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With improved life expectancy, preserving kidney function is paramount to preventing early cardiovascular disease and CF-related bone disease and to maintaining eligibility for lung transplantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine long-term kidney function decline among CF participants following the Standardized Treatment of Pulmonary Exacerbations 2 (STOP2) clinical trial and to identify specific risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We linked participants in STOP2 with the CF Foundation Patient Registry and defined decline in kidney function as a composite of\u2009\u226540% decline in the estimated glomerular filtration rate (eGFR) or development of end-stage renal disease. We calculated the associations of risk factors such as age, diabetes status, and number of pulmonary exacerbations treated with intravenous antibiotics on decline in kidney function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 915 STOP2 participants, the mean \u00b1 SD baseline eGFR was 114 \u00b1 20 mL\/min\/1.73 m2 and 53 (6.0%) reached the composite endpoint over a median follow-up time of 3.8\u2009years. Each 10-year increase in age was associated with a 24% greater risk of the composite outcome (hazard ratio [HR], 1.29 [95% CI, 1.01-1.65]), and participants with insulin-dependent diabetes had a greater risk of the composite endpoint (HR, 2.34 [95% CI, 1.33-4.12]). A multivariable adjusted time-updated Cox regression model demonstrated that each additional pulmonary exacerbation was associated with a greater risk of the composite outcome (HR, 1.13 [95% CI, 1.07-1.20]; P\u2009&amp;lt;.0001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Risk factors associated with kidney function decline included age, insulin-dependent diabetes, and number of pulmonary exacerbations. These findings highlight key contributors to kidney function decline in a modern cohort of adults with CF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/annalsats\/aaoag013","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T16:46:25Z","timestamp":1771951585000},"page":"737-744","source":"Crossref","is-referenced-by-count":1,"title":["Risk factors for longitudinal estimated glomerular filtration rate decline in adults with cystic fibrosis"],"prefix":"10.1093","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3163-0406","authenticated-orcid":false,"given":"Deepthi","family":"Nacharaju","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, University of Washington , Seattle, WA,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8461-5111","authenticated-orcid":false,"given":"Leila 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Medicine, University of Washington , Seattle, WA,","place":["United States"]},{"name":"Division of Nephrology, Department of Medicine, University of Washington , Seattle, WA,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick A","family":"Flume","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Pediatrics, Medical University of South Carolina , Charleston, SC,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8602-0309","authenticated-orcid":false,"given":"Christopher H","family":"Goss","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington , Seattle, WA,","place":["United States"]},{"name":"CF Foundation Therapeutics Development Network Coordinating Center, Seattle Children\u2019s Research Institute , Seattle, WA,","place":["United 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