Web-Based Tool Enables Early Detection and Prevention of Chronic Kidney Disease

Current clinical practice relies on fixed cut-off values, which can overlook early, subtle declines in kidney performance that still fall within the “normal” range. As a result, many at-risk individuals miss the opportunity for early preventive care. Now, a new study shows that comparing kidney function against age- and sex-specific population norms can help identify people at higher risk much earlier.

Researchers at Karolinska Institutet (Stockholm, Sweden) have developed population-based distributions for estimated glomerular filtration rate (eGFR), the most commonly used marker of kidney function. Instead of relying solely on absolute thresholds, the approach evaluates how an individual’s eGFR compares with peers of the same age and sex. To support clinical use, the team created intuitive eGFR “charts,” inspired by pediatric growth curves, alongside a web-based calculator that allows healthcare professionals to quickly assess a patient’s percentile position within the population.

The study analyzed nearly seven million eGFR measurements from more than 1.1 million adults aged 40 to 100 years in the Stockholm region between 2006 and 2021. These data were used to construct detailed age- and sex-specific reference distributions. Results showed that individuals with eGFR values below the 25th percentile for their demographic had a significantly higher risk of progressing to kidney failure requiring dialysis or transplantation. Mortality followed a U-shaped pattern, with both unusually low and high eGFR percentiles linked to increased risk.

Importantly, the study found that many at-risk patients are currently overlooked. Among individuals with eGFR values above 60 ml/min/1.73 m² but below the 25th percentile, only about one quarter received further testing for urinary albumin, a key marker of early kidney damage. By highlighting risk earlier, the researchers believe the tool could support primary prevention, encourage timely follow-up testing, and help slow disease progression before irreversible damage occurs. The team hopes the approach will be adopted more widely in routine care.

“For example, consider a 55-year-old woman with an eGFR of 80. Most clinicians would not react to such a seemingly normal value,” said Juan Jesús Carrero, professor at Karolinska Institutet. “However, our charts show that this corresponds to the 10th percentile for women of that age, and that she has a threefold higher risk of starting dialysis in the future. This signals an opportunity to act earlier.”

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Karolinska Institutet