Effective treatments for chronic kidney disease (CKD) are available but underused, and timely specialist referral is thought to be beneficial for patients at highest risk of cardiovascular events and progressive kidney function loss. Although the current staging system1 (chiefly based on estimated glomerular filtration rate [GFR]) is clinically useful, it classifies approximately 26 million US adults as having CKD—too many to target for intervention.2 Therefore, better methods for identifying the subset of patients who are at the highest risk of adverse outcomes would be extremely useful for clinicians and other decision makers. Two articles in this issue of JAMA describe new approaches to this important objective.
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