CKD classification based on estimated GFR over three years and subsequent cardiac and mortality outcomes: a cohort study
<p>Abstract</p> <p>Background</p> <p>It is unknown whether defining chronic kidney disease (CKD) based on one versus two estimated glomerular filtration rate (eGFR) assessments changes the prognostic importance of reduced eGFR in a community-based population.</p>...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2009-09-01
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| Series: | BMC Nephrology |
| Online Access: | http://www.biomedcentral.com/1471-2369/10/26 |
| _version_ | 1818641678743896064 |
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| author | Salem Deeb N Tighiouart Hocine Krassilnikova Maria Weiner Daniel E Levey Andrew S Sarnak Mark J |
| author_facet | Salem Deeb N Tighiouart Hocine Krassilnikova Maria Weiner Daniel E Levey Andrew S Sarnak Mark J |
| author_sort | Salem Deeb N |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>It is unknown whether defining chronic kidney disease (CKD) based on one versus two estimated glomerular filtration rate (eGFR) assessments changes the prognostic importance of reduced eGFR in a community-based population.</p> <p>Methods</p> <p>Participants in the Atherosclerosis Risk in Communities Study and the Cardiovascular Health Study were classified into 4 groups based on two eGFR assessments separated by 35.3 ± 2.5 months: sustained eGFR < 60 mL/min per 1.73 m<sup>2 </sup>(1 mL/sec per 1.73 m<sup>2</sup>); eGFR increase (change from below to above 60); eGFR decline (change from above to below 60); and eGFR persistently ≥60. Outcomes assessed in stratified multivariable Cox models included cardiac events and a composite of cardiac events, stroke, and mortality.</p> <p>Results</p> <p>There were 891 (4.9%) participants with sustained eGFR < 60, 278 (1.5%) with eGFR increase, 972 (5.4%) with eGFR decline, and 15,925 (88.2%) with sustained eGFR > 60. Participants with eGFR sustained < 60 were at highest risk of cardiac and composite events [HR = 1.38 (1.15, 1.65) and 1.58 (1.41, 1.77)], respectively, followed by eGFR decline [HR = 1.20 (1.00, 1.45) and 1.32 (1.17, 1.49)]. Individuals with eGFR increase trended toward increased cardiac risk [HR = 1.25 (0.88, 1.77)] and did not significantly differ from eGFR decline for any outcome. Results were similar when estimating GFR with the CKD-EPI equation.</p> <p>Conclusion</p> <p>Individuals with persistently reduced eGFR are at highest risk of cardiovascular outcomes and mortality, while individuals with an eGFR < 60 mL/min per 1.73 m<sup>2 </sup>at any time are at intermediate risk. Use of even a single measurement of eGFR to classify CKD in a community population appears to have prognostic value.</p> |
| first_indexed | 2024-12-16T23:30:59Z |
| format | Article |
| id | doaj.art-211ae6f33568416b9c9b60c941f69512 |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-12-16T23:30:59Z |
| publishDate | 2009-09-01 |
| publisher | BMC |
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| series | BMC Nephrology |
| spelling | doaj.art-211ae6f33568416b9c9b60c941f695122022-12-21T22:11:52ZengBMCBMC Nephrology1471-23692009-09-011012610.1186/1471-2369-10-26CKD classification based on estimated GFR over three years and subsequent cardiac and mortality outcomes: a cohort studySalem Deeb NTighiouart HocineKrassilnikova MariaWeiner Daniel ELevey Andrew SSarnak Mark J<p>Abstract</p> <p>Background</p> <p>It is unknown whether defining chronic kidney disease (CKD) based on one versus two estimated glomerular filtration rate (eGFR) assessments changes the prognostic importance of reduced eGFR in a community-based population.</p> <p>Methods</p> <p>Participants in the Atherosclerosis Risk in Communities Study and the Cardiovascular Health Study were classified into 4 groups based on two eGFR assessments separated by 35.3 ± 2.5 months: sustained eGFR < 60 mL/min per 1.73 m<sup>2 </sup>(1 mL/sec per 1.73 m<sup>2</sup>); eGFR increase (change from below to above 60); eGFR decline (change from above to below 60); and eGFR persistently ≥60. Outcomes assessed in stratified multivariable Cox models included cardiac events and a composite of cardiac events, stroke, and mortality.</p> <p>Results</p> <p>There were 891 (4.9%) participants with sustained eGFR < 60, 278 (1.5%) with eGFR increase, 972 (5.4%) with eGFR decline, and 15,925 (88.2%) with sustained eGFR > 60. Participants with eGFR sustained < 60 were at highest risk of cardiac and composite events [HR = 1.38 (1.15, 1.65) and 1.58 (1.41, 1.77)], respectively, followed by eGFR decline [HR = 1.20 (1.00, 1.45) and 1.32 (1.17, 1.49)]. Individuals with eGFR increase trended toward increased cardiac risk [HR = 1.25 (0.88, 1.77)] and did not significantly differ from eGFR decline for any outcome. Results were similar when estimating GFR with the CKD-EPI equation.</p> <p>Conclusion</p> <p>Individuals with persistently reduced eGFR are at highest risk of cardiovascular outcomes and mortality, while individuals with an eGFR < 60 mL/min per 1.73 m<sup>2 </sup>at any time are at intermediate risk. Use of even a single measurement of eGFR to classify CKD in a community population appears to have prognostic value.</p>http://www.biomedcentral.com/1471-2369/10/26 |
| spellingShingle | Salem Deeb N Tighiouart Hocine Krassilnikova Maria Weiner Daniel E Levey Andrew S Sarnak Mark J CKD classification based on estimated GFR over three years and subsequent cardiac and mortality outcomes: a cohort study BMC Nephrology |
| title | CKD classification based on estimated GFR over three years and subsequent cardiac and mortality outcomes: a cohort study |
| title_full | CKD classification based on estimated GFR over three years and subsequent cardiac and mortality outcomes: a cohort study |
| title_fullStr | CKD classification based on estimated GFR over three years and subsequent cardiac and mortality outcomes: a cohort study |
| title_full_unstemmed | CKD classification based on estimated GFR over three years and subsequent cardiac and mortality outcomes: a cohort study |
| title_short | CKD classification based on estimated GFR over three years and subsequent cardiac and mortality outcomes: a cohort study |
| title_sort | ckd classification based on estimated gfr over three years and subsequent cardiac and mortality outcomes a cohort study |
| url | http://www.biomedcentral.com/1471-2369/10/26 |
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