Clinical events and patient-reported outcome measures during CKD progression: findings from the Chronic Renal Insufficiency Cohort Study
| Autor: | Grams, Morgan E, Surapaneni, Aditya, Appel, Lawrence J, Lash, James P, Hsu, Jesse, Diamantidis, Clarissa J, Rosas, Sylvia E, Fink, Jeffrey C, Scialla, Julia J, Sondheimer, James, Hsu, Chi-Yuan, Cheung, Alfred K, Jaar, Bernard G, Navaneethan, Sankar, Cohen, Debbie L, Schrauben, Sarah, Xie, Dawei, Rao, Pandu, Feldman, Harold I, CRIC study investigators |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Aging Kidney Disease Clinical Trials and Supportive Activities Clinical Sciences Renal and urogenital Cardiovascular albuminuria Kidney Failure Cohort Studies 7.1 Individual care needs Clinical Research CKD Humans Renal Insufficiency Patient Reported Outcome Measures Chronic ESKD CRIC study investigators patient-centered outcome Middle Aged Urology & Nephrology Heart Disease Good Health and Well Being Disease Progression Quality of Life Female Management of diseases and conditions Glomerular Filtration Rate |
| Zdroj: | Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association-European Renal Association, vol 36, iss 9 |
| Popis: | BackgroundPatients with chronic kidney disease (CKD) face risks of not only end-stage kidney disease (ESKD), cardiovascular disease (CVD) and death, but also decline in kidney function, quality of life (QOL) and mental and physical well-being. This study describes the multidimensional trajectories of CKD using clinical events, kidney function and patient-reported outcome measures (PROMs). We hypothesized that more advanced CKD stages would associate with more rapid decline in each outcome.MethodsAmong 3939 participants enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study, we evaluated multidimensional disease trajectories by G- and A-stages of enrollment estimated glomerular filtration rate (eGFR) and albuminuria, respectively. These trajectories included clinical events (ESKD, CVD, heart failure and death), eGFR decline and PROMs [kidney disease QOL (KDQOL) burden, effects and symptoms questionnaires, as well as the 12-item short form mental and physical component summaries]. We also evaluated a group-based multitrajectory model to group participants on the basis of longitudinal PROMs and compared group assignments by enrollment G- and A-stage.ResultsThe mean participant age was 58 years, 45% were women, mean baseline eGFR was 44 mL/min/1.73 m2 and median urine albumin:creatinine ratio was 52 mg/g. The incidence of all clinical events was greater and eGFR decline was faster with more advanced G- and A-stages. While baseline KDQOL and physical component measures were lower with more advanced G- and A-stage of CKD, changes in PROMs were inconsistently related to the baseline CKD stage. Groups formed on PROM trajectories were fairly distinct from existing CKD staging (observed agreement 60.6%) and were associated with the risk of ESKD, CVD, heart failure and death.ConclusionsMore advanced baseline CKD stage was associated with a higher risk of clinical events and faster eGFR decline, and was only weakly related to changes in patient-reported metrics over time. |
| Databáze: | OpenAIRE |
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