Longitudinal causal effect of modified creatinine index on all-cause mortality in patients with end-stage renal disease: Accounting for time-varying confounders using G-estimation.
<h4>Background</h4>Standard regression modeling may cause biased effect estimates in the presence of time-varying confounders affected by prior exposure. This study aimed to quantify the relationship between declining in modified creatinine index (MCI), as a surrogate marker of lean body...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0272212 |
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| author | Mohammad Aryaie Hamid Sharifi Azadeh Saber Farzaneh Salehi Mahyar Etminan Maryam Nazemipour Mohammad Ali Mansournia |
| author_facet | Mohammad Aryaie Hamid Sharifi Azadeh Saber Farzaneh Salehi Mahyar Etminan Maryam Nazemipour Mohammad Ali Mansournia |
| author_sort | Mohammad Aryaie |
| collection | DOAJ |
| description | <h4>Background</h4>Standard regression modeling may cause biased effect estimates in the presence of time-varying confounders affected by prior exposure. This study aimed to quantify the relationship between declining in modified creatinine index (MCI), as a surrogate marker of lean body mass, and mortality among end stage renal disease (ESRD) patients using G-estimation accounting appropriately for time-varying confounders.<h4>Methods</h4>A retrospective cohort of all registered ESRD patients (n = 553) was constructed over 8 years from 2011 to 2019, from 3 hemodialysis centers at Kerman, southeast of Iran. According to changes in MCI, patients were dichotomized to either the decline group or no-decline group. Subsequently the effect of interest was estimated using G-estimation and compared with accelerated failure time (AFT) Weibull models using two modelling strategies.<h4>Results</h4>Standard models demonstrated survival time ratios of 0.91 (95% confidence interval [95% CI]: 0.64 to 1.28) and 0.84 (95% CI: 0.58 to 1.23) in patients in the decline MCI group compared to those in no-decline MCI group. This effect was demonstrated to be 0.57 (-95% CI: 0.21 to 0.81) using G-estimation.<h4>Conclusion</h4>Declining in MCI increases mortality in patients with ESRD using G-estimation, while the AFT standard models yield biased effect estimate toward the null. |
| first_indexed | 2024-12-10T18:16:12Z |
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| id | doaj.art-47c1bec941c74e95a5ac2d5f9be27fa8 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-10T18:16:12Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-47c1bec941c74e95a5ac2d5f9be27fa82022-12-22T01:38:19ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01178e027221210.1371/journal.pone.0272212Longitudinal causal effect of modified creatinine index on all-cause mortality in patients with end-stage renal disease: Accounting for time-varying confounders using G-estimation.Mohammad AryaieHamid SharifiAzadeh SaberFarzaneh SalehiMahyar EtminanMaryam NazemipourMohammad Ali Mansournia<h4>Background</h4>Standard regression modeling may cause biased effect estimates in the presence of time-varying confounders affected by prior exposure. This study aimed to quantify the relationship between declining in modified creatinine index (MCI), as a surrogate marker of lean body mass, and mortality among end stage renal disease (ESRD) patients using G-estimation accounting appropriately for time-varying confounders.<h4>Methods</h4>A retrospective cohort of all registered ESRD patients (n = 553) was constructed over 8 years from 2011 to 2019, from 3 hemodialysis centers at Kerman, southeast of Iran. According to changes in MCI, patients were dichotomized to either the decline group or no-decline group. Subsequently the effect of interest was estimated using G-estimation and compared with accelerated failure time (AFT) Weibull models using two modelling strategies.<h4>Results</h4>Standard models demonstrated survival time ratios of 0.91 (95% confidence interval [95% CI]: 0.64 to 1.28) and 0.84 (95% CI: 0.58 to 1.23) in patients in the decline MCI group compared to those in no-decline MCI group. This effect was demonstrated to be 0.57 (-95% CI: 0.21 to 0.81) using G-estimation.<h4>Conclusion</h4>Declining in MCI increases mortality in patients with ESRD using G-estimation, while the AFT standard models yield biased effect estimate toward the null.https://doi.org/10.1371/journal.pone.0272212 |
| spellingShingle | Mohammad Aryaie Hamid Sharifi Azadeh Saber Farzaneh Salehi Mahyar Etminan Maryam Nazemipour Mohammad Ali Mansournia Longitudinal causal effect of modified creatinine index on all-cause mortality in patients with end-stage renal disease: Accounting for time-varying confounders using G-estimation. PLoS ONE |
| title | Longitudinal causal effect of modified creatinine index on all-cause mortality in patients with end-stage renal disease: Accounting for time-varying confounders using G-estimation. |
| title_full | Longitudinal causal effect of modified creatinine index on all-cause mortality in patients with end-stage renal disease: Accounting for time-varying confounders using G-estimation. |
| title_fullStr | Longitudinal causal effect of modified creatinine index on all-cause mortality in patients with end-stage renal disease: Accounting for time-varying confounders using G-estimation. |
| title_full_unstemmed | Longitudinal causal effect of modified creatinine index on all-cause mortality in patients with end-stage renal disease: Accounting for time-varying confounders using G-estimation. |
| title_short | Longitudinal causal effect of modified creatinine index on all-cause mortality in patients with end-stage renal disease: Accounting for time-varying confounders using G-estimation. |
| title_sort | longitudinal causal effect of modified creatinine index on all cause mortality in patients with end stage renal disease accounting for time varying confounders using g estimation |
| url | https://doi.org/10.1371/journal.pone.0272212 |
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