1. Relationship of eGFR and Albuminuria to concurrent laboratory abnormalities: An individual participant data meta-analysis in a global consortium
- Author
-
Lesley A. Inker, Morgan E. Grams, Andrew S. Levey, Josef Coresh, Massimo Cirillo, John F. Collins, Ron T. Gansevoort, Orlando M. Gutierrez, Takayuki Hamano, Gunnar H. Heine, Shizukiyo Ishikawa, Sun Ha Jee, Florian Kronenberg, Martin J. Landray, Katsuyuki Miura, Girish N. Nadkarni, Carmen A. Peralta, Dietrich Rothenbacher, Elke Schaeffner, Sanaz Sedaghat, Michael G. Shlipak, Luxia Zhang, Arjan D. van Zuilen, Stein I. Hallan, Csaba P. Kovesdy, Mark Woodward, Adeera Levin, Brad Astor, Larry Appel, Tom Greene, Teresa Chen, John Chalmers, Hisatomi Arima, Vlado Perkovic, Hiroshi Yatsuya, Koji Tamakoshi, Yuanying Li, Yoshihisa Hirakawa, Kunihiro Matsushita, Morgan Grams, Yingying Sang, Kevan Polkinghorne, Steven Chadban, Robert Atkins, Ognjenka Djurdjev, Lisheng Liu, Minghui Zhao, Fang Wang, Jinwei Wang, Natalie Ebert, Peter Martus, Mila Tang, Gunnar Heine, Insa Emrich, Sarah Seiler, Adam Zawada, Joseph Nally, Sankar Navaneethan, Jesse Schold, Michael Shlipak, Mark Sarnak, Ronit Katz, Jade Hiramoto, Hiroyasu Iso, Kazumasa Yamagishi, Mitsumasa Umesawa, Isao Muraki, Masafumi Fukagawa, Shoichi Maruyama, Takeshi Hasegawa, Naohiko Fujii, David Wheeler, John Emberson, John Townend, Martin Landray, Hermann Brenner, Ben Schöttker, Kai-Uwe Saum, Caroline Fox, Shih-Jen Hwang, Anna Köttgen, Markus P. Schneider, Kai-Uwe Eckardt, Jamie Green, H Lester Kirchner, Alex R. Chang, Kevin Ho, Sadayoshi Ito, Mariko Miyazaki, Masaaki Nakayama, Gen Yamada, Fujiko Irie, Toshimi Sairenchi, Yuichiro Yano, Kazuhiko Kotani, Takeshi Nakamura, Heejin Kimm, Yejin Mok, Gabriel Chodick, Varda Shalev, Jack F.M. Wetzels, Peter J. Blankestijn, Jan van den Brand, Lesley Inker, Carmen Peralta, Barbara Kollerits, Eberhard Ritz, Dorothea Nitsch, Paul Roderick, Astrid Fletcher, Erwin Bottinger, Stephen B. Ellis, Rajiv Nadukuru, Hirotsugu Ueshima, Akira Okayama, Sachiko Tanaka, Tomonori Okamura, Aya Kadota, Timothy Kenealy, C Raina Elley, Paul L. Drury, Takayoshi Ohkubo, Kei Asayama, Hirohito Metoki, Masahiro Kikuya, Robert G. Nelson, William C. Knowler, Stephan JL. Bakker, Eelco Hak, Hiddo J.L. Heerspink, Nigel Brunskill, Rupert Major, David Shepherd, James Medcalf, Simerjot K. Jassal, Jaclyn Bergstrom, Joachim H. Ix, Elizabeth Barrett-Connor, Csaba Kovesdy, Kamyar Kalantar-Zadeh, Keiichi Sumida, Paul Muntner, David Warnock, William McClellan, Dick de Zeeuw, Barry Brenner, M Arfan Ikram, Ewout J. Hoorn, Abbas Dehghan, Juan J. Carrero, Alessandro Gasparini, Björn Wettermark, Carl-Gustaf Elinder, Tien Yin Wong, Charumathi Sabanayagam, Ching-Yu Cheng, Frank L.J. Visseren, Marie Evans, Mårten Segelmark, Maria Stendahl, Staffan Schön, Navdeep Tangri, Maneesh Sud, David Naimark, Chi-Pang Wen, Chwen-Keng Tsao, Min-Kugng Tsai, Chien-Hua Chen, Tsuneo Konta, Atsushi Hirayama, Kazunobu Ichikawa, Lars Lannfelt, Anders Larsson, Johan Ärnlöv, Henk J.G. Bilo, Gijs W.D. Landman, Kornelis J.J. van Hateren, Nanne Kleefstra, Josef Coresh (Chair, Stein Hallan, Shoshana H. Ballew, Jingsha Chen, Lucia Kwak, Aditya Surapaneni, Inker, La, Grams, Me, Levey, A, Coresh, J, Cirillo, Massimo, Collins, Jf, Gansevoort, Rt, Gutierrez, Om, Hamano, T, Heine, Gh, Ishikawa, S, Jee, Sh, Kronenberg, F, Landray, Mj, Miura, K, Nadkarni, Gn, Peralta, Ca, Rothenbacher, D, Schaeffner, E, Sedaghat, S, Shlipak, Mg, Zhang, L, Van, Zuilen, Ad, Hallan, Si, Kovesdy, Cp, Woodward, M, Levin, A, Ckd, Prognosi, Consortiu, M., Epidemiology, Radiology & Nuclear Medicine, Internal Medicine, Cardiovascular Centre (CVC), and Groningen Kidney Center (GKC)
- Subjects
Nephrology ,Male ,Hypertension, Renal ,Internationality ,Cross-sectional study ,030232 urology & nephrology ,Chronic kidney disease (CKD) ,Logistic regression ,Kidney Function Tests ,Hypertension, Renal/epidemiology ,Global Health ,Severity of Illness Index ,meta-analysi ,hyperparathyroidism ,serum phosphorus ,0302 clinical medicine ,Creatinine/urine ,Glomerular Filtration Rate/physiology ,staging system ,Albuminuria/epidemiology ,Medicine ,individual-level meta-analysi ,030212 general & internal medicine ,Renal Insufficiency ,Non-U.S. Gov't ,kidney function ,laboratory abnormality ,Chronic/epidemiology ,education.field_of_study ,diabetes ,Research Support, Non-U.S. Gov't ,Middle Aged ,serum bicarbonate ,anemia ,Multicenter Study ,Creatinine ,laboratory test ,Disease Progression ,Female ,medicine.symptom ,glomerular filtration rate (GFR) ,serum phosphoru ,Glomerular Filtration Rate ,medicine.medical_specialty ,hypertension ,hematocrit ,Population ,Renal function ,laboratory tests ,Urinalysis ,Research Support ,Sensitivity and Specificity ,Article ,albuminuria ,N.I.H ,03 medical and health sciences ,All institutes and research themes of the Radboud University Medical Center ,Research Support, N.I.H., Extramural ,Predictive Value of Tests ,Internal medicine ,Severity of illness ,CKD Prognosis Consortium ,CKD stage ,hemoglobin ,individual-level meta-analysis ,meta-analysis ,serum calcium ,serum intact parathyroid hormone ,serum potassium ,Journal Article ,Humans ,Renal/epidemiology ,Renal Insufficiency, Chronic ,education ,Renal Insufficiency, Chronic/epidemiology ,Retrospective Studies ,Aged ,business.industry ,Extramural ,medicine.disease ,Cross-Sectional Studies ,diabete ,Albuminuria ,Renal disorders Radboud Institute for Health Sciences [Radboudumc 11] ,business ,Blood Chemical Analysis ,Kidney disease - Abstract
Rationale & Objective Chronic kidney disease (CKD) is complicated by abnormalities that reflect disruption in filtration, tubular, and endocrine functions of the kidney. Our aim was to explore the relationship of specific laboratory result abnormalities and hypertension with the estimated glomerular filtration rate (eGFR) and albuminuria CKD staging framework. Study Design Cross-sectional individual participant-level analyses in a global consortium. Setting & Study Populations 17 CKD and 38 general population and high-risk cohorts. Selection Criteria for Studies Cohorts in the CKD Prognosis Consortium with data for eGFR and albuminuria, as well as a measurement of hemoglobin, bicarbonate, phosphorus, parathyroid hormone, potassium, or calcium, or hypertension. Data Extraction Data were obtained and analyzed between July 2015 and January 2018. Analytical Approach We modeled the association of eGFR and albuminuria with hemoglobin, bicarbonate, phosphorus, parathyroid hormone, potassium, and calcium values using linear regression and with hypertension and categorical definitions of each abnormality using logistic regression. Results were pooled using random-effects meta-analyses. Results The CKD cohorts (n = 254,666 participants) were 27% women and 10% black, with a mean age of 69 (SD, 12) years. The general population/high-risk cohorts (n = 1,758,334) were 50% women and 2% black, with a mean age of 50 (16) years. There was a strong graded association between lower eGFR and all laboratory result abnormalities (ORs ranging from 3.27 [95% CI, 2.68-3.97] to 8.91 [95% CI, 7.22-10.99] comparing eGFRs of 15 to 29 with eGFRs of 45 to 59 mL/min/1.73 m 2), whereas albuminuria had equivocal or weak associations with abnormalities (ORs ranging from 0.77 [95% CI, 0.60-0.99] to 1.92 [95% CI, 1.65-2.24] comparing urinary albumin-creatinine ratio > 300 vs < 30 mg/g). Limitations Variations in study era, health care delivery system, typical diet, and laboratory assays. Conclusions Lower eGFR was strongly associated with higher odds of multiple laboratory result abnormalities. Knowledge of risk associations might help guide management in the heterogeneous group of patients with CKD. © 2018. This is the authors’ accepted and refereed manuscript to the article. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ "
- Published
- 2018