Rapid eGFR Decline Linked to Higher Mortality Risk in Compensated Cirrhosis: Study

A new study published in the journal of BMC Nephrology showed that a swift decrease in estimated glomerular filtration rate (eGFR) based on creatinine in individuals with compensated cirrhosis was linked to an increased likelihood of death.

Kidney dysfunction is a crucial factor affecting the future outlook of individuals with stable cirrhosis, sometimes emerging prior to noticeable health deterioration. A sudden decrease in the eGFR calculated from creatinine levels could signal initial kidney damage and the advancement of the disease. Understanding how this is linked to extended results could help in better categorizing risks and suggesting timely medical actions. This research examined how the gradual decline in eGFR based on creatinine levels is connected to the long-term health outcomes in individuals with stable cirrhosis.

In this study, patients with stable liver disease from 2016 to 2025 were examined. The study analyzed the patterns of eGFR based on creatinine levels measured during regular check-ups. A rapid decrease in eGFR was considered when there was a yearly decline of over 5 mL/min/1.73 m². The primary analysis focused on predicting outcomes, where the eGFR trend was calculated within the initial 2 years, and monitoring for mortality commenced at this point.

The complete longitudinal group consisted of 249 patients, with 37 individuals (14.9%) experiencing a rapid decrease in eGFR based on creatinine levels. In the primary analysis at the 2-year mark, out of 191 patients, 45 (23.6%) had a rapid decline. Following this analysis, there were 29 deaths recorded during the post-landmark period, with 11 out of 45 patients (24.4%) who had a rapid decline and 18 out of 146 patients (12.3%) who did not experience a rapid decline passing away.

The rapid decline was linked to a higher risk of mortality (unadjusted hazard ratio [HR], 2.32; 95% CI, 1.10–4.93; P = 0.028) and this association persisted even after taking into account MELD-Na and baseline ascites (adjusted HR, 2.55; 95% CI, 1.19–5.47; P = 0.016). A sensitivity analysis conducted at the 1-year mark showed similar outcomes (adjusted HR, 3.42; 95% CI, 1.62–7.21; P = 0.001).

Overall, a swift deterioration in creatinine-derived estimated glomerular filtration rate (eGFR) among individuals with compensated cirrhosis correlated with a heightened likelihood of mortality. Continual tracking of eGFR patterns could offer supplementary predictive insights and aid in the detection of individuals with elevated risks.

Source:

Chatkrailert, A., Mangkang, V., & Jeerangsapasuk, W. (2026). Rapid creatinine-based eGFR decline and long-term outcomes in patients with compensated cirrhosis. BMC Nephrology. https://doi.org/10.1186/s12882-026-05427-6