In Reply: We agree with Dr Nonoguchi and colleagues that there are several potential metrics for assessing the rate of kidney function loss, including those based on absolute changes in eGFR. Because of space limitations, we were not able to present or discuss all of them in our article.
As shown in Table 2 of our article, the rate of developing end-stage renal disease increased significantly (P < .001) with heavier proteinuria across all eGFR strata. This outcome assessed absolute rather than relative kidney function loss, in keeping with the suggestion of Nonoguchi et al that absolute measures may be preferable.
Hemmelgarn BR, Lloyd A, Tonelli M. Kidney Function, Proteinuria, and Adverse Outcomes—Reply. JAMA. 2010;303(20):2030. doi:10.1001/jama.2010.657