Interactive exploration of adverse events and multimorbidity in CKD.

Autor:	Steinbrenner I; Institute of Genetic Epidemiology, Faculty of Medicine and Medical Center - University of Freiburg, Freiburg, Germany., Kotsis F; Institute of Genetic Epidemiology, Faculty of Medicine and Medical Center - University of Freiburg, Freiburg, Germany.; Department of Medicine IV, Nephrology and Primary Care, Faculty of Medicine and Medical Center - University of Freiburg, Freiburg, Germany., Kosch R; Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Hannover Medical School, Hannover, Germany.; Department of Medical Bioinformatics, University Medical Center Göttingen, Göttingen, Germany., Meiselbach H; Department of Nephrology and Hypertension, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany., Bärthlein B; Medical Centre for Information and Communication Technology, University Hospital Erlangen, Erlangen, Germany., Stockmann H; Department of Nephrology and Medical Intensive Care, Charité-Universitätsmedizin Berlin, Berlin, Germany.; Department of Nephrology, University Medical Center Regensburg, Regensburg, Germany., Lipovsek J; Institute of Genetic Epidemiology, Faculty of Medicine and Medical Center - University of Freiburg, Freiburg, Germany., Zacharias HU; Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Hannover Medical School, Hannover, Germany., Altenbuchinger M; Department of Medical Bioinformatics, University Medical Center Göttingen, Göttingen, Germany., Dienemann T; Department of Operative Intensive Care, University Hospital Regensburg, Regensburg, Germany., Wytopil M; Institute of Clinical and Molecular Virology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany., Bächle H; Institute of Genetic Epidemiology, Faculty of Medicine and Medical Center - University of Freiburg, Freiburg, Germany., Sommerer C; Department of Nephrology, University Hospital Heidelberg, Renal Center, Heidelberg, Germany., Titze S; Department of Nephrology and Hypertension, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany., Weigel A; Department of Nephrology and Hypertension, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany., Weissensteiner H; Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria., Schönherr S; Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria., Forer L; Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria., Kurz NS; Department of Medical Bioinformatics, University Medical Center Göttingen, Göttingen, Germany., Menne J; Department of Nephrology, Rheumatology and Vascular Medicine, KRH Klinikum Siloah, Hannover, Germany., Schlieper G; Zentrum für Nieren-, Hochdruck- und Stoffwechselerkrankungen, Hannover, Germany.; Division of Nephrology and Clinical Immunology, University Hospital RWTH Aachen, Aachen, Germany., Schneider MP; Department of Nephrology and Hypertension, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany., Schaeffner E; Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany., Kielstein JT; Medical Clinic V Nephrology, Rheumatology, Blood Purification - Academic Teaching Hospital Braunschweig, Braunschweig, Germany., Sitter T; Department of Nephrology and Hypertension, Ludwig-Maximilians University, Munich, Germany., Floege J; Division of Nephrology and Clinical Immunology, University Hospital RWTH Aachen, Aachen, Germany., Wanner C; Department of Clinical Research and Epidemiology, German Heart Failure Center, University Hospital Würzburg, Würzburg, Germany., Kronenberg F; Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria., Köttgen A; Institute of Genetic Epidemiology, Faculty of Medicine and Medical Center - University of Freiburg, Freiburg, Germany., Busch M; Department of Internal Medicine III, Nephrology, University Hospital Jena - Friedrich Schiller University Jena, Jena, Germany., Krane V; Department of Clinical Research and Epidemiology, German Heart Failure Center, University Hospital Würzburg, Würzburg, Germany.; Department of Medicine I, Division of Nephrology, University Hospital Würzburg, Würzburg, Germany., Schmid M; Department of Medical Biometry, Informatics, and Epidemiology, University Hospital Bonn, Bonn, Germany., Eckardt KU; Department of Nephrology and Hypertension, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.; Department of Nephrology and Medical Intensive Care, Charité-Universitätsmedizin Berlin, Berlin, Germany., Schultheiss UT; Institute of Genetic Epidemiology, Faculty of Medicine and Medical Center - University of Freiburg, Freiburg, Germany.; Department of Medicine IV, Nephrology and Primary Care, Faculty of Medicine and Medical Center - University of Freiburg, Freiburg, Germany.
Jazyk:	angličtina
Zdroj:	Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association [Nephrol Dial Transplant] 2024 Nov 27; Vol. 39 (12), pp. 2016-2024.
DOI:	10.1093/ndt/gfae092
Abstrakt:	Background: Persons with chronic kidney disease (CKD) are at increased risk of adverse events, early mortality and multimorbidity. A detailed overview of adverse event types and rates from a large CKD cohort under regular nephrological care is missing. We generated an interactive tool to enable exploration of adverse events and their combinations in the prospective, observational German CKD (GCKD) study. Methods: The GCKD study enrolled 5217 participants under regular nephrological care with an estimated glomerular filtration rate of 30-60 or >60 mL/min/1.73 m2 and an overt proteinuria. Cardiovascular, cerebrovascular and peripheral vascular, kidney, infection, and cancer events, as well as deaths were adjudicated following a standard operation procedure. We summarized these time-to-event data points for exploration in interactive graphs within an R shiny app. Multivariable adjusted Cox models for time to first event were fitted. Cumulative incidence functions, Kaplan-Meier curves and intersection plots were used to display main adverse events and their combinations by sex and CKD etiology. Results: Over a median of 6.5 years, 10 271 events occurred in 2947 participants (56.5%), of which 680 participants (13.0%) died. The new publicly available interactive platform enables readers to scrutinize adverse events and their combinations as well as mortality trends as a gateway to better understand multimorbidity in CKD: incident rates per 1000 patient-years varied by event type, CKD etiology and baseline characteristics. Incidence rates for the most frequent events and their recurrence were 113.6 (cardiovascular), 75.0 (kidney) and 66.0 (infection). Participants with presumed diabetic kidney disease and men were more prone to experiencing events. Conclusion: This comprehensive explorative tool to visualize adverse events (https://www.gckd.org/studienhintergrund/previous-study-results/event-analysis/), their combination, mortality and multimorbidity among persons with CKD may serve as a valuable resourec for patient care, identification of high-risk groups, health services and public health policy planning. (© The Author(s) 2024. Published by Oxford University Press on behalf of the ERA.)
Databáze:	MEDLINE
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