Lower estimated glomerular filtration rate and higher albuminuria are associated with mortality and end-stage renal disease. A collaborative meta-analysis of kidney disease population cohorts
| Autor: | Astor, BC, Matsushita, K, Gansevoort, RT, van der Velde, M, Woodward, M, Levey, AS, Jong, PE, Coresh, J, de Jong, PE, El-Nahas, M, Eckardt, KU, Kasiske, BL, Wright, J, Appel, L, Greene, T, Levin, A, Djurdjev, O, Wheeler, DC, Landray, MJ, Townend, JN, Emberson, J, Clark, LE, Macleod, A, Marks, A, Ali, T, Fluck, N, Prescott, G, Smith, DH, Weinstein, JR, Johnson, ES, Thorp, ML, Wetzels, JF, Blankestijn, PJ, van Zuilen, AD, Menon, V, Sarnak, M, Beck, G, Kronenberg, F, Kollerits, B, Froissart, M, Stengel, B, Metzger, M, Remuzzi, G, Ruggenenti, P, Perna, A, Heerspink, HJ, Brenner, B, de Zeeuw, D, Rossing, P, Parving, HH, Auguste, P, Veldhuis, K, Wang, Y, Camarata, L, Thomas, B, Manley, T |
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| Přispěvatelé: | Cardiovascular Centre (CVC), Groningen Kidney Center (GKC) |
| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
Male
PROGRESSION Kidney urologic and male genital diseases Cohort Studies Risk Factors Renal disorder [IGMD 9] education.field_of_study OUTCOMES CARDIOVASCULAR RISK Hazard ratio Confounding Middle Aged Prognosis female genital diseases and pregnancy complications Nephrology Disease Progression Regression Analysis Female Kidney Diseases epidemiology TRIAL medicine.symptom epidemiology and outcomes Glomerular Filtration Rate Adult medicine.medical_specialty Population Renal function Risk Assessment Article albuminuria End stage renal disease Predictive Value of Tests Internal medicine medicine CKD Humans education Aged Proportional Hazards Models Chi-Square Distribution Proportional hazards model business.industry urogenital system A300 medicine.disease Creatine Endocrinology Albuminuria Kidney Failure Chronic business Biomarkers chronic kidney disease Kidney disease |
| Zdroj: | Kidney International. Supplement, 79, 1331-40 Kidney International, 79(12), 1331-1340. ELSEVIER SCIENCE INC Kidney International. Supplement, 79, 12, pp. 1331-40 |
| ISSN: | 0085-2538 2157-1724 |
| DOI: | 10.1038/ki.2010.550 |
| Popis: | We studied here the independent associations of estimated glomerular filtration rate (eGFR) and albuminuria with mortality and end-stage renal disease (ESRD) in individuals with chronic kidney disease (CKD). We performed a collaborative meta-analysis of 13 studies totaling 21,688 patients selected for CKD of diverse etiology. After adjustment for potential confounders and albuminuria, we found that a 15 ml/min per 1.73 m(2) lower eGFR below a threshold of 45 ml/min per 1.73 m(2) was significantly associated with mortality and ESRD (pooled hazard ratios (HRs) of 1.47 and 6.24, respectively). There was significant heterogeneity between studies for both HR estimates. After adjustment for risk factors and eGFR, an eightfold higher albumin-or protein-to-creatinine ratio was significantly associated with mortality (pooled HR 1.40) without evidence of significant heterogeneity and with ESRD (pooled HR 3.04), with significant heterogeneity between HR estimates. Lower eGFR and more severe albuminuria independently predict mortality and ESRD among individuals selected for CKD, with the associations stronger for ESRD than for mortality. Thus, these relationships are consistent with CKD stage classifications based on eGFR and suggest that albuminuria provides additional prognostic information among individuals with CKD. Kidney International (2011) 79, 1331-1340; doi:10.1038/ki.2010.550; published online 2 February 2011 |
| Databáze: | OpenAIRE |
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