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1. Efficacy of everolimus in ABO-incompatible kidney transplantation: a retrospective study

Author

Tsujimura K, Ota M, Chinen K, Nagayama K, Oroku M, Nishihira M, Shiohira Y, Iseki K, Ishida H, and Tanabe K

Subjects
Blood Group Incompatibility, Immunosuppression, Kidney Transplantation, Medicine (General), R5-920
Abstract

Kazuma Tsujimura,1 Morihito Ota,1 Kiyoshi Chinen,1 Kiyomitsu Nagayama,2 Masato Oroku,2 Morikuni Nishihira,2 Yoshiki Shiohira,2 Kunitoshi Iseki,3 Hideki Ishida,4 Kazunari Tanabe4 1Department of Surgery, 2Department of Nephrology, 3Clinical Research Support Center, Tomishiro Central Hospital, Okinawa, Japan; 4Department of Urology, Tokyo Women’s Medical University, Tokyo, Japan Background: There are limited reports on the use of everolimus for maintaining immunosuppression in ABO-incompatible (ABOi) kidney transplantation (KT). As everolimus (EVR) is effective for preventing calcineurin inhibitor (CNI) nephrotoxicity without increasing the risk of chronic rejection and viral infection, we aimed to assess the efficacy of EVR in ABOi KT.Patients and methods: We retrospectively studied 22 patients who underwent KT and received EVR. Patients in the ABOi KT group (n=7) were compared with those in the ABO-compatible kidney transplantation group (ABOc KT; n=15). We recorded the frequency of CNI nephrotoxicity, chronic rejection, and viral infection in the 2 groups.Results: CNI nephrotoxicity, chronic rejection, and viral infection occurred in the ABOi KT and ANOc KT groups at rates of 28.3% (2/7 patients) and 13.3% (2/15 patients) (P=0.388), 28.3% (2/7 patients) and 26.7% (4/15 patients) (P=0.926), and 14.3% (1/7 patients) and 26.7% (4/15 patients) (P=0.517), respectively.Conclusion: Administration of EVR is effective in preventing CNI nephrotoxicity after KT. The rate of CNI nephrotoxicity was lower in the ABOc KT group than in the ABOi KT group. The rate of chronic rejection and viral infection was comparable between the groups. This study was conducted in a small cohort of patients. Hence, further evaluation with large sample sizes is necessary in the future to confirm the outcomes. Keywords: blood group incompatibility, immunosuppression, kidney transplantation

Published
2017

3. Relative risks of chronic kidney disease for mortality and end-stage renal disease across races are similar

Author

Peralta, Carmen, Wen, C, Matsushita, K, Coresh, J, Iseki, K, Islam, MS, Katz, R, McClellan, WM, Wang, H, and De, D

Abstract

Some suggest race-specific cutpoints for kidney measures to define and stage chronic kidney disease (CKD), but evidence for race-specific clinical impact is limited. To address this issue, we compared hazard ratios of estimated glomerular filtration rates

Published
2014

6. The Kidney Failure Risk Equation: Evaluation of Novel Input Variables including eGFR Estimated Using the CKD-EPI 2021 Equation in 59 Cohorts

Author

Grams, M.E., Brunskill, N.J., Ballew, Shoshana H., Sang, Y., Coresh, J., Matsushita, K., Surapaneni, A., Bell, S., Carrero, J.J., Chodick, G., Evans, M., Heerspink, H.J., Inker, L.A., Iseki, K., Kalra, P.A., Kirchner, H.L., Lee, B.J., Levin, A., Major, R.W., Medcalf, J., Nadkarni, G.N., Naimark, D.M.J., Ricardo, A.C., Sawhney, S., Sood, M.M., Staplin, N., Stempniewicz, N., Stengel, B., Sumida, K., Traynor, J.P., Brand, J. van den, Wen, C.P., Woodward, M., Yang, J.W., Wang, A.Y., Tangri, N., Grams, M.E., Brunskill, N.J., Ballew, Shoshana H., Sang, Y., Coresh, J., Matsushita, K., Surapaneni, A., Bell, S., Carrero, J.J., Chodick, G., Evans, M., Heerspink, H.J., Inker, L.A., Iseki, K., Kalra, P.A., Kirchner, H.L., Lee, B.J., Levin, A., Major, R.W., Medcalf, J., Nadkarni, G.N., Naimark, D.M.J., Ricardo, A.C., Sawhney, S., Sood, M.M., Staplin, N., Stempniewicz, N., Stengel, B., Sumida, K., Traynor, J.P., Brand, J. van den, Wen, C.P., Woodward, M., Yang, J.W., Wang, A.Y., and Tangri, N.

Abstract

Item does not contain fulltext, SIGNIFICANCE STATEMENT: The kidney failure risk equation (KFRE) uses age, sex, GFR, and urine albumin-to-creatinine ratio (ACR) to predict 2- and 5-year risk of kidney failure in populations with eGFR <60 ml/min per 1.73 m 2 . However, the CKD-EPI 2021 creatinine equation for eGFR is now recommended for use but has not been fully tested in the context of KFRE. In 59 cohorts comprising 312,424 patients with CKD, the authors assessed the predictive performance and calibration associated with the use of the CKD-EPI 2021 equation and whether additional variables and accounting for the competing risk of death improves the KFRE's performance. The KFRE generally performed well using the CKD-EPI 2021 eGFR in populations with eGFR <45 ml/min per 1.73 m 2 and was not improved by adding the 2-year prior eGFR slope and cardiovascular comorbidities. BACKGROUND: The kidney failure risk equation (KFRE) uses age, sex, GFR, and urine albumin-to-creatinine ratio (ACR) to predict kidney failure risk in people with GFR <60 ml/min per 1.73 m 2 . METHODS: Using 59 cohorts with 312,424 patients with CKD, we tested several modifications to the KFRE for their potential to improve the KFRE: using the CKD-EPI 2021 creatinine equation for eGFR, substituting 1-year average ACR for single-measure ACR and 1-year average eGFR in participants with high eGFR variability, and adding 2-year prior eGFR slope and cardiovascular comorbidities. We also assessed calibration of the KFRE in subgroups of eGFR and age before and after accounting for the competing risk of death. RESULTS: The KFRE remained accurate and well calibrated overall using the CKD-EPI 2021 eGFR equation. The other modifications did not improve KFRE performance. In subgroups of eGFR 45-59 ml/min per 1.73 m 2 and in older adults using the 5-year time horizon, the KFRE demonstrated systematic underprediction and overprediction, respectively. We developed and tested a new model with a spline term in eGFR and incorporating the competing risk

Published
2023

7. Estimated Glomerular Filtration Rate, Albuminuria, and Adverse Outcomes: An Individual-Participant Data Meta-Analysis

Author

Grams, M.E., Coresh, J., Matsushita, K., Ballew, S.H., Sang, Y., Surapaneni, A., Pinho, N. Alencar de, Anderson, A., Appel, L.J., Ärnlöv, J., Azizi, F., Bansal, N., Bell, S., Bilo, H.J.G., Brunskill, N.J., Carrero, J.J., Chadban, S., Chalmers, J., Chen, J., Ciemins, E., Cirillo, M., Ebert, N., Evans, M., Ferreiro, Alejandro, Fu, E.L., Fukagawa, M., Green, J.A., Gutierrez, O.M., Herrington, W.G., Hwang, S.J., Inker, L.A., Iseki, K., Jafar, T., Jassal, S.K., Jha, V., Kadota, A., Katz, R., Köttgen, A., Konta, T., Kronenberg, F., Lee, B.J., Lees, J., Levin, A., Looker, H.C., Major, R., Cohen, C. Melzer, Mieno, M., Miyazaki, M., Moranne, O., Muraki, I., Naimark, D., Nitsch, D., Oh, W., Pena, M., Purnell, T.S., Sabanayagam, C., Satoh, M., Sawhney, S., Schaeffner, E., Schöttker, B., Shen, J.I., Shlipak, M.G., Sinha, S., Stengel, B., Sumida, K., Tonelli, M., Valdivielso, J.M., Zuilen, A.D. van, Visseren, F.L.J., Wang, A.Y., Wen, C.P., Wheeler, D.C., Yatsuya, H., Yamagata, K., Yang, J.W., Young, A., Zhang, Haitao, Zhang, L., Wetzels, J.F.M., Levey, A.S., Gansevoort, R.T., Grams, M.E., Coresh, J., Matsushita, K., Ballew, S.H., Sang, Y., Surapaneni, A., Pinho, N. Alencar de, Anderson, A., Appel, L.J., Ärnlöv, J., Azizi, F., Bansal, N., Bell, S., Bilo, H.J.G., Brunskill, N.J., Carrero, J.J., Chadban, S., Chalmers, J., Chen, J., Ciemins, E., Cirillo, M., Ebert, N., Evans, M., Ferreiro, Alejandro, Fu, E.L., Fukagawa, M., Green, J.A., Gutierrez, O.M., Herrington, W.G., Hwang, S.J., Inker, L.A., Iseki, K., Jafar, T., Jassal, S.K., Jha, V., Kadota, A., Katz, R., Köttgen, A., Konta, T., Kronenberg, F., Lee, B.J., Lees, J., Levin, A., Looker, H.C., Major, R., Cohen, C. Melzer, Mieno, M., Miyazaki, M., Moranne, O., Muraki, I., Naimark, D., Nitsch, D., Oh, W., Pena, M., Purnell, T.S., Sabanayagam, C., Satoh, M., Sawhney, S., Schaeffner, E., Schöttker, B., Shen, J.I., Shlipak, M.G., Sinha, S., Stengel, B., Sumida, K., Tonelli, M., Valdivielso, J.M., Zuilen, A.D. van, Visseren, F.L.J., Wang, A.Y., Wen, C.P., Wheeler, D.C., Yatsuya, H., Yamagata, K., Yang, J.W., Young, A., Zhang, Haitao, Zhang, L., Wetzels, J.F.M., Levey, A.S., and Gansevoort, R.T.

Abstract

Item does not contain fulltext, IMPORTANCE: Chronic kidney disease (low estimated glomerular filtration rate [eGFR] or albuminuria) affects approximately 14% of adults in the US. OBJECTIVE: To evaluate associations of lower eGFR based on creatinine alone, lower eGFR based on creatinine combined with cystatin C, and more severe albuminuria with adverse kidney outcomes, cardiovascular outcomes, and other health outcomes. DESIGN, SETTING, AND PARTICIPANTS: Individual-participant data meta-analysis of 27 503 140 individuals from 114 global cohorts (eGFR based on creatinine alone) and 720 736 individuals from 20 cohorts (eGFR based on creatinine and cystatin C) and 9 067 753 individuals from 114 cohorts (albuminuria) from 1980 to 2021. EXPOSURES: The Chronic Kidney Disease Epidemiology Collaboration 2021 equations for eGFR based on creatinine alone and eGFR based on creatinine and cystatin C; and albuminuria estimated as urine albumin to creatinine ratio (UACR). MAIN OUTCOMES AND MEASURES: The risk of kidney failure requiring replacement therapy, all-cause mortality, cardiovascular mortality, acute kidney injury, any hospitalization, coronary heart disease, stroke, heart failure, atrial fibrillation, and peripheral artery disease. The analyses were performed within each cohort and summarized with random-effects meta-analyses. RESULTS: Within the population using eGFR based on creatinine alone (mean age, 54 years [SD, 17 years]; 51% were women; mean follow-up time, 4.8 years [SD, 3.3 years]), the mean eGFR was 90 mL/min/1.73 m2 (SD, 22 mL/min/1.73 m2) and the median UACR was 11 mg/g (IQR, 8-16 mg/g). Within the population using eGFR based on creatinine and cystatin C (mean age, 59 years [SD, 12 years]; 53% were women; mean follow-up time, 10.8 years [SD, 4.1 years]), the mean eGFR was 88 mL/min/1.73 m2 (SD, 22 mL/min/1.73 m2) and the median UACR was 9 mg/g (IQR, 6-18 mg/g). Lower eGFR (whether based on creatinine alone or based on creatinine and cystatin C) and higher UACR were each significantly associ

Published
2023

13. Blood pressure, hypertension and the risk of aortic dissection incidence and mortality: results from the Japan-specific health checkups study, the UK biobank study and a metaanalysis of cohort studies

Author

Hibino, M, Otaki, Y, Kobeissi, E, Pan, H, Hibino, H, Taddese, H, Majeed, Z, Verma, S, Konta, T, Yamagata, K, Fujimoto, S, Tsuruya, K, Narita, I, Kasahara, M, Shibagaki, Y, Iseki, K, Moriyama, T, Kondo, M, Asahi, K, Watanabe, T, Watanabe, M, and Aune, D

Subjects
hypertension, blood pressure, 1103 Clinical Sciences, aneurysm, dissecting, United Kingdom, 1117 Public Health and Health Services, meta-analysis, cohort studies, Japan, Cardiovascular System & Hematology, Risk Factors, Humans, 1102 Cardiorespiratory Medicine and Haematology, dose-response relationship, drug, Biological Specimen Banks
Abstract

Background: Hypertension or elevated blood pressure (BP) is an important risk factor for aortic dissection (AD); however, few prospective studies concerning this topic have been published. We investigated the association between hypertension/elevated BP and AD in two cohorts and conducted a meta-analysis of published prospective studies, including these two studies. Methods: We analyzed data from the Japan Specific Health Checkups (J-SHC) Study and UK Biobank, which prospectively followed 534,378 and 502,424 participants, respectively. Multivariable Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the association of hypertension/elevated BP with AD incidence in the UK Biobank and AD mortality in the J-SHC Study. In the meta-analysis, summary relative risks (RRs) were calculated using random effects models. A potential nonlinear dose-response relationship between BP and AD was tested using fractional polynomial models, and the best-fitting second-order fractional polynomial regression model was determined. Results: In the J-SHC Study and UK Biobank, there were 84 and 182 ADs during 4- and 9-year follow-up, and the adjusted HRs of AD were 3.57 (95% CI, 2.17-6.11) and 2.68 (95% CI: 1.78-4.04) in hypertensive individuals, 1.33 (95% CI: 1.05-1.68) and 1.27 (95% CI: 1.11-1.48) per 20-mmHg increase in systolic BP (SBP), and 1.67 (95% CI: 1.40-2.00) and 1.66 (95% CI: 1.46-1.89) per 10-mmHg increase in diastolic BP (DBP), respectively. In the meta-analysis, the summary RRs were 3.07 (95% CI 2.15-4.38, I2=76.7%, n=7 studies, 2,818 ADs, 4,563,501 participants) for hypertension and 1.39 (95% CI: 1.16-1.66, I2=47.7%, n=3) and 1.79 (95% CI: 1.51-2.12, I2=57.0%, n=3) per 20-mmHg increase in SBP and per 10-mmHg in DBP, respectively. The AD risk showed a strong, positive dose-response relationship with SBP and even more so with DBP. The risk of AD in the nonlinear dose-response analysis was significant at SBP >132 mmHg and DBP >75 mmHg. Conclusions: Hypertension and elevated SBP and DBP are associated with a high risk of AD. The risk of AD was positively dose-dependent, even within the normal BP range. These findings provide further evidence for the optimization of BP to prevent AD.

Published
2021

14. Blood pressure in chronic kidney disease: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

Author

Cheung, A, Chang, T, Cushman, W, Furth, S, Ix, J, Pecoits-Filho, R, Perkovic, V, Sarnak, M, Tobe, S, Tomson, C, Cheung, M, Wheeler, D, Winkelmayer, W, Mann, J, Bakris, G, Damasceno, A, Dwyer, J, Fried, L, Haynes, R, Hirawa, N, Holdaas, H, Ibrahim, H, Ingelfinger, J, Iseki, K, Khwaja, A, Kimmel, P, Kovesdy, C, Ku, E, Lerma, E, Luft, F, Lv, J, Mcfadden, C, Muntner, P, Myers, M, Navaneethan, S, Parati, G, Peixoto, A, Prasad, R, Rahman, M, Rocco, M, Rodrigues, C, Roger, S, Stergiou, G, Tomlinson, L, Tonelli, M, Toto, R, Tsukamoto, Y, Walker, R, Wang, A, Wang, J, Warady, B, Whelton, P, Williamson, J, Cheung A. K., Chang T. I., Cushman W. C., Furth S. L., Ix J. H., Pecoits-Filho R., Perkovic V., Sarnak M. J., Tobe S. W., Tomson C. R. V., Cheung M., Wheeler D. C., Winkelmayer W. C., Mann J. F. E., Bakris G. L., Damasceno A., Dwyer J. P., Fried L. F., Haynes R., Hirawa N., Holdaas H., Ibrahim H. N., Ingelfinger J. R., Iseki K., Khwaja A., Kimmel P. L., Kovesdy C. P., Ku E., Lerma E. V., Luft F. C., Lv J., McFadden C. B., Muntner P., Myers M. G., Navaneethan S. D., Parati G., Peixoto A. J., Prasad R., Rahman M., Rocco M. V., Rodrigues C. I. S., Roger S. D., Stergiou G. S., Tomlinson L. A., Tonelli M., Toto R. D., Tsukamoto Y., Walker R., Wang A. Y. -M., Wang J., Warady B. A., Whelton P. K., Williamson J. D., Cheung, A, Chang, T, Cushman, W, Furth, S, Ix, J, Pecoits-Filho, R, Perkovic, V, Sarnak, M, Tobe, S, Tomson, C, Cheung, M, Wheeler, D, Winkelmayer, W, Mann, J, Bakris, G, Damasceno, A, Dwyer, J, Fried, L, Haynes, R, Hirawa, N, Holdaas, H, Ibrahim, H, Ingelfinger, J, Iseki, K, Khwaja, A, Kimmel, P, Kovesdy, C, Ku, E, Lerma, E, Luft, F, Lv, J, Mcfadden, C, Muntner, P, Myers, M, Navaneethan, S, Parati, G, Peixoto, A, Prasad, R, Rahman, M, Rocco, M, Rodrigues, C, Roger, S, Stergiou, G, Tomlinson, L, Tonelli, M, Toto, R, Tsukamoto, Y, Walker, R, Wang, A, Wang, J, Warady, B, Whelton, P, Williamson, J, Cheung A. K., Chang T. I., Cushman W. C., Furth S. L., Ix J. H., Pecoits-Filho R., Perkovic V., Sarnak M. J., Tobe S. W., Tomson C. R. V., Cheung M., Wheeler D. C., Winkelmayer W. C., Mann J. F. E., Bakris G. L., Damasceno A., Dwyer J. P., Fried L. F., Haynes R., Hirawa N., Holdaas H., Ibrahim H. N., Ingelfinger J. R., Iseki K., Khwaja A., Kimmel P. L., Kovesdy C. P., Ku E., Lerma E. V., Luft F. C., Lv J., McFadden C. B., Muntner P., Myers M. G., Navaneethan S. D., Parati G., Peixoto A. J., Prasad R., Rahman M., Rocco M. V., Rodrigues C. I. S., Roger S. D., Stergiou G. S., Tomlinson L. A., Tonelli M., Toto R. D., Tsukamoto Y., Walker R., Wang A. Y. -M., Wang J., Warady B. A., Whelton P. K., and Williamson J. D.

Abstract

In September 2017, KDIGO (Kidney Disease: Improving Global Outcomes) convened a Controversies Conference titled Blood Pressure in Chronic Kidney Disease (CKD). The purpose of the meeting was to consider which recommendations from the 2012 KDIGO Clinical Practice Guideline for the Management of Blood Pressure in CKD should be reevaluated based on new evidence from clinical trials. Participants included a multidisciplinary panel of clinical and scientific experts. Discussions focused on the optimal means for measuring blood pressure (BP) as well as managing BP in CKD patients. Consistent with the 2012 Guideline, the conference did not address BP management in patients on maintenance dialysis.

Published
2019

16. Adiposity and risk of decline in glomerular filtration rate : Meta-analysis of individual participant data in a global consortium

Author

Chang AR, Grams ME, Ballew SH, Bilo H, Correa A, Evans M, Gutierrez OM, Hosseinpanah F, Iseki K, Kenealy T, Klein B, Kronenberg F, Lee BJ, Li Y, Miura K, Navaneethan SD, Roderick PJ, Valdivielso JM, Visseren FLJ, Zhang L, Gansevoort RT, Hallan SI, Levey AS, Matsushita K, Shalev V, Woodward M, Astor B, Appel L, Greene T, Chen T, Chalmers J, Arima H, Perkovic V, Yatsuya H, Tamakoshi K, Hirakawa Y, Coresh J, Sang Y, Polkinghorne K, Chadban S, Atkins R, Levin A, Djurdjev O, Klein R, Lee K, Liu L, Zhao M, Wang F, Wang J, Tang M, Heine G, Emrich I, Zawada A, Bauer L, Nally J, Schold J, Shlipak M, Sarnak M, Katz R, Hiramoto J, Iso H, Yamagishi K, Umesawa M, Muraki I, Fukagawa M, Maruyama S, Hamano T, Hasegawa T, Fujii N, Jafar T, Hatcher J, Poulter N, Chaturvedi N, Wheeler D, Emberson J, Townend J, Landray M, Brenner H, Schöttker B, Saum KU, Rothenbacher D, Fox C, Hwang SJ, Köttgen A, Schneider MP, Eckardt KU, Green J, Kirchner HL, Ito S, Miyazaki M, Nakayama M, Yamada G, Cirillo M, Romundstad S, Øvrehus M, Langlo KA, Irie F, Sairenchi T, Rebholz CM, Young B, Boulware LE, Ishikawa S, Yano Y, Kotani K, Nakamura T, Jee SH, Kimm H, Mok Y, Chodick G, Wetzels JFM, Blankestijn PJ, van Zuilen AD, Bots M, Inker L, Peralta C, Kollerits B, Ritz E, Nitsch D, Fletcher A, Bottinger E, Nadkarni GN, Ellis SB, Nadukuru R, Fernandez E, Betriu A, Bermudez-Lopez M, Stengel B, Metzger M, Flamant M, Houillier P, Haymann JP, Froissart M, Ueshima H, Okayama A, Tanaka S, Okamura T, Elley CR, Collins JF, Drury PL, Ohkubo T, Asayama K, Metoki H, Kikuya M, Iseki C, Nelson RG, Knowler WC, Bakker SJL, Heerspink HJL, Brunskill N, Major R, Shepherd D, Medcalf J, Jassal SK, Bergstrom J, Ix JH, Barrett-Connor E, Kovesdy C, Kalantar-Zadeh K, Sumida K, Muntner P, Warnock D, Judd S, Panwar B, de Zeeuw D, Brenner B, Sedaghat S, Ikram MA, Hoorn EJ, Dehghan A, Wong TY, Sabanayagam C, Cheng CY, Banu R, Segelmark M, Stendahl M, Schön S, Tangri N, Sud M, Naimark D, Wen CP, Tsao CK, Tsai MK, Chen CH, Konta T, Hirayama A, Ichikawa K, Hadaegh F, Mirbolouk M, Azizi F, Solbu MD, Jenssen TG, Eriksen BO, Eggen AE, Lannfelt L, Larsson A, Ärnlöv J, Landman GWD, van Hateren KJJ, Kleefstra N, Chen J, Kwak L, Surapaneni A., Chang, Ar, Grams, Me, Ballew, Sh, Bilo, H, Correa, A, Evans, M, Gutierrez, Om, Hosseinpanah F, Iseki K, Kenealy, T, Klein, B, Kronenberg, F, Lee, Bj, Li, Y, Miura, K, Navaneethan, Sd, Roderick, Pj, Valdivielso, Jm, Visseren, Flj, Zhang, L, Gansevoort, Rt, Hallan, Si, Levey, A, Matsushita, K, Shalev, V, Woodward, M, Astor, B, Appel, L, Greene, T, Chen, T, Chalmers, J, Arima, H, Perkovic, V, Yatsuya, H, Tamakoshi, K, Hirakawa, Y, Coresh, J, Sang, Y, Polkinghorne, K, Chadban, S, Atkins, R, Levin, A, Djurdjev, O, Klein, R, Lee, K, Liu, L, Zhao, M, Wang, F, Wang, J, Tang, M, Heine, G, Emrich, I, Zawada, A, Bauer, L, Nally, J, Schold, J, Shlipak, M, Sarnak, M, Katz, R, Hiramoto, J, Iso, H, Yamagishi, K, Umesawa, M, Muraki, I, Fukagawa, M, Maruyama, S, Hamano, T, Hasegawa, T, Fujii, N, Jafar, T, Hatcher, J, Poulter, N, Chaturvedi, N, Wheeler, D, Emberson, J, Townend, J, Landray, M, Brenner, H, Schöttker, B, Saum, Ku, Rothenbacher, D, Fox, C, Hwang, Sj, Köttgen, A, Schneider, Mp, Eckardt, Ku, Green, J, Kirchner, Hl, Ito, S, Miyazaki, M, Nakayama, M, Yamada, G, Cirillo, M, Romundstad, S, Øvrehus, M, Langlo, Ka, Irie, F, Sairenchi, T, Rebholz, Cm, Young, B, Boulware, Le, Ishikawa, S, Yano, Y, Kotani, K, Nakamura, T, Jee, Sh, Kimm, H, Mok, Y, Chodick, G, Wetzels, Jfm, Blankestijn, Pj, van Zuilen, Ad, Bots, M, Inker, L, Peralta, C, Kollerits, B, Ritz, E, Nitsch, D, Fletcher, A, Bottinger, E, Nadkarni, Gn, Ellis, Sb, Nadukuru, R, Fernandez, E, Betriu, A, Bermudez-Lopez, M, Stengel, B, Metzger, M, Flamant, M, Houillier, P, Haymann, Jp, Froissart, M, Ueshima, H, Okayama, A, Tanaka, S, Okamura, T, Elley, Cr, Collins, Jf, Drury, Pl, Ohkubo, T, Asayama, K, Metoki, H, Kikuya, M, Iseki, C, Nelson, Rg, Knowler, Wc, Bakker, Sjl, Heerspink, Hjl, Brunskill, N, Major, R, Shepherd, D, Medcalf, J, Jassal, Sk, Bergstrom, J, Ix, Jh, Barrett-Connor, E, Kovesdy, C, Kalantar-Zadeh, K, Sumida, K, Muntner, P, Warnock, D, Judd, S, Panwar, B, de Zeeuw, D, Brenner, B, Sedaghat, S, Ikram, Ma, Hoorn, Ej, Dehghan, A, Wong, Ty, Sabanayagam, C, Cheng, Cy, Banu, R, Segelmark, M, Stendahl, M, Schön, S, Tangri, N, Sud, M, Naimark, D, Wen, Cp, Tsao, Ck, Tsai, Mk, Chen, Ch, Konta, T, Hirayama, A, Ichikawa, K, Hadaegh, F, Mirbolouk, M, Azizi, F, Solbu, Md, Jenssen, Tg, Eriksen, Bo, Eggen, Ae, Lannfelt, L, Larsson, A, Ärnlöv, J, Landman, Gwd, van Hateren, Kjj, Kleefstra, N, Chen, J, Kwak, L, Surapaneni, A., Lifestyle Medicine (LM), Cardiovascular Centre (CVC), Groningen Kidney Center (GKC), Groningen Institute for Organ Transplantation (GIOT), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Asayama, Kei, and Sedaghat, SeyyedMah

Subjects
CHRONIC KIDNEY-DISEASE, Male, 030232 urology & nephrology, 030204 cardiovascular system & hematology, OBESITY PARADOX, Body Mass Index, BMI, eGFR, CKD-PC, Cohort Studies, 0302 clinical medicine, Risk Factors, Urologi och njurmedicin, Medicine, ALL-CAUSE MORTALITY, Adiposity, 2. Zero hunger, Aged, 80 and over, Medicine(all), education.field_of_study, Hazard ratio, ASSOCIATION, General Medicine, Middle Aged, 3. Good health, Cohort, Female, Waist Circumference, Life Sciences & Biomedicine, WAIST CIRCUMFERENCE, Obesity paradox, Glomerular Filtration Rate, Adult, Waist, Population, Renal function, 03 medical and health sciences, Medicine, General & Internal, General & Internal Medicine, CKD, Urology and Nephrology, Humans, Mortality, education, Aged, Science & Technology, business.industry, Research, medicine.disease, Body Height, BODY-MASS INDEX, Kidney Failure, Chronic, WEIGHT, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11], business, Body mass index, Demography, Kidney disease
Abstract

ObjectiveTo evaluate the associations between adiposity measures (body mass index, waist circumference, and waist-to-height ratio) with decline in glomerular filtration rate (GFR) and with all cause mortality.DesignIndividual participant data meta-analysis.SettingCohorts from 40 countries with data collected between 1970 and 2017.ParticipantsAdults in 39 general population cohorts (n=5 459 014), of which 21 (n=594 496) had data on waist circumference; six cohorts with high cardiovascular risk (n=84 417); and 18 cohorts with chronic kidney disease (n=91 607).Main outcome measuresGFR decline (estimated GFR decline ≥40%, initiation of kidney replacement therapy or estimated GFR 2) and all cause mortality.ResultsOver a mean follow-up of eight years, 246 607 (5.6%) individuals in the general population cohorts had GFR decline (18 118 (0.4%) end stage kidney disease events) and 782 329 (14.7%) died. Adjusting for age, sex, race, and current smoking, the hazard ratios for GFR decline comparing body mass indices 30, 35, and 40 with body mass index 25 were 1.18 (95% confidence interval 1.09 to 1.27), 1.69 (1.51 to 1.89), and 2.02 (1.80 to 2.27), respectively. Results were similar in all subgroups of estimated GFR. Associations weakened after adjustment for additional comorbidities, with respective hazard ratios of 1.03 (0.95 to 1.11), 1.28 (1.14 to 1.44), and 1.46 (1.28 to 1.67). The association between body mass index and death was J shaped, with the lowest risk at body mass index of 25. In the cohorts with high cardiovascular risk and chronic kidney disease (mean follow-up of six and four years, respectively), risk associations between higher body mass index and GFR decline were weaker than in the general population, and the association between body mass index and death was also J shaped, with the lowest risk between body mass index 25 and 30. In all cohort types, associations between higher waist circumference and higher waist-to-height ratio with GFR decline were similar to that of body mass index; however, increased risk of death was not associated with lower waist circumference or waist-to-height ratio, as was seen with body mass index.ConclusionsElevated body mass index, waist circumference, and waist-to-height ratio are independent risk factors for GFR decline and death in individuals who have normal or reduced levels of estimated GFR.

Published
2019

17. KDIGO Controversies Conference on onco-nephrology: kidney disease in hematological malignancies and the burden of cancer after kidney transplantation

Author

Małyszko, J. Bamias, A. Danesh, F.R. Dębska-Ślizień, A. Gallieni, M. Gertz, M.A. Kielstein, J.T. Tesarova, P. Wong, G. Cheung, M. Wheeler, D.C. Winkelmayer, W.C. Porta, C. Abu-Alfa, A.K. Amer, H. Beutel, G. Chapman, J. Chen, X. Chudek, J. Cosmai, L. Danesi, R. De Stefano, F. Iseki, K. Jaimes, E.A. Jhaveri, K.D. Jurczyszyn, A. Kazancioğlu, R. Kitchlu, A. Kollmannsberger, C. Lahoti, A. Li, Y. Macía, M. Matsubara, T. Mitropoulos, D. Noiri, E. Perazella, M.A. Ronco, P. Rosner, M.H. Soler Romeo, M.J. Sprangers, B. Stadler, W.M. Stevens, P.E. Tesař, V. Torres da Costa e Silva, V. Vesole, D.H. Vijayan, A. Viklický, O. Workeneh, B.T. Yanagita, M. Zakharova, E. Conference Participants

Abstract

The bidirectional relationship between cancer and chronic kidney disease (CKD) is complex. Patients with cancer, particularly those with hematological malignancies such as multiple myeloma and lymphoma, are at increased risk of developing acute kidney injury and CKD. On the other hand, emerging evidence from large observational registry analyses have consistently shown that cancer risk is increased by at least 2- to 3-fold in kidney transplant recipients, and the observed increased risk occurs not only in those who have received kidney transplants but also in those on dialysis and with mild- to moderate-stage CKD. The interactions between cancer and CKD have raised major therapeutic and clinical challenges in the management of these patients. Given the magnitude of the problem and uncertainties, and current controversies within the existing evidence, Kidney Disease: Improving Global Outcomes (KDIGO) assembled a global panel of multidisciplinary clinical and scientific expertise for a controversies conference on onco-nephrology to identify key management issues in nephrology relevant to patients with malignancy. This report covers the discussed controversies in kidney disease in hematological malignancies, as well as cancer after kidney transplantation. An overview of future research priorities is also discussed. © 2020 Kidney Disease: Improving Global Outcomes (KDIGO)

Published
2020

18. KDIGO Controversies Conference on onco-nephrology: understanding kidney impairment and solid-organ malignancies, and managing kidney cancer

Author

Porta, C. Bamias, A. Danesh, F.R. Dębska-Ślizień, A. Gallieni, M. Gertz, M.A. Kielstein, J.T. Tesarova, P. Wong, G. Cheung, M. Wheeler, D.C. Winkelmayer, W.C. Małyszko, J. Abu-Alfa, A.K. Amer, H. Beutel, G. Chapman, J. Chen, X. Chudek, J. Cosmai, L. Danesi, R. De Stefano, F. Iseki, K. Jaimes, E.A. Jhaveri, K.D. Jurczyszyn, A. Kazancioğlu, R. Kitchlu, A. Kollmannsberger, C. Lahoti, A. Li, Y. Macía, M. Matsubara, T. Mitropoulos, D. Noiri, E. Perazella, M.A. Ronco, P. Rosner, M.H. Soler Romeo, M.J. Sprangers, B. Stadler, W.M. Stevens, P.E. ladimír Tesař Torres da Costa e Silva, V. Vesole, D.H. Vijayan, A. Viklický, O. Workeneh, B.T. Yanagita, M. Zakharova, E.

Abstract

The association between kidney disease and cancer is multifaceted and complex. Persons with chronic kidney disease (CKD) have an increased incidence of cancer, and both cancer and cancer treatments can cause impaired kidney function. Renal issues in the setting of malignancy can worsen patient outcomes and diminish the adequacy of anticancer treatments. In addition, the oncology treatment landscape is changing rapidly, and data on tolerability of novel therapies in patients with CKD are often lacking. Caring for oncology patients has become more specialized and interdisciplinary, currently requiring collaboration among specialists in nephrology, medical oncology, critical care, clinical pharmacology/pharmacy, and palliative care, in addition to surgeons and urologists. To identify key management issues in nephrology relevant to patients with malignancy, KDIGO (Kidney Disease: Improving Global Outcomes) assembled a global panel of multidisciplinary clinical and scientific expertise for a controversies conference on onco-nephrology in December 2018. This report covers issues related to kidney impairment and solid organ malignancies as well as management and treatment of kidney cancer. Knowledge gaps, areas of controversy, and research priorities are described. © 2020 Kidney Disease:Improving Global Outcomes (KDIGO)

Published
2020

19. Blood pressure and volume management in dialysis: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference.

Author

Wilkie M., Madero M., Sarafidis P.A., Unruh M.L., Wang A.Y.-M., Weiner D.E., Cheung M., Jadoul M., Winkelmayer W.C., Adragao T., Anumudu S.J., Chan C.T., Cheung A.K., Costanzo M.R., Dasgupta I., Davenport A., Davies S.J., Dekker M.J.E., Dember L.M., Gallego D., Gomez R., Hawley C.M., Hecking M., Iseki K., Jha V., Kooman J.P., Kovesdy C.P., Lacson E., Liew A., Lok C.E., McIntyre C.W., Mehrotra R., Miskulin D.C., Movilli E., Paglialonga F., Pecoits-Filho R., Perl J., Pollock C.A., Riella M.C., Rossignol P., Shroff R., Sola L., Sondergaard H., Tang S.C.W., Tong A., Tsukamoto Y., Watnick S., Weir M.R., Wetmore J.B., Wilkie C., Lindley E., Polkinghorne K.R., Flythe J.E., Chang T.I., Gallagher M.P., Wilkie M., Madero M., Sarafidis P.A., Unruh M.L., Wang A.Y.-M., Weiner D.E., Cheung M., Jadoul M., Winkelmayer W.C., Adragao T., Anumudu S.J., Chan C.T., Cheung A.K., Costanzo M.R., Dasgupta I., Davenport A., Davies S.J., Dekker M.J.E., Dember L.M., Gallego D., Gomez R., Hawley C.M., Hecking M., Iseki K., Jha V., Kooman J.P., Kovesdy C.P., Lacson E., Liew A., Lok C.E., McIntyre C.W., Mehrotra R., Miskulin D.C., Movilli E., Paglialonga F., Pecoits-Filho R., Perl J., Pollock C.A., Riella M.C., Rossignol P., Shroff R., Sola L., Sondergaard H., Tang S.C.W., Tong A., Tsukamoto Y., Watnick S., Weir M.R., Wetmore J.B., Wilkie C., Lindley E., Polkinghorne K.R., Flythe J.E., Chang T.I., and Gallagher M.P.

Abstract

Blood pressure (BP) and volume control are critical components of dialysis care and have substantial impacts on patient symptoms, quality of life, and cardiovascular complications. Yet, developing consensus best practices for BP and volume control have been challenging, given the absence of objective measures of extracellular volume status and the lack of high-quality evidence for many therapeutic interventions. In February of 2019, Kidney Disease: Improving Global Outcomes (KDIGO) held a Controversies Conference titled Blood Pressure and Volume Management in Dialysis to assess the current state of knowledge related to BP and volume management and identify opportunities to improve clinical and patient-reported outcomes among individuals receiving maintenance dialysis. Four major topics were addressed: BP measurement, BP targets, and pharmacologic management of suboptimal BP; dialysis prescriptions as they relate to BP and volume; extracellular volume assessment and management with a focus on technology-based solutions; and volume-related patient symptoms and experiences. The overarching theme resulting from presentations and discussions was that managing BP and volume in dialysis involves weighing multiple clinical factors and risk considerations as well as patient lifestyle and preferences, all within a narrow therapeutic window for avoiding acute or chronic volume-related complications. Striking this challenging balance requires individualizing the dialysis prescription by incorporating comorbid health conditions, treatment hemodynamic patterns, clinical judgment, and patient preferences into decision-making, all within local resource constraints.Copyright © 2020 International Society of Nephrology

Published
2020

25. The Effect of Lifestyle on the Mortality Associated with Respiratory Diseases in the General Population

Author

Murano, H., primary, Inoue, S., additional, Watanabe, M., additional, Konta, T., additional, Fujimoto, S., additional, Iseki, K., additional, Moriyama, T., additional, Shibagaki, Y., additional, Kasahara, M., additional, Narita, I., additional, Yamagata, K., additional, Tsuruya, K., additional, Kondo, M., additional, Asahi, K., additional, and Watanabe, T., additional

Published
2020
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26. SUN-107 THE PREVALENCE OF CHRONIC KIDNEY DISEASE IN ASIA – A SYSTEMATIC REVIEW AND ANALYSIS

Author

Liyanage, T., primary, Toyama, T., additional, Ninomiya, T., additional, Perkovic, V., additional, Woodward, M., additional, Fukagawa, M., additional, Matsushita, K., additional, Praditpornsilpa, K., additional, Seong, H.L., additional, Iseki, K., additional, Lin, M.Y., additional, Stirnadel-Farrant, H.A., additional, Jha, V., additional, and Jun, M., additional

Published
2020
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27. SUN-225 Significant association between posterior mitral annular calcification and the mortality in maintenance hemodialysis patients

Author

MINAKATA, T., primary, Ohya, M., additional, Kusube, M., additional, Matsumoto, N., additional, Shinozaki, H., additional, Higashiura, M., additional, Kunimoto, S., additional, Iseki, K., additional, Tanaka, Y., additional, Yano, T., additional, Yamamoto, S., additional, Nakashima, Y., additional, Mima, T., additional, Negi, S., additional, and Shigematsu, T., additional

Published
2020
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35. Adiposity and risk of decline in glomerular filtration rate: meta-analysis of individual participant data in a global consortium

Author

Chang, A.R., Grams, M.E., Ballew, Shoshana H., Bilo, H., Correa, A., Evans, M., Gutierrez, O.M., Hosseinpanah, F., Iseki, K., Kenealy, T., Klein, B., Kronenberg, F., Lee, B.J., Li, Y., Miura, K., Navaneethan, S.D., Roderick, P.J., Valdivielso, J.M., Visseren, F.L., Zhang, L., Gansevoort, R.T., Hallan, S.I., Levey, A.S., Matsushita, K., Wetzels, J.F.M., Shalev, V., Woodward, M., Chang, A.R., Grams, M.E., Ballew, Shoshana H., Bilo, H., Correa, A., Evans, M., Gutierrez, O.M., Hosseinpanah, F., Iseki, K., Kenealy, T., Klein, B., Kronenberg, F., Lee, B.J., Li, Y., Miura, K., Navaneethan, S.D., Roderick, P.J., Valdivielso, J.M., Visseren, F.L., Zhang, L., Gansevoort, R.T., Hallan, S.I., Levey, A.S., Matsushita, K., Wetzels, J.F.M., Shalev, V., and Woodward, M.

Abstract

Contains fulltext : 203008.pdf (publisher's version ) (Open Access), OBJECTIVE: To evaluate the associations between adiposity measures (body mass index, waist circumference, and waist-to-height ratio) with decline in glomerular filtration rate (GFR) and with all cause mortality. DESIGN: Individual participant data meta-analysis. SETTING: Cohorts from 40 countries with data collected between 1970 and 2017. PARTICIPANTS: Adults in 39 general population cohorts (n=5 459 014), of which 21 (n=594 496) had data on waist circumference; six cohorts with high cardiovascular risk (n=84 417); and 18 cohorts with chronic kidney disease (n=91 607). MAIN OUTCOME MEASURES: GFR decline (estimated GFR decline >/=40%, initiation of kidney replacement therapy or estimated GFR <10 mL/min/1.73 m(2)) and all cause mortality. RESULTS: Over a mean follow-up of eight years, 246 607 (5.6%) individuals in the general population cohorts had GFR decline (18 118 (0.4%) end stage kidney disease events) and 782 329 (14.7%) died. Adjusting for age, sex, race, and current smoking, the hazard ratios for GFR decline comparing body mass indices 30, 35, and 40 with body mass index 25 were 1.18 (95% confidence interval 1.09 to 1.27), 1.69 (1.51 to 1.89), and 2.02 (1.80 to 2.27), respectively. Results were similar in all subgroups of estimated GFR. Associations weakened after adjustment for additional comorbidities, with respective hazard ratios of 1.03 (0.95 to 1.11), 1.28 (1.14 to 1.44), and 1.46 (1.28 to 1.67). The association between body mass index and death was J shaped, with the lowest risk at body mass index of 25. In the cohorts with high cardiovascular risk and chronic kidney disease (mean follow-up of six and four years, respectively), risk associations between higher body mass index and GFR decline were weaker than in the general population, and the association between body mass index and death was also J shaped, with the lowest risk between body mass index 25 and 30. In all cohort types, associations between higher waist circumference and higher waist-to-heig

Published
2019

36. Adiposity and risk of decline in glomerular filtration rate: Meta-analysis of individual participant data in a global consortium

Author

Chang, AR, Grams, ME, Ballew, SH, Bilo, H, Correa, A, Evans, M, Gutierrez, OM, Hosseinpanah, F, Iseki, K, Kenealy, T, Klein, B, Kronenberg, F, Lee, BJ, Li, Y, Miura, K, Navaneethan, SD, Roderick, PJ, Valdivielso, JM, Visseren, FLJ, Zhang, L, Gansevoort, RT, Hallan, SI, Levey, AS, Matsushita, K, Shalev, V, Woodward, M, Chang, AR, Grams, ME, Ballew, SH, Bilo, H, Correa, A, Evans, M, Gutierrez, OM, Hosseinpanah, F, Iseki, K, Kenealy, T, Klein, B, Kronenberg, F, Lee, BJ, Li, Y, Miura, K, Navaneethan, SD, Roderick, PJ, Valdivielso, JM, Visseren, FLJ, Zhang, L, Gansevoort, RT, Hallan, SI, Levey, AS, Matsushita, K, Shalev, V, and Woodward, M

Abstract

Objective To evaluate the associations between adiposity measures (body mass index, waist circumference, and waist-to-height ratio) with decline in glomerular filtration rate (GFR) and with all cause mortality. Design Individual participant data meta-analysis. Setting Cohorts from 40 countries with data collected between 1970 and 2017. Participants Adults in 39 general population cohorts (n=5 459 014), of which 21 (n=594 496) had data on waist circumference; six cohorts with high cardiovascular risk (n=84 417); and 18 cohorts with chronic kidney disease (n=91 607). Main outcome measures GFR decline (estimated GFR decline ≥40%, initiation of kidney replacement therapy or estimated GFR <10 mL/min/1.73 m 2) and all cause mortality. Results Over a mean follow-up of eight years, 246 607 (5.6%) individuals in the general population cohorts had GFR decline (18 118 (0.4%) end stage kidney disease events) and 782 329 (14.7%) died. Adjusting for age, sex, race, and current smoking, the hazard ratios for GFR decline comparing body mass indices 30, 35, and 40 with body mass index 25 were 1.18 (95% confidence interval 1.09 to 1.27), 1.69 (1.51 to 1.89), and 2.02 (1.80 to 2.27), respectively. Results were similar in all subgroups of estimated GFR. Associations weakened after adjustment for additional comorbidities, with respective hazard ratios of 1.03 (0.95 to 1.11), 1.28 (1.14 to 1.44), and 1.46 (1.28 to 1.67). The association between body mass index and death was J shaped, with the lowest risk at body mass index of 25. In the cohorts with high cardiovascular risk and chronic kidney disease (mean follow-up of six and four years, respectively), risk associations between higher body mass index and GFR decline were weaker than in the general population, and the association between body mass index and death was also J shaped, with the lowest risk between body mass index 25 and 30. In all cohort types, associations between higher waist circumference and higher waist-to-height ratio

Published
2019

37. Development of Risk Prediction Equations for Incident Chronic Kidney Disease

Author

Nelson, RG, Grams, ME, Ballew, SH, Sang, Y, Azizi, F, Chadban, SJ, Chaker, L, Dunning, SC, Fox, C, Hirakawa, Y, Iseki, K, Ix, J, Jafar, TH, Köttgen, A, Naimark, DMJ, Ohkubo, T, Prescott, GJ, Rebholz, CM, Sabanayagam, C, Sairenchi, T, Schöttker, B, Shibagaki, Y, Tonelli, M, Zhang, L, Gansevoort, RT, Matsushita, K, Woodward, M, Coresh, J, Shalev, V, Nelson, RG, Grams, ME, Ballew, SH, Sang, Y, Azizi, F, Chadban, SJ, Chaker, L, Dunning, SC, Fox, C, Hirakawa, Y, Iseki, K, Ix, J, Jafar, TH, Köttgen, A, Naimark, DMJ, Ohkubo, T, Prescott, GJ, Rebholz, CM, Sabanayagam, C, Sairenchi, T, Schöttker, B, Shibagaki, Y, Tonelli, M, Zhang, L, Gansevoort, RT, Matsushita, K, Woodward, M, Coresh, J, and Shalev, V

Abstract

Importance: Early identification of individuals at elevated risk of developing chronic kidney disease (CKD) could improve clinical care through enhanced surveillance and better management of underlying health conditions. Objective: To develop assessment tools to identify individuals at increased risk of CKD, defined by reduced estimated glomerular filtration rate (eGFR). Design, Setting, and Participants: Individual-level data analysis of 34 multinational cohorts from the CKD Prognosis Consortium including 5222711 individuals from 28 countries. Data were collected from April 1970 through January 2017. A 2-stage analysis was performed, with each study first analyzed individually and summarized overall using a weighted average. Because clinical variables were often differentially available by diabetes status, models were developed separately for participants with diabetes and without diabetes. Discrimination and calibration were also tested in 9 external cohorts (n = 2253540). Exposures: Demographic and clinical factors. Main Outcomes and Measures: Incident eGFR of less than 60 mL/min/1.73 m2. Results: Among 4441084 participants without diabetes (mean age, 54 years, 38% women), 660856 incident cases (14.9%) of reduced eGFR occurred during a mean follow-up of 4.2 years. Of 781627 participants with diabetes (mean age, 62 years, 13% women), 313646 incident cases (40%) occurred during a mean follow-up of 3.9 years. Equations for the 5-year risk of reduced eGFR included age, sex, race/ethnicity, eGFR, history of cardiovascular disease, ever smoker, hypertension, body mass index, and albuminuria concentration. For participants with diabetes, the models also included diabetes medications, hemoglobin A1c, and the interaction between the 2. The risk equations had a median C statistic for the 5-year predicted probability of 0.845 (interquartile range [IQR], 0.789-0.890) in the cohorts without diabetes and 0.801 (IQR, 0.750-0.819) in the cohorts with diabetes. Calibration analys

Published
2019

40. Relative risks of Chronic Kidney Disease for mortality and End Stage Renal Disease across races is similar

Author

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

Subjects
Male, GLOMERULAR-FILTRATION-RATE, Cohort Studies, Risk Factors, eGFR, Odds Ratio, ASSOCIATIONS, African Continental Ancestry Group, Aged, 80 and over, education.field_of_study, end-stage renal disease, Hazard ratio, PROTEINURIA, Urology & Nephrology, Middle Aged, CKD-EPI EQUATION, 3. Good health, PREVALENCE, Nephrology, Cardiovascular Diseases, Creatinine, ethnicity, Female, medicine.symptom, epidemiology and outcomes, Glomerular Filtration Rate, Asian Continental Ancestry Group, Adult, medicine.medical_specialty, Population, European Continental Ancestry Group, Renal function, Black People, ALL-CAUSE, Article, White People, End stage renal disease, Asian People, Internal medicine, medicine, Chronic Kidney Disease Prognosis Consortium, Albuminuria, Humans, Renal Insufficiency, Chronic, education, Aged, business.industry, 1103 Clinical Sciences, Odds ratio, POPULATION COHORTS, medicine.disease, INDIVIDUALS, Endocrinology, Relative risk, COLLABORATIVE METAANALYSIS, mortality risk, Kidney Failure, Chronic, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11], business, HIGHER ALBUMINURIA, chronic kidney disease, Kidney disease
Abstract

Item does not contain fulltext Some suggest race-specific cutpoints for kidney measures to define and stage chronic kidney disease (CKD), but evidence for race-specific clinical impact is limited. To address this issue, we compared hazard ratios of estimated glomerular filtration rates (eGFR) and albuminuria across races using meta-regression in 1.1 million adults (75% Asians, 21% Whites, and 4% Blacks) from 45 cohorts. Results came mainly from 25 general population cohorts comprising 0.9 million individuals. The associations of lower eGFR and higher albuminuria with mortality and end-stage renal disease (ESRD) were largely similar across races. For example, in Asians, Whites, and Blacks, the adjusted hazard ratios (95% confidence interval) for eGFR 45-59 versus 90-104 ml/min per 1.73 m(2) were 1.3 (1.2-1.3), 1.1 (1.0-1.2), and 1.3 (1.1-1.7) for all-cause mortality, 1.6 (1.5-1.7), 1.4 (1.2-1.7), and 1.4 (0.7-2.9) for cardiovascular mortality, and 27.6 (11.1-68.7), 11.2 (6.0-20.9), and 4.1 (2.2-7.5) for ESRD, respectively. The corresponding hazard ratios for urine albumin-to-creatinine ratio 30-299 mg/g or dipstick 1+ versus an albumin-to-creatinine ratio under 10 or dipstick negative were 1.6 (1.4-1.8), 1.7 (1.5-1.9), and 1.8 (1.7-2.1) for all-cause mortality, 1.7 (1.4-2.0), 1.8 (1.5-2.1), and 2.8 (2.2-3.6) for cardiovascular mortality, and 7.4 (2.0-27.6), 4.0 (2.8-5.9), and 5.6 (3.4-9.2) for ESRD, respectively. Thus, the relative mortality or ESRD risks of lower eGFR and higher albuminuria were largely similar among three major races, supporting similar clinical approach to CKD definition and staging, across races.

Published
2014

43. Uric Acid in Chronic Kidney Disease

Author

Treviño-Becerra, A., Iseki, K., Treviño-Becerra, A., and Iseki, K.

Subjects
Uric acid, Hyperuricemia, Chronic renal failure, Diabetic nephropathies, Gout
Abstract

Hyperuricemia is often associated with life-style related disorders such as diabetes mellitus, hypertension, and dyslipidemia, which, in turn, are major causes of CKD. Improved management of hyperuricemia is thus expected to be beneficial for both the general population and CKD patients. This book presents new information on uric acid in tubular transport, early recognition of renal lesions, genetic predisposition, preeclampsia, metabolic syndrome, diabetes, high blood pressure in the young, and the relationship with vitamin D. Moreover, the relationship between AKI and uric acid, as well as the rejection of renal transplants due to hyperuricemia, are discussed. This publication will be of interest to both general practitioners and researchers working in the field of CKD. It provides new insights into renal damage caused by hyperuricemia and into prevention and treatment possibilities.

Published
2018

45. Past Decline Versus Current eGFR and Subsequent Mortality Risk

Author

Naimark DMJ, Grams ME, Matsushita K, Black C, Drion I, Fox CS, Inker LA, Ishani A, Jee SA, Kitamura A, Lea JP, Nally J, Peralta CA, Rothenbacher D, Ryu S, Tonelli M, Yatsuya H, Coresh J, Gansevoort RT, Warnock DG, Woodward M, de Jong PE, the CKD Prognosis Consortium, Wright JTJr, Appel LJ, Greene T, MacMahon S, Chalmers J, Arima H, Yamashita K, Toyoshima H, Tamakoshi K, Hemmelgarn B, James M, Sang Y, Atkins RC, Polkinghorne KR, Chadban S, Shankar A, Klein R, Klein BEK, Lee KE, Levin A, Djurdjev O, Sacks FM, Curhan GC, Zawada AM, Rogacev KS, Seiler S, Heine GH, Navaneethan SD, Schold JD, Shlipak M, Sarnak MJ, Katz R, Imano H, Yamagishi K, Wheeler DC, Emberson J, Townend JN, Landray MJ, Brenner H, Müller H, Schöttker B, Hwang S-J, Meigs JB, Uphadhay A, Green J, Kirchner HL, Perkins R, Chang AR, Fluck N, Prescott GJ, Cirillo M, Hallan S, Aasarød K, Øien CM, Radtke M, Irie F, Iso H, Sairenchi T, Smith DH, Thorp ML, Johnson ES, Lee BJ, Guallar E, Chang SY, Cho J, Shin H, Chodick G, Shalev V, Birnbaum YC, Shainberg B, Wetzels JFM, Blankestijn PJ, van Zuilen AD, Levey AS, Neaton JD, Froissart M, Stengel B, Metzger M, Haymann J-P, Houillier P, Flamant M, Elley CR, Kenealy T, Moyes SA, Collins JF, Drury PL, Ohkubo T, Metoki H, Nakayama M, Imai Y, Iseki K, Nelson RG, Knowler WC, Bakker SJL, LHillege H, Jassal SK, Bergstrom J, Ix JH, Barrett-Connor E, Heerspink HJL, Brenner BE, de Zeeuw D, Kimm H, Mok Y, Tangri N, Wen C-P, Wen S-F, Tsao C-K, Tsai M-K, Ärnlöv J, Lannfelt L, Larsson A, Kovesdy CP, Kalantar-Zadeh K, Bilo HJ, Kleefstra N, Groenier KH, Joosten H, Ballew SH, Naimark, Dmj, Grams, Me, Matsushita, K, Black, C, Drion, I, Fox, C, Inker, La, Ishani, A, Jee, Sa, Kitamura, A, Lea, Jp, Nally, J, Peralta, Ca, Rothenbacher, D, Ryu, S, Tonelli, M, Yatsuya, H, Coresh, J, Gansevoort, Rt, Warnock, Dg, Woodward, M, de Jong, Pe, the CKD Prognosis, Consortium, Wright, Jtjr, Appel, Lj, Greene, T, Macmahon, S, Chalmers, J, Arima, H, Yamashita, K, Toyoshima, H, Tamakoshi, K, Hemmelgarn, B, James, M, Sang, Y, Atkins, Rc, Polkinghorne, Kr, Chadban, S, Shankar, A, Klein, R, Klein, Bek, Lee, Ke, Levin, A, Djurdjev, O, Sacks, Fm, Curhan, Gc, Zawada, Am, Rogacev, K, Seiler, S, Heine, Gh, Navaneethan, Sd, Schold, Jd, Shlipak, M, Sarnak, Mj, Katz, R, Imano, H, Yamagishi, K, Wheeler, Dc, Emberson, J, Townend, Jn, Landray, Mj, Brenner, H, Müller, H, Schöttker, B, Hwang, S-J, Meigs, Jb, Uphadhay, A, Green, J, Kirchner, Hl, Perkins, R, Chang, Ar, Fluck, N, Prescott, Gj, Cirillo, M, Hallan, S, Aasarød, K, Øien, Cm, Radtke, M, Irie, F, Iso, H, Sairenchi, T, Smith, Dh, Thorp, Ml, Johnson, E, Lee, Bj, Guallar, E, Chang, Sy, Cho, J, Shin, H, Chodick, G, Shalev, V, Birnbaum, Yc, Shainberg, B, Wetzels, Jfm, Blankestijn, Pj, van Zuilen, Ad, Levey, A, Neaton, Jd, Froissart, M, Stengel, B, Metzger, M, Haymann, J-P, Houillier, P, Flamant, M, Elley, Cr, Kenealy, T, Moyes, Sa, Collins, Jf, Drury, Pl, Ohkubo, T, Metoki, H, Nakayama, M, Imai, Y, Iseki, K, Nelson, Rg, Knowler, Wc, Bakker, Sjl, Lhillege, H, Jassal, Sk, Bergstrom, J, Ix, Jh, Barrett-Connor, E, Heerspink, Hjl, Brenner, Be, de Zeeuw, D, Kimm, H, Mok, Y, Tangri, N, Wen, C-P, Wen, S-F, Tsao, C-K, Tsai, M-K, Ärnlöv, J, Lannfelt, L, Larsson, A, Kovesdy, Cp, Kalantar-Zadeh, K, Bilo, Hj, Kleefstra, N, Groenier, Kh, Joosten, H, Ballew, Sh, Cardiovascular Centre (CVC), and Groningen Kidney Center (GKC)

Subjects
Gerontology, Male, CHRONIC KIDNEY-DISEASE, medicine.medical_specialty, Time Factors, 030232 urology & nephrology, Renal function, 030204 cardiovascular system & hematology, ALL-CAUSE, GLOMERULAR-FILTRATION-RATE, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, Cause of Death, Epidemiology, Risk of mortality, medicine, EQUATION, Humans, Clinical Epidemiology, Renal Insufficiency, Chronic, Aged, Proportional Hazards Models, business.industry, Hazard ratio, STAGE RENAL-DISEASE, DEATH, General Medicine, Middle Aged, POPULATION COHORTS, Confidence interval, Increased risk, Nephrology, CARDIOVASCULAR-DISEASE, COLLABORATIVE METAANALYSIS, Female, business, HIGHER ALBUMINURIA, All cause mortality, Glomerular Filtration Rate
Abstract

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 slope5 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 versus3 years). We conclude that prior decline or rise in eGFR associates with an increased risk of mortality, independent of current eGFR.

Published
2016

46. Age and Association of Kidney Measures With Mortality and End-stage Renal Disease

Author

Wright, Jt, Appel, Lj, Greene, T, Astor, Bc, Chalmers, J, Macmahon, S, Woodward, M, Arima, H, Yatsuya, H, Yamashita, K, Toyoshima, H, Tamakoshi, K, Tonelli, M, Hemmelgarn, Br, Bello, A, James, Mt, Coresh, J, Matsushita, 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, Lf, Iso, H, Kitamura, A, Ohira, T, Yamagishi, K, Jafar, Th, Islam, M, Hatcher, J, Poulter, N, Chaturvedi, N, Landray, Mj, Emberson, J, 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, Smith, Dh, Weiss, Jw, Johnson, Es, Thorp, Ml, Collins, Aj, Vassalotti, Ja, Li, S, Chen, Sc, Lee, Bj, Wetzels, Jf, Blankestijn, Pj, Van, Zuilen, Sarnak, M, Levey, As, Inker, La, Menon, V, 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, Metoki, H, Nakayama, M, Kikuya, M, Imai, Y, Iseki, K, Nelson, Rg, Knowler, Wc, Gansevoort, Rt, Jong, De, Mahmoodi, Bk, Heerspink, Hj, Jassal, Sk, Barrett Connor, E, Bergstrom, J, Brenner, Be, Zeeuw, De, D, Warnock, Dg, Muntner, P, Judd, S, Mcclellan, W, Jee, Sh, Kimm, H, Jo, J, Mok, Y, Lim, Je, Rossing, P, Parving, Hh, Tangri, N, Naimark, D, Wen, Cp, Wen, Sf, Tsao, Ck, Tsai, Mk, Ärnlöv, J, Lannfelt, L, Larsson, A, Bilo, Hj, Joosten, H, Kleefstra, N, Groenier, Kh, Drion, I, Ballew, Sh, Grams, M, Camarata, L, Hui, X, Seltzer, J, Winegrad, H., Cardiovascular Centre (CVC), Groningen Kidney Center (GKC), Wright JT Jr, Appel, Lj, Greene, T, Astor, Bc, Chalmers, J, Macmahon, S, Woodward, M, Arima, H, Yatsuya, H, Yamashita, K, Toyoshima, H, Tamakoshi, K, Tonelli, M, Hemmelgarn, Br, Bello, A, James, Mt, Coresh, J, Matsushita, 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, Lf, Iso, H, Kitamura, A, Ohira, T, Yamagishi, K, Jafar, Th, Islam, M, Hatcher, J, Poulter, N, Chaturvedi, N, Landray, Mj, Emberson, J, 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, Smith, Dh, Weiss, Jw, Johnson, E, Thorp, Ml, Collins, Aj, Vassalotti, Ja, Li, S, Chen, Sc, Lee, Bj, Wetzels, Jf, Blankestijn, Pj, van Zuilen AD, Sarnak, M, Levey, A, Inker, La, Menon, V, 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, Metoki, H, Nakayama, M, Kikuya, M, Imai, Y, Iseki, K, Nelson, Rg, Knowler, Wc, Gansevoort, Rt, de Jong PE, Mahmoodi, Bk, Heerspink, Hj, Jassal, Sk, Barrett-Connor, E, Bergstrom, J, Brenner, Be, de Zeeuw, D, Warnock, Dg, Muntner, P, Judd, S, Mcclellan, W, Jee, Sh, Kimm, H, Jo, J, Mok, Y, Lim, Je, Rossing, P, Parving, Hh, Tangri, N, Naimark, D, Wen, Cp, Wen, Sf, Tsao, Ck, Tsai, Mk, Ärnlöv, J, Lannfelt, L, Larsson, A, Bilo, Hj, Joosten, H, Kleefstra, N, Groenier, Kh, Drion, I, Ballew, Sh, Grams, M, Camarata, L, Hui, X, Seltzer, J, and Winegrad, H.

Subjects
Male, BLOOD-PRESSURE, urologic and male genital diseases, Kidney, età, GLOMERULAR-FILTRATION-RATE, Cohort Studies, eGFR, Young adult, Renal disorder [IGMD 9], ALL-CAUSE MORTALITY, GENERAL-POPULATION, insufficienza renale, biology, CYSTATIN C, CARDIOVASCULAR RISK, Age Factors, General Medicine, Middle Aged, female genital diseases and pregnancy complications, RISK POPULATION COHORTS, medicine.anatomical_structure, Female, medicine.symptom, Glomerular Filtration Rate, albuminuria, rischio, mortalità, Adult, Risk, medicine.medical_specialty, Adolescent, Renal function, Context (language use), End stage renal disease, Young Adult, Internal medicine, medicine, Albuminuria, Humans, OLDER-ADULTS, Aged, urogenital system, business.industry, URINARY ALBUMIN EXCRETION, medicine.disease, Endocrinology, Cystatin C, COLLABORATIVE METAANALYSIS, biology.protein, Kidney Failure, Chronic, business, Kidney disease
Abstract

Context Chronic kidney disease (CKD) is prevalent in older individuals, but the risk implications of low estimated glomerular filtration rate (eGFR) and high albuminuria across the full age range are controversial.Objective To evaluate possible effect modification (interaction) by age of the association of eGFR and albuminuria with clinical risk, examining both relative and absolute risks.Design, Setting, and Participants Individual-level meta-analysis including 2 051 244 participants from 33 general population or high-risk (of vascular disease) cohorts and 13 CKD cohorts from Asia, Australasia, Europe, and North/South America, conducted in 1972-2011 with a mean follow-up time of 5.8 years (range, 0-31 years).Main Outcome Measures Hazard ratios (HRs) of mortality and end-stage renal disease (ESRD) according to eGFR and albuminuria were meta-analyzed across age categories after adjusting for sex, race, cardiovascular disease, diabetes, systolic blood pressure, cholesterol, body mass index, and smoking. Absolute risks were estimated using HRs and average incidence rates.Results Mortality (112 325 deaths) and ESRD (8411 events) risks were higher at lower eGFR and higher albuminuria in every age category. In general and high-risk cohorts, relative mortality risk for reduced eGFR decreased with increasing age; eg, adjusted HRs at an eGFR of 45 mL/min/1.73 m(2) vs 80 mL/min/1.73 m(2) were 3.50 (95% CI, 2.55-4.81), 2.21 (95% CI, 2.02-2.41), 1.59 (95% CI, 1.42-1.77), and 1.35 (95% CI, 1.23-1.48) in age categories 18-54, 55-64, 65-74, and >= 75 years, respectively (P Conclusions Both low eGFR and high albuminuria were independently associated with mortality and ESRD regardless of age across a wide range of populations. Mortality showed lower relative risk but higher absolute risk differences at older age.

Published
2012
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47. 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

48. Estimated glomerular filtration rate and albuminuria for prediction of cardiovascular outcomes: a collaborative meta-analysis of individual participant data

Author

Matsushita, K, Coresh, J, Sang, Y, Chalmers, J, Fox, C, Guallar, E, Jafar, T, Jassal, Sk, Landman, Gw, Muntner, P, Roderick, P, Sairenchi, T, Schöttker, B, Shankar, A, Shlipak, M, Tonelli, M, Townend, J, van Zuilen, A, Yamagishi, K, Yamashita, K, Gansevoort, R, Sarnak, M, Warnock, Dg, Woodward, M, Ärnlöv J, CKD Prognosis Consortium, Macmahon, S, Arima, H, Yatsuya, H, Toyoshima, H, Tamakoshi, K, Atkins, Rc, Polkinghorne, Kr, Chadban, S, Klein, R, Klein, Be, Lee, Ke, Sacks, Fm, Curhan, Gc, Sarnak, Mj, Katz, R, Iso, H, Kitamura, A, Imano, H, Jafar, Th, Islam, M, Hatcher, J, Poulter, N, Chaturvedi, N, Wheeler, Dc, Emberson, J, Townend, Jn, Landray, Mj, Brenner, H, Rothenbacher, D, Müller, H, Fox, Cs, Hwang, Sj, Meigs, Jb, Upadhyay, A, Perkins, R, Chang, Ar, Cirillo, Massimo, Hallan, S, Aasarød, K, Øien, Cm, Romundstad, S, Ryu, S, Chang, Y, Cho, J, Shin, H, Chodick, G, Shalev, V, Ash, N, Shainberg, B, Wetzels, Jf, Blankestijn, Pj, Van, Zuilen, Levey, As, Inker, La, Menon, V, Peralta, C, Nitsch, D, Fletcher, A, Bulpitt, C, Elley, Cr, Kenealy, T, Moyes, Sa, Collins, Jf, Drury, P, Ohkubo, T, Metoki, H, Nakayama, M, Kikuya, M, Imai, Y, Gansevoort, Rt, Bakker, Sj, Hillege, Hl, Heerspink, Hj, Bergstrom, J, Jh, Ix, Barrett Connor, E, Judd, S, Mcclellan, W, Jee, Sh, Kimm, H, Mok, Y, Tangri, N, Sud, M, Naimark, D, Wen, Cp, Wen, Sf, Tsao, Ck, Tsai, Mk, Ärnlöv, J, Lannfelt, L, Larsson, A, Bilo, Hj, Kleefstra, N, Groenier, Kh, Joosten, H, Drion, I, Jong, De, Iseki, K, Stengel, B, Warnock, D, Ballew, Sh, Woodward, M., Matsushita, K, Coresh, J, Sang, Y, Chalmers, J, Fox, C, Guallar, E, Jafar, T, Jassal, Sk, Landman, Gw, Muntner, P, Roderick, P, Sairenchi, T, Schöttker, B, Shankar, A, Shlipak, M, Tonelli, M, Townend, J, van Zuilen, A, Yamagishi, K, Yamashita, K, Gansevoort, R, Sarnak, M, Warnock, Dg, Woodward, M, Ärnlöv, J, CKD Prognosis, Consortium, Macmahon, S, Arima, H, Yatsuya, H, Toyoshima, H, Tamakoshi, K, Atkins, Rc, Polkinghorne, Kr, Chadban, S, Klein, R, Klein, Be, Lee, Ke, Sacks, Fm, Curhan, Gc, Sarnak, Mj, Katz, R, Iso, H, Kitamura, A, Imano, H, Jafar, Th, Islam, M, Hatcher, J, Poulter, N, Chaturvedi, N, Wheeler, Dc, Emberson, J, Townend, Jn, Landray, Mj, Brenner, H, Rothenbacher, D, Müller, H, Hwang, Sj, Meigs, Jb, Upadhyay, A, Perkins, R, Chang, Ar, Cirillo, Massimo, Hallan, S, Aasarød, K, Øien, Cm, Romundstad, S, Ryu, S, Chang, Y, Cho, J, Shin, H, Chodick, G, Shalev, V, Ash, N, Shainberg, B, Wetzels, Jf, Blankestijn, Pj, Van, Zuilen, Ad, Levey, A, Inker, La, Menon, V, Peralta, C, Nitsch, D, Fletcher, A, Bulpitt, C, Elley, Cr, Kenealy, T, Moyes, Sa, Collins, Jf, Drury, P, Ohkubo, T, Metoki, H, Nakayama, M, Kikuya, M, Imai, Y, Gansevoort, Rt, Bakker, Sj, Hillege, Hl, Heerspink, Hj, Bergstrom, J, Ix, Jh, Barrett Connor, E, Judd, S, Mcclellan, W, Jee, Sh, Kimm, H, Mok, Y, Tangri, N, Sud, M, Naimark, D, Wen, Cp, Wen, Sf, Tsao, Ck, Tsai, Mk, Lannfelt, L, Larsson, A, Bilo, Hj, Kleefstra, N, Groenier, Kh, Joosten, H, Drion, I, De, Jong, Pe, Iseki, K, Stengel, B, Warnock, D, Ballew, Sh, Woodward, M., Cardiovascular Centre (CVC), and Groningen Kidney Center (GKC)

Subjects
CHRONIC KIDNEY-DISEASE, Male, Endocrinology, Diabetes and Metabolism, Coronary Disease, 030204 cardiovascular system & hematology, chemistry.chemical_compound, 0302 clinical medicine, Endocrinology, cardiovascular disease, Risk Factors, eGFR, EQUATION, ARTERY-DISEASE, EPIDEMIOLOGY, 030212 general & internal medicine, RISK, education.field_of_study, CYSTATIN C, biology, ASSOCIATION, Middle Aged, 3. Good health, Stroke, 1101 Medical Biochemistry and Metabolomics, Cardiovascular Diseases, Creatinine, eGFR, albuminuria, cardiovascular disease, HEART, Female, medicine.symptom, Life Sciences & Biomedicine, Glomerular Filtration Rate, Adult, medicine.medical_specialty, Population, Renal function, 1117 Public Health and Health Services, Endocrinology & Metabolism, 03 medical and health sciences, Diabetes mellitus, Internal medicine, CKD, Internal Medicine, medicine, Albuminuria, Humans, education, CKD Prognosis Consortium, Heart Failure, Science & Technology, business.industry, MORTALITY, 1103 Clinical Sciences, medicine.disease, chemistry, Cystatin C, Heart failure, biology.protein, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11], business, Follow-Up Studies, Kidney disease
Abstract

Item does not contain fulltext BACKGROUND: The usefulness of estimated glomerular filtration rate (eGFR) and albuminuria for prediction of cardiovascular outcomes is controversial. We aimed to assess the addition of creatinine-based eGFR and albuminuria to traditional risk factors for prediction of cardiovascular risk with a meta-analytic approach. METHODS: We meta-analysed individual-level data for 637 315 individuals without a history of cardiovascular disease from 24 cohorts (median follow-up 4.2-19.0 years) included in the Chronic Kidney Disease Prognosis Consortium. We assessed C statistic difference and reclassification improvement for cardiovascular mortality and fatal and non-fatal cases of coronary heart disease, stroke, and heart failure in a 5 year timeframe, contrasting prediction models for traditional risk factors with and without creatinine-based eGFR, albuminuria (either albumin-to-creatinine ratio [ACR] or semi-quantitative dipstick proteinuria), or both. FINDINGS: The addition of eGFR and ACR significantly improved the discrimination of cardiovascular outcomes beyond traditional risk factors in general populations, but the improvement was greater with ACR than with eGFR, and more evident for cardiovascular mortality (C statistic difference 0.0139 [95% CI 0.0105-0.0174] for ACR and 0.0065 [0.0042-0.0088] for eGFR) and heart failure (0.0196 [0.0108-0.0284] and 0.0109 [0.0059-0.0159]) than for coronary disease (0.0048 [0.0029-0.0067] and 0.0036 [0.0019-0.0054]) and stroke (0.0105 [0.0058-0.0151] and 0.0036 [0.0004-0.0069]). Dipstick proteinuria showed smaller improvement than ACR. The discrimination improvement with eGFR or ACR was especially evident in individuals with diabetes or hypertension, but remained significant with ACR for cardiovascular mortality and heart failure in those without either of these disorders. In individuals with chronic kidney disease, the combination of eGFR and ACR for risk discrimination outperformed most single traditional predictors; the C statistic for cardiovascular mortality fell by 0.0227 (0.0158-0.0296) after omission of eGFR and ACR compared with less than 0.007 for any single modifiable traditional predictor. INTERPRETATION: Creatinine-based eGFR and albuminuria should be taken into account for cardiovascular prediction, especially when these measures are already assessed for clinical purpose or if cardiovascular mortality and heart failure are outcomes of interest. ACR could have particularly broad implications for cardiovascular prediction. In populations with chronic kidney disease, the simultaneous assessment of eGFR and ACR could facilitate improved classification of cardiovascular risk, supporting current guidelines for chronic kidney disease. Our results lend some support to also incorporating eGFR and ACR into assessments of cardiovascular risk in the general population. FUNDING: US National Kidney Foundation, National Institute of Diabetes and Digestive and Kidney Diseases.

Published
2015

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