1. Change in albuminuria and subsequent risk of end-stage kidney disease: an individual participant-level consortium meta-analysis of observational studies
- Author
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Fan F Hou, Kimberly Smith, David Shepherd, William G. Herrington, Andrew S. Levey, Keiichi Sumida, Marc Froissart, Kazunobu Ichikawa, Jamie A. Green, Mila Tang, John Chalmers, Paul L Drury, Jack F.M. Wetzels, Misghina Weldegiorgis, Laura E Clark, Enyu Imai, Di Xie, John K Cuddeback, Gabriel Chodick, Gordon Prescott, Tom Greene, Julia B. Lewis, Sankar D. Navaneethan, Thorsten Vetter, Sadayoshi Ito, Kaleab Z. Abebe, Staffan Schön, Dick de Zeeuw, Ronald D. Perrone, Rajiv Nadukuru, C Yenchih Hsu, Carl-Gustaf Elinder, Stephen J Bakker, James F Medcalf, John F. Collins, Aliza Thompson, Fumiaki Kobayashi, Raina C Elley, Edmund J. Lewis, Richard D. Rohde, Brad C. Astor, Hirofumi Makino, Miklos Z. Molnar, Mark J. Sarnak, Abdul Rashid Qureshi, Roger A. Rodby, Hrefna Gudmundsdottir, Nigel J. Brunskill, Adeera Levin, Caroline S. Fox, Giuseppe Remuzzi, Hisatomi Arima, Varda Shalev, Arjan D. van Zuilen, Mårten Segelmark, Ognjenka Djurdjev, Margaret Smith, Simerjot K. Jassal, Sushrut S. Waikar, Nick Fluck, Joachim H. Ix, Barry M. Brenner, Mark Woodward, Kunihiro Matsushita, Chi Pang Wen, Kornelis Jj Van Hateren, Nanne Kleefstra, Jean-Philippe Haymann, Joseph V. Nally, Elizabeth L Ciemins, Henk J. G. Bilo, Lawrence J. Appel, Kerry Willis, Peter J. Blankestijn, Lesley A. Inker, Hans-Henrik Parving, Hiddo J.L. Heerspink, Luxia Zhang, Teresa K. Chen, Marie Evans, Areef Ishani, Girish N. Nadkarni, Pascal Houillier, Kai-Uwe Eckardt, Mitsumasa Umesawa, Jingsha Chen, Stein Hallan, Maria Stendahl, Corri Black, Robert G. Nelson, H. Lester Kirchner, Björn Runesson, Shoshana H. Ballew, Elizabeth Barrett-Connor, Angharad Marks, Ron T. Gansevoort, Martin Flamant, William C. Knowler, Jaclyn Bergstrom, Tsuneo Konta, Jan A.J.G. van den Brand, Stephen G Ellis, Marit Dahl Solbu, Lucia Kwak, Bénédicte Stengel, Alex R. Chang, Aditya Surapaneni, Jesse D. Schold, Shih-Jen Hwang, Marcello Tonelli, Juan Jesus Carrero, Tom Manley, Timothy Kenealy, Erwin P. Bottinger, Nikita Stempniewicz, Johan Ärnlöv, Rich Stempniewicz, Norman Stockbridge, Gijs W D Landman, Vlado Perkovic, Piero Ruggenenti, Marie Metzger, David Naimark, Josef Coresh, Lawrence G. Hunsicker, Kevin Ho, Solfrid Romundstad, Morgan E. Grams, Csaba P. Kovesdy, Atsushi Hirayama, Harold I. Feldman, Yingying Sang, Kevan R. Polkinghorne, Romaldas Maciulaitis, Navdeep Tangri, Rupert W. Major, Maneesh Sud, Groningen Kidney Center (GKC), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), and Cardiovascular Centre (CVC)
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SURROGATE ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Regression dilution ,Renal function ,030209 endocrinology & metabolism ,ALL-CAUSE ,Kidney Function Tests ,GLOMERULAR-FILTRATION-RATE ,Article ,APPROPRIATE THERAPEUTIC TARGET ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Risk Factors ,Internal medicine ,Diabetes mellitus ,CKD ,medicine ,Internal Medicine ,Albuminuria ,Humans ,030212 general & internal medicine ,Surrogate endpoint ,business.industry ,urogenital system ,MORTALITY ,Hazard ratio ,PROTEINURIA ,medicine.disease ,Prognosis ,Diabetes and Metabolism ,RENAL-DISEASE ,Observational Studies as Topic ,COLLABORATIVE METAANALYSIS ,Cohort ,Disease Progression ,Kidney Failure, Chronic ,medicine.symptom ,Renal disorders Radboud Institute for Health Sciences [Radboudumc 11] ,business ,POINT ,Kidney disease ,Glomerular Filtration Rate - Abstract
Item does not contain fulltext BACKGROUND: Change in albuminuria as a surrogate endpoint for progression of chronic kidney disease is strongly supported by biological plausibility, but empirical evidence to support its validity in epidemiological studies is lacking. We aimed to assess the consistency of the association between change in albuminuria and risk of end-stage kidney disease in a large individual participant-level meta-analysis of observational studies. METHODS: In this meta-analysis, we collected individual-level data from eligible cohorts in the Chronic Kidney Disease Prognosis Consortium (CKD-PC) with data on serum creatinine and change in albuminuria and more than 50 events on outcomes of interest. Cohort data were eligible if participants were aged 18 years or older, they had a repeated measure of albuminuria during an elapsed period of 8 months to 4 years, subsequent end-stage kidney disease or mortality follow-up data, and the cohort was active during this consortium phase. We extracted participant-level data and quantified percentage change in albuminuria, measured as change in urine albumin-to-creatinine ratio (ACR) or urine protein-to-creatinine ratio (PCR), during baseline periods of 1, 2, and 3 years. Our primary outcome of interest was development of end-stage kidney disease after a baseline period of 2 years. We defined an end-stage kidney disease event as initiation of kidney replacement therapy. We quantified associations of percentage change in albuminuria with subsequent end-stage kidney disease using Cox regression in each cohort, followed by random-effects meta-analysis. We further adjusted for regression dilution to account for imprecision in the estimation of albuminuria at the participant level. We did multiple subgroup analyses, and also repeated our analyses using participant-level data from 14 clinical trials, including nine clinical trials not in CKD-PC. FINDINGS: Between July, 2015, and June, 2018, we transferred and analysed data from 28 cohorts in the CKD-PC, which included 693 816 individuals (557 583 [80%] with diabetes). Data for 675 904 individuals and 7461 end-stage kidney disease events were available for our primary outcome analysis. Change in ACR was consistently associated with subsequent risk of end-stage kidney disease. The adjusted hazard ratio (HR) for end-stage kidney disease after a 30% decrease in ACR during a baseline period of 2 years was 0.83 (95% CI 0.74-0.94), decreasing to 0.78 (0.66-0.92) after further adjustment for regression dilution. Adjusted HRs were fairly consistent across cohorts and subgroups (ie, estimated glomerular filtration rate, diabetes, and sex), but the association was somewhat stronger among participants with higher baseline ACR than among those with lower baseline ACR (pinteraction
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- 2019