STUDY PROTOCOL Open Access The natural history of, and e

Full list of author information is available at the end of the articleBackground Chronic kidney disease (CKD) is strongly associated with poor health outcomes [1-5]. It affects up to 16 % of the adult population in the UK and internationally [6,7]. Those at highest risk from progressive CKD have an accelerated deterioration of kidney function, significant albuminuria, and/or more advanced CKD at inception [8,9]. The large majority of people with CKD die before they reach end-stage kidney disease (ESKD) and have an increased risk of cardiovascular disease (CVD) that is directly related to the severity of their kidney disease [10,11]. These associations were recently explored in meta-analyses of both general and high risk cohorts conducted by the Chronic Kidney Disease Prognosis Consortium; both low eGFR and proteinuria were independent pre-dictors of acute kidney injury, ESKD and progression of CKD independent of other cardiovascular risk factors [7]. In the same cohorts low eGFR and albuminuria wer