Patient selection into this study is shown in Fig. 1. All the outpatient eGFR values, performed as part of routine renal care and accessed via the hospital’s electronic patient record, were used to calculate the delta (Δ) eGFR slope for each patient using linear regression. As a minimum, we required at least 4 eGFR values over 2 years follow-up for the ΔeGFR to be ascertained for each patient. Patients with a ΔeGFR≤ − 3 ml/min/1.73m2/yr (ie. losing more than 3ml/min/1.73m2/yr), a threshold associated with worse outcomes [2], were defined as a rapid progressor, and they had to have baseline CKD G3a-4 (eGFR 15 to < 60 ml/min/1.73m2) for study inclusion. To differentiate linear versus non-linear progression, the eGFR-time graphs were visually inspected independently by two clinicians, an approach that has been successfully utilised in previous studies [1, 8], and also quantitively assessed with the coefficient of determination (R2).
Assembling the study cohort. Abbreviations: SKS (Salford Kidney Study)
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