{"id":"fa09028359de","type":"article","url":"https://hartvaat.nl/2026/07/31/steilere-egfr-daling-voorspelt-nierfalen-en-cardiovasculaire-mortaliteit-narrati/","title":"Steilere eGFR-daling voorspelt nierfalen en cardiovasculaire mortaliteit — narratieve review","title_en":"Estimated glomerular filtration rate slope and clinical outcomes: a narrative review.","category":"chronische nierziekte","category_label":"Nierziekte","professions":["apotheker","cardioloog","internist"],"tags":[],"journal":"Diabetes research and clinical practice","doi":"10.1016/j.diabres.2026.113477","source_url":"https://doi.org/10.1016/j.diabres.2026.113477","authors":["Fan Zhang","Yue Xing","Wanhaier Abudoureheman","Yifei Zhong"],"significance":5,"published":"2026-08-14","source_date":"2026-07-31","image":"","kennis":["https://hartvaat.nl/kennis/nierziekte/nierziekte-en-cardiovasculair-risico/","https://hartvaat.nl/kennis/nierziekte/kdigo-richtlijn-ckd-2024/"],"congress":"","summary_en":"This narrative review synthesizes current evidence on the prognostic value of the estimated glomerular filtration rate (eGFR) slope for kidney failure, cardiovascular events, and all-cause mortality. A steeper decline over three years is consistently associated with higher risks of end-stage kidney disease, hospitalization, and death, with a notable U-shaped relationship observed for mortality. Incorporating eGFR slope into routine clinical assessment can improve risk stratification, support personalized management, and serve as a reliable surrogate endpoint for evaluating renoprotective therapies like SGLT2 inhibitors.","created":"2026-08-07T01:40:05Z","updated":"2026-08-10T10:35:35Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Deze narratieve review vat het huidige bewijs samen over de prognostische waarde van de eGFR-dalingssnelheid voor nierfalen, cardiovasculaire gebeurtenissen en mortaliteit. Een steilere daling over drie jaar correleert sterk met een hoger risico op end-stage nierziekte, hospitalisaties en overlijden, waarbij ook een U-vormig verband met mortaliteit wordt beschreven. De integratie van eGFR-slope in de klinische praktijk kan helpen bij risicostratificatie en het monitoren van effecten van nierbeschermende therapieën, zoals SGLT2-remmers.","abstract_original":"This review aims to synthesize current evidence on the association betweenestimated glomerular filtration rate (eGFR)slope and clinical outcomes. A narrative review was conducted based on a structured literature search of PubMed and Embase from inception to April 2026. Relevant studies examining eGFR slope in relation to kidney outcomes, cardiovascular events, and mortality were included, with emphasis on meta-analyses, randomized controlled trials, andcohort studies. Evidencedemonstratedthat eGFR slope isassociated with kidney failure outcomes, with three-year total slope showing high predictive validity. Observational and clinical studies consistently show that steeper declines in eGFR are linked to increased risks of end-stage kidney disease, cardiovascular events, hospitalization, and all-cause mortality across diverse populations. A U-shaped relationship between eGFR changes and mortality has also been observed. Several factors, including baseline kidney function, albuminuria, comorbidities, and variability in eGFR, influence its trajectory and prognostic value. Pharmacological interventions, particularly SGLT2 inhibitors, significantly slow eGFR decline and improve clinical outcomes. The eGFR slope is a validated and clinically meaningful surrogate endpoint that reliably predicts kidney and cardiovascular outcomes. Its integration into clinical practice and research may enhance risk stratification, improve trial efficiency, and support personalized management ofkidney disease."}