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Higher incidence of ESRD than mortality in the AASK study.

An estimated 15.5 million individuals in the United States have stage 3 chronic kidney disease (CKD).1 In contrast, the number of individuals with ESRD approximates 525,000.2 This suggests that most people with stage 3 CKD will die before reaching the need for renal replacement therapy. This is what most observational studies have found.3–7 In an analysis of Kaiser data, Go et al. 3 found a increasing risk for mortality and cardiovascular disease with lower levels of estimated GFR (eGFR). In those with an eGFR 10 times greater than the risk for ESRD.

In this issue of JASN , Alves et al. 8 evaluate the incidence of ESRD versus all-cause and cardiovascular mortality before ESRD in the African American Study of Kidney Disease and Hypertension (AASK). Their study combined the trial period and then a noninterventional cohort period for a total of 11 years of follow-up. In this study, the rate of ESRD was 1.8 times greater than mortality. Does …