Evaluation of Surrogate End Points for Progression to ESKD: Necessary and Challenging

Chronic kidney disease (CKD) is recognized as a global health problem and is associated with significant morbidity and mortality, in particular, progression to kidney failure. There is a paucity of therapies to slow kidney disease progression.1 In part, this is because CKD often progresses slowly, requiring randomized controlled trials (RCTs) of long duration, or restricting enrollment to patients with rapidly progressive or more severe forms of the disease. The use of surrogate end points can increase the number of patients with events, thereby allowing for clinical studies of shorter duration or the enrollment of patients in early stages of CKD for whom therapeutic benefits may be larger.

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