all-cause mortality and reduced progression to eGFR <15 mL/min/1.73 m² over long-term follow-up. Risks of ≥50% eGFR decline and a kidney–death composite outcome were also reduced, with stronger associations in per-protocol analyses than intention-to-treat. Overall effects on kidney outcomes were modest but consistent, supporting statins for combined cardiovascular and renal risk reduction in eligible CKD patients.
High ESA doses on dialysis associated with increased incident cancer risk
This nested case-control study in 9776 Korean dialysis patients evaluated cancer incidence according to ESA dose exposure. High-dose ESA use was linked to higher cancer risk than low-dose use (adjusted OR 1.23; 95% CI 1.11-1.35). Among patients aged ≥60 years, high-dose ESA was associated with substantially greater cancer odds (adjusted OR 1.47; 95% CI 1.30-1.67), unlike younger patients. The results support avoiding aggressive ESA dose escalation and favor conservative hemoglobin targets, especially in older dialysis patients.
References
Numbered in order of appearance. Click any reference to view details.
Additional Reads
Optional additional studies from this edition.