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Past Decline VersusCurrent eGFR andSubsequent MortalityRisk David NaimarkMorgan E. GramsKunihiro Matsushita2015 год

Past Decline Versus Current eGFR and Subsequent Mortality Risk
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Аннотация: A single determination of eGFR associates with subsequent mortality risk. Prior decline in eGFR indicates loss of kidney function, but the relationship to mortality risk is uncertain. We conducted an individual–level meta-analysis of the risk of mortality associated with antecedent eGFR slope, adjusting for established risk factors, including last eGFR, among 1.2 million subjects from 12 CKD and 22 other cohorts within the CKD Prognosis Consortium. Over a 3-year antecedent period, 12% of participants in the CKD cohorts and 11% in the other cohorts had an eGFR slope <−5 ml/min per 1.73 m 2 per year, whereas 7% and 4% had a slope >5 ml/min per 1.73 m 2 per year, respectively. Compared with a slope of 0 ml/min per 1.73 m 2 per year, a slope of −6 ml/min per 1.73 m 2 per year associated with adjusted hazard ratios for all-cause mortality of 1.25 (95% confidence interval [95% CI], 1.09 to 1.44) among CKD cohorts and 1.15 (95% CI, 1.01 to 1.31) among other cohorts during a follow-up of 3.2 years. A slope of +6 ml/min per 1.73 m 2 per year also associated with higher all–cause mortality risk, with adjusted hazard ratios of 1.58 (95% CI, 1.29 to 1.95) among CKD cohorts and 1.43 (95% CI, 1.11 to 1.84) among other cohorts. Results were similar for cardiovascular and noncardiovascular causes of death and stronger for longer antecedent periods (3 versus <3 years). We conclude that prior decline or rise in eGFR associates with an increased risk of mortality, independent of current eGFR.
Год издания: 2015
Авторы: David Naimark, Morgan E. Grams, Kunihiro Matsushita, Corri Black, Iefke Drion, Caroline S. Fox, Lesley A. Inker, Areef Ishani, Sun Ha Jee, Akihiko Kitamura, Janice P. Lea, Joseph V. Nally, Carmen A. Peralta, Dietrich Rothenbacher, Seungho Ryu, Marcello Tonelli, Hiroshi Yatsuya, Josef Coresh, Ron T. Gansevoort, David G. Warnock, Mark Woodward, Paul E. de Jong
Издательство: American Society of Nephrology
Источник: Journal of the American Society of Nephrology
Ключевые слова: Chronic Kidney Disease and Diabetes, Renal cell carcinoma treatment, Pancreatic and Hepatic Oncology Research
Другие ссылки: Journal of the American Society of Nephrology (PDF)
Journal of the American Society of Nephrology (HTML)
eScholarship (California Digital Library) (PDF)
eScholarship (California Digital Library) (HTML)
Aberdeen University Research Archive (Aberdeen University) (HTML)
PubMed Central (HTML)
Aberdeen University Research Archive (Aberdeen University) (PDF)
Aberdeen University Research Archive (Aberdeen University) (HTML)
PubMed (HTML)