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Chronic kidney disease (CKD) is defined by a persistent reduction in GFR and/or the presence of other signs of kidney damage, in particular presence of albuminuria, and is categorized based on eGFR and albuminuria. Work within the CKD field has tended to focus on the prognosis of patients with “earlier” stages and those on renal replacement therapy (RRT). Less attention has been paid to patients with “advanced” CKD (category G4+; i.e. GFR < 30 ml/min) not receiving RRT. A better understanding of the prevalence and prognosis of patients with CKD G4+ and the factors associated with different outcomes may help to generate hypotheses about optimal treatment strategies in this high risk population, including decision making about initiation of RRT. KDIGO therefore chose to organize a conference focusing on patients with CKD G4+. The KDIGO Controversies Conference on Advanced CKD took place in Barcelona, Spain on December 2-5, 2016.

The objective of this KDIGO conference was to gather a global panel of multi-disciplinary clinical and scientific expertise to identify key issues relevant to the prognosis and optimal management of patients with advanced CKD. The goal was to assess our current state of knowledge related to prognosis and management, as well as explore novel analyses provided by the CKD-Prognosis Consortium (CKD-PC). The CKD-PC presented their original analyses of 230,000 advanced CKD patients from 29 CKD cohorts and examining how variation in prognosis could be influenced by cohort, demographic, or health characteristics.

Drs. Kai-Uwe Eckardt (Friedrich-Alexander University Erlangen-Nürnberg, Germany) and Brenda Hemmelgarn (University of Calgary, Canada) co-chaired this conference.

The conference report outlining the discussions and recommendations from this meeting is currently being drafted.