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1. Associations of kidney disease measures with mortality and end-stage renal disease in individuals with and without diabetes: a meta-analysis

Author

Fox, Cs, Matsushita, K, Woodward, M, Bilo, Hj, Chalmers, J, Heerspink, Hj, Lee, Bj, Perkins, Rm, Rossing, P, Sairenchi, T, Tonelli, M, Vassalotti, Ja, Yamagishi, K, Coresh, J, Jong, De, Wen, Cp, Nelson, Rg, Chronic, Kidney, Disease, Prognosis, Consortium, Investigators/collaborators:, Wright, J, Appel, L, Greene, T, Astor, Bc, Macmahon, S, Arima, H, Yatsuya, H, Yamashita, K, Toyoshima, H, Tamakoshi, K, Sang, Y, Atkins, Rc, Polkinghorne, Kr, Chadban, S, Shankar, A, Klein, R, Klein, Be, Lee, Ke, Wang, H, Wang, F, Zhang, L, Zuo, L, Levin, A, Djurdjev, O, Sacks, Fm, Curhan, Gc, Shlipak, M, Peralta, C, Katz, R, Fried, L, Iso, H, Kitamura, A, Ohira, T, Jafar, Th, Islam, M, Hatcher, J, Poulter, N, Chaturvedi, N, Landray, Mj, Emberson, Jr, Townend, Jn, Wheeler, Dc, Rothenbacher, D, Brenner, H, Müller, H, Schöttker, B, Hwang, Sj, Meigs, Jb, Fluck, N, Clark, Le, Prescott, Gj, Marks, A, Black, C, Cirillo, Massimo, Hallan, S, Aasarød, K, Øien, Cm, Radtke, M, Irie, F, Smith, Dh, Weiss, Jw, Johnson, Es, Thorp, Ml, Collins, Aj, Li, S, Chen, Sc, Wetzels, Jf, Blankestijn, Pj, Van, Zuilen, Sarnak, M, Levey, As, Menon, V, Kramer, Hj, Boer, De, Kronenberg, F, Kollerits, B, Ritz, E, Roderick, P, Nitsch, D, Fletcher, A, Bulpitt, C, Ishani, A, Neaton, Jd, Froissart, M, Stengel, B, Metzger, M, Haymann, Jp, Houillier, P, Flamant, M, Ohkubo, T, Metoki, H, Nakayama, M, Kikuya, M, Imai, Y, Knowler, Wc, Gansevoort, Rt, Mahmoodi, Bk, Bakker, Sj, Jassal, Sk, Barrett Connor, E, Bergstrom, J, Lambers, Heerspink, Brenner, Be, Zeeuw, D, Warnock, Dg, Muntner, P, Judd, S, Mcclellan, W, Jee, Sh, Kimm, H, Jo, J, Mok, Y, Lim, Je, Parving, Hh, Tangri, N, Naimark, D, Wen, Sf, Tsao, Ck, Tsai, Mk, Ärnlöv, J, Lannfelt, L, Larsson, A, Joosten, H, Kleefstra, N, Groenier, Kh, Drion, I, Hemmelgarn, B, Ballew, Sh, Grams, M, Camarata, L, Hui, X, Seltzer, J, Winegrad, H., Groningen Kidney Center (GKC), Methods in Medicines evaluation & Outcomes research (M2O), Lifestyle Medicine (LM), Fox, C, Matsushita, K, Woodward, M, Bilo, Hj, Chalmers, J, Heerspink, Hj, Lee, Bj, Perkins, Rm, Rossing, P, Sairenchi, T, Tonelli, M, Vassalotti, Ja, Yamagishi, K, Coresh, J, de Jong PE, Wen, Cp, Nelson, Rg, Investigators/Collaborators: Wright J, Chronic Kidney Disease Prognosis Consortium, Appel, L, Greene, T, Astor, Bc, Macmahon, S, Arima, H, Yatsuya, H, Yamashita, K, Toyoshima, H, Tamakoshi, K, Sang, Y, Atkins, Rc, Polkinghorne, Kr, Chadban, S, Shankar, A, Klein, R, Klein, Be, Lee, Ke, Wang, H, Wang, F, Zhang, L, Zuo, L, Levin, A, Djurdjev, O, Sacks, Fm, Curhan, Gc, Shlipak, M, Peralta, C, Katz, R, Fried, L, Iso, H, Kitamura, A, Ohira, T, Jafar, Th, Islam, M, Hatcher, J, Poulter, N, Chaturvedi, N, Landray, Mj, Emberson, Jr, Townend, Jn, Wheeler, Dc, Rothenbacher, D, Brenner, H, Müller, H, Schöttker, B, Hwang, Sj, Meigs, Jb, Fluck, N, Clark, Le, Prescott, Gj, Marks, A, Black, C, Cirillo, Massimo, Hallan, S, Aasarød, K, Øien, Cm, Radtke, M, Irie, F, Smith, Dh, Weiss, Jw, Johnson, E, Thorp, Ml, Collins, Aj, Li, S, Chen, Sc, Wetzels, Jf, Blankestijn, Pj, van Zuilen AD, Sarnak, M, Levey, A, Menon, V, Kramer, Hj, de Boer IH, Kronenberg, F, Kollerits, B, Ritz, E, Roderick, P, Nitsch, D, Fletcher, A, Bulpitt, C, Ishani, A, Neaton, Jd, Froissart, M, Stengel, B, Metzger, M, Haymann, Jp, Houillier, P, Flamant, M, Ohkubo, T, Metoki, H, Nakayama, M, Kikuya, M, Imai, Y, Knowler, Wc, Gansevoort, Rt, Mahmoodi, Bk, Bakker, Sj, Jassal, Sk, Barrett-Connor, E, Bergstrom, J, Lambers Heerspink HJ, Brenner, Be, Zeeuw, D, Warnock, Dg, Muntner, P, Judd, S, Mcclellan, W, Jee, Sh, Kimm, H, Jo, J, Mok, Y, Lim, Je, Parving, Hh, Tangri, N, Naimark, D, Wen, Sf, Tsao, Ck, Tsai, Mk, Ärnlöv, J, Lannfelt, L, Larsson, A, Joosten, H, Kleefstra, N, Groenier, Kh, Drion, I, Hemmelgarn, B, Ballew, Sh, Grams, M, Camarata, L, Hui, X, Seltzer, J, and Winegrad, H.

Subjects
medicine.medical_specialty, Population, UNITED-STATES, Renal function, ALL-CAUSE, GLOMERULAR-FILTRATION-RATE, albuminuria, End stage renal disease, Diabetic nephropathy, CKD-PC Consortium, Diabetes mellitus, Internal medicine, eGFR, Medicine, ESTIMATED GFR, education, Intensive care medicine, Renal disorder [IGMD 9], OUTCOMES, education.field_of_study, end-stage renal disease, diabetes, business.industry, Hazard ratio, PROTEINURIA, General Medicine, mortality, medicine.disease, RISK POPULATION COHORTS, PREVALENCE, diabete, COLLABORATIVE METAANALYSIS, Albuminuria, medicine.symptom, HIGHER ALBUMINURIA, business, Kidney disease
Abstract

Item does not contain fulltext BACKGROUND: Chronic kidney disease is characterised by low estimated glomerular filtration rate (eGFR) and high albuminuria, and is associated with adverse outcomes. Whether these risks are modified by diabetes is unknown. METHODS: We did a meta-analysis of studies selected according to Chronic Kidney Disease Prognosis Consortium criteria. Data transfer and analyses were done between March, 2011, and June, 2012. We used Cox proportional hazards models to estimate the hazard ratios (HR) of mortality and end-stage renal disease (ESRD) associated with eGFR and albuminuria in individuals with and without diabetes. FINDINGS: We analysed data for 1,024,977 participants (128,505 with diabetes) from 30 general population and high-risk cardiovascular cohorts and 13 chronic kidney disease cohorts. In the combined general population and high-risk cohorts with data for all-cause mortality, 75,306 deaths occurred during a mean follow-up of 8.5 years (SD 5.0). In the 23 studies with data for cardiovascular mortality, 21,237 deaths occurred from cardiovascular disease during a mean follow-up of 9.2 years (SD 4.9). In the general and high-risk cohorts, mortality risks were 1.2-1.9 times higher for participants with diabetes than for those without diabetes across the ranges of eGFR and albumin-to-creatinine ratio (ACR). With fixed eGFR and ACR reference points in the diabetes and no diabetes groups, HR of mortality outcomes according to lower eGFR and higher ACR were much the same in participants with and without diabetes (eg, for all-cause mortality at eGFR 45 mL/min per 1.73 m(2) [vs 95 mL/min per 1.73 m(2)], HR 1.35; 95% CI 1.18-1.55; vs 1.33; 1.19-1.48 and at ACR 30 mg/g [vs 5 mg/g], 1.50; 1.35-1.65 vs 1.52; 1.38-1.67). The overall interactions were not significant. We identified much the same findings for ESRD in the chronic kidney disease cohorts. INTERPRETATION: Despite higher risks for mortality and ESRD in diabetes, the relative risks of these outcomes by eGFR and ACR are much the same irrespective of the presence or absence of diabetes, emphasising the importance of kidney disease as a predictor of clinical outcomes. FUNDING: US National Kidney Foundation.

Published
2012
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2. Comparison of risk prediction using the CKD-EPI equation and the MDRD study equation for estimated glomerular filtration rate

Author

Matsushita, K, Mahmoodi, Bk, Woodward, M, Emberson, Jr, Jafar, Th, Jee, Sh, Polkinghorne, Kr, Shankar, A, Smith, Dh, Tonelli, M, Warnock, Dg, Wen, Cp, Coresh, J, Gansevoort, Rt, Hemmelgarn, Br, Levey, As, Chronic, Kidney, Disease, Prognosis, Consortium, Wright, J, Appel, Lj, Greene, T, Astor, Bc, Chalmers, J, Macmahon, S, Yatsuya, H, Yamashita, K, Toyoshima, H, Tamakoshi, K, Sang, Y, Atkins, Rc, Chadban, S, Klein, R, Klein, Be, Lee, Ke, Wang, H, Wang, F, Zhang, L, Zuo, L, Levin, A, Djurdjev, O, Sacks, Fm, Curhan, Gc, Shlipak, M, Peralta, C, Katz, R, Fried, Lf, Iso, H, Ohira, T, Kitamura, A, Yamagishi, K, Islam, M, Hatcher, J, Poulter, N, Chaturvedi, N, Landray, Mj, Townend, Jn, Wheeler, Dc, Rothenbacher, D, Brenner, H, Müller, H, Schöttker, B, Fox, Cs, Hwang, Sj, Meigs, Jb, Perkins, Rm, Fluck, N, Clark, Le, Prescott, Gj, Marks, A, Black, C, Cirillo, Massimo, Hallan, S, Aasarød, K, Øien, Cm, Radtke, M, Irie, F, Sairenchi, T, Johnson, Es, Thorp, Ml, Weiss, Jw, Collins, Aj, Li, S, Chen, Sc, Vassalotti, Ja, Lee, Bj, Wetzels, Jf, Blankestijn, Pj, Van, Zuilen, Sarnak, M, Menon, V, Boer, De, Kramer, Hj, Kronenberg, F, Kollerits, B, Ritz, E, Roderick, P, Nitsch, D, Fletcher, A, Bulpitt, C, Ishani, A, Neaton, Jd, Froissart, M, Stengel, B, Metzger, M, Haymann, Jp, Houillier, P, Flamant, M, Ohkubo, T, Nakayama, M, Metoki, H, Kikuya, M, Imai, Y, Iseki, K, Nelson, Rg, Knowler, Wc, Jong, De, Bakker, Sj, Jassal, Sk, Barrett-Connor, E, Bergstrom, J, Heerspink, Hj, Zeeuw, De, D, Brenner, Be, Muntner, P, Judd, S, Mcclellan, W, Kimm, H, Jo, J, Mok, Y, Choi, E, Rossing, P, Parving, Hh, Tangri, N, Naimark, D, Wen, Sf, Tsao, Ck, Tsai, Mk, Ärnlöv, J, Larsson, A, Lannfelt, L, Bilo, Hj, Kleefstra, N, Groenier, Kh, Drion, I, Joosten, H, Ballew, Sh, Grams, M, Camarata, L, Hui, X, Seltzer, J, Winegrad, H., Matsushita, K, Mahmoodi, Bk, Woodward, M, Emberson, Jr, Jafar, Th, Jee, Sh, Polkinghorne, Kr, Shankar, A, Smith, Dh, Tonelli, M, Warnock, Dg, Wen, Cp, Coresh, J, Gansevoort, Rt, Hemmelgarn, Br, Levey, A, Chronic, Kidney, Disease, Prognosi, Consortium, Wright, J, Appel, Lj, Greene, T, Astor, Bc, Chalmers, J, Macmahon, S, Yatsuya, H, Yamashita, K, Toyoshima, H, Tamakoshi, K, Sang, Y, Atkins, Rc, Chadban, S, Klein, R, Klein, Be, Lee, Ke, Wang, H, Wang, F, Zhang, L, Zuo, L, Levin, A, Djurdjev, O, Sacks, Fm, Curhan, Gc, Shlipak, M, Peralta, C, Katz, R, Fried, Lf, Iso, H, Ohira, T, Kitamura, A, Yamagishi, K, Islam, M, Hatcher, J, Poulter, N, Chaturvedi, N, Landray, Mj, Townend, Jn, Wheeler, Dc, Rothenbacher, D, Brenner, H, Müller, H, Schöttker, B, Fox, C, Hwang, Sj, Meigs, Jb, Perkins, Rm, Fluck, N, Clark, Le, Prescott, Gj, Marks, A, Black, C, Cirillo, Massimo, Hallan, S, Aasarød, K, Øien, Cm, Radtke, M, Irie, F, Sairenchi, T, Johnson, E, Thorp, Ml, Weiss, Jw, Collins, Aj, Li, S, Chen, Sc, Vassalotti, Ja, Lee, Bj, Wetzels, Jf, Blankestijn, Pj, Van, Zuilen, Ad, Sarnak, M, Menon, V, De, Boer, Ih, Kramer, Hj, Kronenberg, F, Kollerits, B, Ritz, E, Roderick, P, Nitsch, D, Fletcher, A, Bulpitt, C, Ishani, A, Neaton, Jd, Froissart, M, Stengel, B, Metzger, M, Haymann, Jp, Houillier, P, Flamant, M, Ohkubo, T, Nakayama, M, Metoki, H, Kikuya, M, Imai, Y, Iseki, K, Nelson, Rg, Knowler, Wc, De, Jong, Pe, Bakker, Sj, Jassal, Sk, Barrett-Connor, E, Bergstrom, J, Heerspink, Hj, De, Zeeuw, D, Brenner, Be, Muntner, P, Judd, S, Mcclellan, W, Kimm, H, Jo, J, Mok, Y, Choi, E, Rossing, P, Parving, Hh, Tangri, N, Naimark, D, Wen, Sf, Tsao, Ck, Tsai, Mk, Ärnlöv, J, Larsson, A, Lannfelt, L, Bilo, Hj, Kleefstra, N, Groenier, Kh, Drion, I, Joosten, H, Ballew, Sh, Grams, M, Camarata, L, Hui, X, Seltzer, J, Winegrad, H., Cardiovascular Centre (CVC), and Groningen Kidney Center (GKC)

Subjects
CHRONIC KIDNEY-DISEASE, Gerontology, Male, EVALUATION PROGRAM KEEP, Population, Renal function, Black People, Ckd epi equation, urologic and male genital diseases, Risk Assessment, White People, Article, Decision Support Techniques, Cohort Studies, Sex Factors, Asian People, EPIDEMIOLOGY COLLABORATION EQUATION, Diabetes mellitus, CYSTATIN-C, Medicine, Humans, education, ALL-CAUSE MORTALITY, Cardiovascular mortality, Aged, Renal disorder [IGMD 9], GENERAL-POPULATION, education.field_of_study, business.industry, CARDIOVASCULAR RISK, Hazard ratio, STAGE RENAL-DISEASE, General Medicine, POPULATION COHORTS, Middle Aged, Models, Theoretical, medicine.disease, female genital diseases and pregnancy complications, Net reclassification improvement, SERUM CREATININE VALUES, Cardiovascular Diseases, Kidney Failure, Chronic, Female, business, Algorithms, Demography, Glomerular Filtration Rate
Abstract

Contains fulltext : 110640.pdf (Publisher’s version ) (Closed access) CONTEXT: The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation more accurately estimates glomerular filtration rate (GFR) than the Modification of Diet in Renal Disease (MDRD) Study equation using the same variables, especially at higher GFR, but definitive evidence of its risk implications in diverse settings is lacking. OBJECTIVE: To evaluate risk implications of estimated GFR using the CKD-EPI equation compared with the MDRD Study equation in populations with a broad range of demographic and clinical characteristics. DESIGN, SETTING, AND PARTICIPANTS: A meta-analysis of data from 1.1 million adults (aged >/= 18 years) from 25 general population cohorts, 7 high-risk cohorts (of vascular disease), and 13 CKD cohorts. Data transfer and analyses were conducted between March 2011 and March 2012. MAIN OUTCOME MEASURES: All-cause mortality (84,482 deaths from 40 cohorts), cardiovascular mortality (22,176 events from 28 cohorts), and end-stage renal disease (ESRD) (7644 events from 21 cohorts) during 9.4 million person-years of follow-up; the median of mean follow-up time across cohorts was 7.4 years (interquartile range, 4.2-10.5 years). RESULTS: Estimated GFR was classified into 6 categories (>/=90, 60-89, 45-59, 30-44, 15-29, and /=65 years), sex, race/ethnicity (white, Asian, and black), and presence or absence of diabetes and hypertension. The results in the high-risk and CKD cohorts were largely consistent with the general population cohorts. CONCLUSION: The CKD-EPI equation classified fewer individuals as having CKD and more accurately categorized the risk for mortality and ESRD than did the MDRD Study equation across a broad range of populations.

Published
2012

3. Associations of kidney disease measures with mortality and end-stage renal disease in individuals with and without hypertension: a meta-analysis

Author

Mahmoodi, Bk, Matsushita, K., Woodward, M., Blankestijn, Pj, Cirillo, Massimo, Ohkubo, T., Rossing, P., Sarnak, Mj, Stengel, B., Yamagishi, K., Yamashita, K., Zhang, L., Coresh, J., PE de Jong, Wright, BC Astor for the Chronic Kidney Disease Prognosis C. o. n. s. o. r. t. i. u. m. Investigators/Collaborators: J., Appel, L., Greene, T., Astor, Bc, Chalmers, J., Macmahon, S., Arima, H., Yatsuya, H., Toyoshima, H., Tamakoshi, K., Sang, Y., Atkins, R. C., Polkinghorne, Kr, Chadban, S., Shankar, A., Klein, R., Bek, Klein, Lee, Ke, Wang, H., Wang, F., Zuo, L., Levin, A., Djurdjev, O., Tonelli, M., Sacks, Fm, Curhan, Gc, Shlipak, M., Peralta, C., Katz, R., Fried, L., Iso, H., Kitamura, A., Ohira, T., Jafar, Th, Islam, M., Hatcher, J., Poulter, N., Chaturvedi, N., Landray, M. J., Emberson, Jr, Townend, Jn, Wheeler, Dc, Rothenbacher, D., Brenner, H., Muller, H., Schottker, B., Fox, Cs, Hwang, S. J., Meigs, Jb, Perkins, Rm, Fluck, N., Clark, Le, Prescott, Gj, Marks, A., Black, C., Hallan, S., Aasarod, K., Oien, Cm, Radtke, M., Irie, F., Sairenchi, T., Smith, Dh, Weiss, Jw, Johnson, Es, Thorp, Ml, Collins, Aj, Vassalotti, Ja, Li, S., Chen, S. C., Lee, Bj, Wetzels, Jf, AD van Zuilen, Sarnak, M., Levey, As, Menon, V., Kramer, Hj, IH de Boer, Kronenberg, F., Kollerits, B., Roderick, E. R. i. t. z. P., Nitsch, D., Fletcher, A., Bulpitt, C., Ishani, A., Neaton, Jd, Froissart, M., Metzger, M., Haymann, J. P., Houillier, P., Flamant, M., Metoki, H., Nakayama, M., Kikuya, M., Imai, Y., Iseki, K., Nelson, Rg, Knowler, Wc, Gansevoort, Rt, Hillege, H., Jassal, Sk, Barrett Connor, E., Bergstrom, J., HJ Lambers Heerspink, Brenner, Be, de Zeeuw, D., Warnock, Dg, Muntner, P., Judd, S., Mcclellan, W., Jee, Sh, Kimm, H., Jo, J., Mok, Y., Parving, H. H., Tangri, N., Naimark, D., Wen, C. P., Wen, S. F., Tsao, C. K., Tsai, M. K., Arnlov, J., Lannfelt, L., Larsson, A., Bilo, Hj, Joosten, H., Kleefstra, N., Groenier, Kh, Steering Committee: BC Astor, I. D. r. i. o. n., Hemmelgarn, Br, Data Coordinating Center: SH Ballew, M. W. o. o. d. w. a. r. d., Grams, M., Camarata, L., Hui, X., Seltzer, J., Winegrad, H., Mahmoodi, Bk, Matsushita, K, Woodward, M, Blankestijn, Pj, Cirillo, M, Ohkubo, T, Rossing, P, Sarnak, Mj, Stengel, B, Yamagishi, K, Yamashita, K, Zhang, L, Coresh, J, de Jong, Pe, Investigators/Collaborators: J Wright, BC Astor for the Chronic Kidney Disease Prognosis Consortium., Appel, L, Greene, T, Astor, Bc, Chalmers, J, Macmahon, S, Arima, H, Yatsuya, H, Toyoshima, H, Tamakoshi, K, Sang, Y, C Atkins, R, Polkinghorne, Kr, Chadban, S, Shankar, A, Klein, R, Klein, Bek, Lee, Ke, Wang, H, Wang, F, Zuo, L, Levin, A, Djurdjev, O, Tonelli, M, Sacks, Fm, Curhan, Gc, Shlipak, M, Peralta, C, Katz, R, Fried, L, Iso, H, Kitamura, A, Ohira, T, Jafar, Th, Islam, M, Hatcher, J, Poulter, N, Chaturvedi, N, J Landray, M, Emberson, Jr, Townend, Jn, Wheeler, Dc, Rothenbacher, D, Brenner, H, Muller, H, Schottker, B, Fox, C, Hwang, S-J, Meigs, Jb, Perkins, Rm, Fluck, N, Clark, Le, Prescott, Gj, Marks, A, Black, C, Hallan, S, Aasarod, K, Oien, Cm, Radtke, M, Irie, F, Sairenchi, T, Smith, Dh, Weiss, Jw, Johnson, E, Thorp, Ml, Collins, Aj, Vassalotti, Ja, Li, S, Chen, S-C, Lee, Bj, Wetzels, Jf, van Zuilen, Ad, Sarnak, M, Levey, A, Menon, V, Kramer, Hj, de Boer, Ih, Kronenberg, F, Kollerits, B, P Roderick, E Ritz., Nitsch, D, Fletcher, A, Bulpitt, C, Ishani, A, Neaton, Jd, Froissart, M, Metzger, M, Haymann, J-P, Houillier, P, Flamant, M, Metoki, H, Nakayama, M, Kikuya, M, Imai, Y, Iseki, K, Nelson, Rg, Knowler, Wc, Gansevoort, Rt, Hillege, H, Jassal, Sk, Barrett-Connor, E, Bergstrom, J, Lambers Heerspink, Hj, Brenner, Be, de Zeeuw, D, Warnock, Dg, Muntner, P, Judd, S, Mcclellan, W, Jee, Sh, Kimm, H, Jo, J, Mok, Y, Parving, H-H, Tangri, N, Naimark, D, Wen, C-P, Wen, S-F, Tsao, C-K, Tsai, M-K, Arnlov, J, Lannfelt, L, Larsson, A, Bilo, Hj, Joosten, H, Kleefstra, N, Groenier, Kh, Steering Committee: BC Astor, I Drion., Hemmelgarn, Br, Data Coordinating Center: SH Ballew, M Woodward., Grams, M, Camarata, L, Hui, X, Seltzer, J, and Winegrad., H

Subjects
Male, medicine.medical_specialty, hypertension, Blood Pressure, BLOOD-PRESSURE, GLOMERULAR-FILTRATION-RATE, Article, albuminuria, DIABETIC-NEPHROPATHY, End stage renal disease, CKD-PC Consortium, Risk Factors, Cause of Death, Internal medicine, REVERSE EPIDEMIOLOGY, eGFR, EQUATION, medicine, Humans, Intensive care medicine, Aged, Proportional Hazards Models, ALL-CAUSE MORTALITY, Renal disorder [IGMD 9], Aged, 80 and over, end-stage renal disease, business.industry, General Medicine, Middle Aged, medicine.disease, mortality, RISK POPULATION COHORTS, PREVALENCE, Chronic Disease, COLLABORATIVE METAANALYSIS, Kidney Failure, Chronic, Female, HIGHER ALBUMINURIA, business, Glomerular Filtration Rate, Kidney disease
Abstract

Item does not contain fulltext BACKGROUND: Hypertension is the most prevalent comorbidity in individuals with chronic kidney disease. However, whether the association of the kidney disease measures, estimated glomerular filtration rate (eGFR) and albuminuria, with mortality or end-stage renal disease (ESRD) differs by hypertensive status is unknown. METHODS: We did a meta-analysis of studies selected according to Chronic Kidney Disease Prognosis Consortium criteria. Data transfer and analyses were done between March, 2011, and June, 2012. We used Cox proportional hazards models to estimate the hazard ratios (HR) of mortality and ESRD associated with eGFR and albuminuria in individuals with and without hypertension. FINDINGS: We analysed data for 45 cohorts (25 general population, seven high-risk, and 13 chronic kidney disease) with 1,127,656 participants, 364,344 of whom had hypertension. Low eGFR and high albuminuria were associated with mortality irrespective of hypertensive status in the general population and high-risk cohorts. All-cause mortality risk was 1.1-1.2 times higher in individuals with hypertension than in those without hypertension at preserved eGFR. A steeper relative risk gradient in individuals without hypertension than in those with hypertension at eGFR range 45-75 mL/min per 1.73 m(2) led to much the same mortality risk at lower eGFR. With a reference eGFR of 95 mL/min per 1.73 m(2) in each group to explicitly assess interaction, adjusted HR for all-cause mortality at eGFR 45 mL/min per 1.73 m(2) was 1.77 (95% CI 1.57-1.99) in individuals without hypertension versus 1.24 (1.11-1.39) in those with hypertension (p for overall interaction=0.0003). Similarly, for albumin-creatinine ratio of 300 mg/g (vs 5 mg/g), HR was 2.30 (1.98-2.68) in individuals without hypertension versus 2.08 (1.84-2.35) in those with hypertension (p for overall interaction=0.019). We recorded much the same results for cardiovascular mortality. The associations of eGFR and albuminuria with ESRD, however, did not differ by hypertensive status. Results for chronic kidney disease cohorts were similar to those for general and high-risk population cohorts. INTERPRETATION: Chronic kidney disease should be regarded as at least an equally relevant risk factor for mortality and ESRD in individuals without hypertension as it is in those with hypertension. FUNDING: US National Kidney Foundation.

Published
2012

4. Improving the prognosis of patients with severely decreased glomerular filtration rate (CKD G4+): conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

Author

Bertrand L. Kasiske, Manjula Kurella Tamura, Kathryn Griffith, Marie Evans, Mustafa Arici, Min Jun, David C. Wheeler, Brenda R. Hemmelgarn, Edgar V. Lerma, Hiddo J.L. Heerspink, Michael Cheung, Kamyar Kalantar-Zadeh, Matthew T. James, Wolfgang C. Winkelmayer, Elke Schäffner, Adeera Levin, Shuchi Anand, Bénédicte Stengel, Kitty J. Jager, Zofia Das-Gupta, Paul E. Stevens, Ali K. Abu-Alfa, Jamie P. Dwyer, Angela Yee-Moon Wang, Amy W. Williams, Nisha Bansal, Dorry L. Segev, Edmund J. Lamb, David M. Charytan, Carol A. Pollock, Danielle M. Nash, Danilo Fliser, Roberto Pecoits-Filho, Miguel A. Vazquez, Kai-Uwe Eckardt, Juan Carlos Julián Mauro, Kate Huffman, Mintu P. Turakhia, Rafael Burgos-Calderon, Andrew S. Levey, Lesley A. Inker, Csaba P. Kovesdy, Marc Froissart, David Harris, Charles A. Herzog, Geoffrey A. Block, Shoshana H. Ballew, Bruce M. Robinson, Donal O'Donoghue, Sankar D. Navaneethan, Josef Coresh, Vera Krane, Francesca Tentori, Navdeep Tangri, Yusuke Tsukamoto, Peter Stenvinkel, John S. Gill, Gregorio T. Obrador, Morgan E. Grams, Marcello Tonelli, Conference Participants, Abu-Alfa, A.K., Anand, S., Arici, M., Ballew, S.H., Block, G.A., Burgos-Calderon, R., Charytan, D.M., Das-Gupta, Z., Dwyer, J.P., Fliser, D., Froissart, M., Gill, J.S., Griffith, K.E., Harris, D.C., Huffman, K., Inker, L.A., Jager, K.J., Jun, M., Kalantar-Zadeh, K., Kasiske, B.L., Kovesdy, C.P., Krane, V., Lamb, E.J., Lerma, E.V., Levey, A.S., Levin, A., Julián Mauro, J.C., Nash, D.M., Navaneethan, S.D., O'Donoghue, D., Obrador, G.T., Pecoits-Filho, R., Robinson, B.M., Schäffner, E., Segev, D.L., Stengel, B., Stenvinkel, P., Tangri, N., Tentori, F., Tsukamoto, Y., Turakhia, M.P., Vazquez, M.A., Yee-Moon Wang, A., Williams, A.W., Groningen Kidney Center (GKC), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), APH - Aging & Later Life, APH - Quality of Care, APH - Global Health, and ACS - Pulmonary hypertension & thrombosis

Subjects
medicine.medical_specialty, Consensus, Clinical Decision-Making, 030232 urology & nephrology, Context (language use), HEMODIALYSIS-PATIENTS, Disease, 030204 cardiovascular system & hematology, urologic and male genital diseases, Kidney, Severity of Illness Index, OUTPUT CARDIAC-FAILURE, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, medicine, Humans, Renal Insufficiency, Chronic, Intensive care medicine, CARDIOVASCULAR EVENTS, Evidence-Based Medicine, business.industry, INCIDENT HEART-FAILURE, STAGE RENAL-DISEASE, INSUFFICIENCY COHORT, RANDOMIZED CONTROLLED-TRIAL, medicine.disease, Prognosis, female genital diseases and pregnancy complications, Clinical trial, chronic kidney disease, kidney failure, prediction, prognosis, progression, supportive care, medicine.anatomical_structure, Decreased glomerular filtration rate, Nephrology, Heart failure, business, REDUCED EJECTION FRACTION, CLINICAL-TRIALS, Kidney disease, Cohort study, DIALYSIS INITIATION, Glomerular Filtration Rate
Abstract

Patients with severely decreased glomerular filtration rate (GFR) (i.e., chronic kidney disease [CKD] G4+) are at increased risk for kidney failure, cardiovascular disease (CVD) events (including heart failure), and death. However, little is known about the variability of outcomes and optimal therapeutic strategies, including initiation of kidney replacement therapy (KRT). Kidney Disease: Improving Global Outcomes (KDIGO) organized a Controversies Conference with an international expert group in December 2016 to address this gap in knowledge. In collaboration with the CKD Prognosis Consortium (CKD-PC) a global meta-analysis of cohort studies (n = 264,515 individuals with CKD G4+) was conducted to better understand the timing of clinical outcomes in patients with CKD G4+ and risk factors for different outcomes. The results confirmed the prognostic value of traditional CVD risk factors in individuals with severely decreased GFR, although the risk estimates vary for kidney and CVD outcomes. A 2- and 4-year model of the probability and timing of kidney failure requiring KRT was also developed. The implications of these findings for patient management were discussed in the context of published evidence under 4 key themes: management of CKD G4+, diagnostic and therapeutic challenges of heart failure, shared decision-making, and optimization of clinical trials in CKD G4+ patients. Participants concluded that variable prognosis of patients with advanced CKD mandates individualized, risk-based management, factoring in competing risks and patient preferences.

Published
2017

5. EROS2 microlensing search towards the Magellanic clouds

Author

Milsztajn, A., Afonso, C., J-N, Albert, Andersen, J., Ansari, R., Aubourg, E., Bareyre, P., Bauer, F., J-P, Beaulieu, Bouquet, A., Char, S., Charlot, X., François Couchot, Coutures, C., Derue, F., Ferlet, R., J-F, Glicenstein, Goldman, B., Gould, A., Graff, D., Gros, M., Haissinski, J., J-C, Hamilton, Hardin, D., Kat, J., Lesquoy, E., Loup, C., Magneville, C., Mansoux, B., J-B, Marquette, Maurice, E., Moniez, M., Palanque-Delabrouille, N., Perdereau, O., Prevot, L., Renault, C., Rich, J., Spiro, M., Vidal-Madjar, A., Vigrou, L., Zylberajch, S., Physique Corpusculaire et Cosmologie - Collège de France (PCC), Collège de France (CdF (institution))-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), Dumarchez J. Froissart M. Vignaud D., EROS, and Lantz, Simone

Subjects
[PHYS.ASTR.CO]Physics [physics]/Astrophysics [astro-ph]/Cosmology and Extra-Galactic Astrophysics [astro-ph.CO], [PHYS.ASTR.CO] Physics [physics]/Astrophysics [astro-ph]/Cosmology and Extra-Galactic Astrophysics [astro-ph.CO]

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