Past decline versus current eGFR and subsequent mortality risk

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Naimark, David M J (author)

Past decline versus current eGFR and subsequent mortality risk

Article/chapterEnglish2016

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2016
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LIBRIS-ID:oai:DiVA.org:du-20563
https://urn.kb.se/resolve?urn=urn:nbn:se:du-20563URI
https://doi.org/10.1681/ASN.2015060688DOI

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Language:English
Summary in:English

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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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.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine hsv//eng
chronic kidney disease
glomerular filtration rate
mortality
epidemiology
outcomes
Hälsa och välfärd
Health and Welfare

Added entries (persons, corporate bodies, meetings, titles ...)

Grams, Morgan E (author)
Matsushita, Kunihiro (author)
Black, Corri (author)
Drion, Iefke (author)
Fox, Caroline S (author)
Inker, Lesley A (author)
Ishani, Areef (author)
Jee, Sun Ha (author)
Ärnlöv, Johan,1970-Högskolan Dalarna,Medicinsk vetenskap(Swepub:du)jan (author)
Högskolan DalarnaMedicinsk vetenskap (creator_code:org_t)

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In:Journal of the American Society of Nephrology27:8, s. 2456-24661046-66731533-3450

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By the author/editor: Naimark, David M ...; Grams, Morgan E; Matsushita, Kuni ...; Black, Corri; Drion, Iefke; Fox, Caroline S; show more...; Inker, Lesley A; Ishani, Areef; Jee, Sun Ha; Ärnlöv, Johan, 1 ...; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...

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By the university: Högskolan Dalarna

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