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Glomerular filtration rate, albuminuria, and risk of cardiovascular and all-cause mortality in the US population.
Am J Epidemiol. 2008 May 15; 167(10):1226-34.AJ

Abstract

Decreased glomerular filtration rate (GFR) and albuminuria are used in combination to define chronic kidney disease, but their separate and combined effects on cardiovascular and all-cause mortality have not been studied in the general population. The linked mortality file of the Third National Health and Nutrition Examination Survey includes data from 13 years of follow-up (1988-2000) for 14,586 US adults. The authors estimated GFR from standardized serum creatinine levels. Albuminuria was defined by the urinary albumin:creatinine ratio. Incidence rate ratios (IRRs) were adjusted for major cardiovascular disease risk factors and C-reactive protein. Lower estimated GFR was associated with higher risks of cardiovascular and all-cause mortality overall and within every albuminuria category. Likewise, increasing albuminuria was associated with higher risk of estimated GFR overall and within every category. When estimated GFR and albuminuria were examined simultaneously, a 10-ml/minute/1.73 m(2) lower estimated GFR (among persons with estimated GFR <60 ml/minute/1.73 m(2)) was associated with an IRR of 1.29 (95% confidence interval: 1.06, 1.55) for cardiovascular mortality and a doubling of albuminuria was associated with an IRR of 1.06 (95% confidence interval: 1.04, 1.08) for cardiovascular mortality. The authors conclude that moderately decreased estimated GFR and albuminuria independently predict cardiovascular and all-cause mortality in the general population. These data support recent recommendations defining chronic kidney disease and stratifying subsequent risks based on both decreased GFR and albuminuria.

Authors+Show Affiliations

Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. bastor@jhsph.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

18385206

Citation

Astor, Brad C., et al. "Glomerular Filtration Rate, Albuminuria, and Risk of Cardiovascular and All-cause Mortality in the US Population." American Journal of Epidemiology, vol. 167, no. 10, 2008, pp. 1226-34.
Astor BC, Hallan SI, Miller ER, et al. Glomerular filtration rate, albuminuria, and risk of cardiovascular and all-cause mortality in the US population. Am J Epidemiol. 2008;167(10):1226-34.
Astor, B. C., Hallan, S. I., Miller, E. R., Yeung, E., & Coresh, J. (2008). Glomerular filtration rate, albuminuria, and risk of cardiovascular and all-cause mortality in the US population. American Journal of Epidemiology, 167(10), 1226-34. https://doi.org/10.1093/aje/kwn033
Astor BC, et al. Glomerular Filtration Rate, Albuminuria, and Risk of Cardiovascular and All-cause Mortality in the US Population. Am J Epidemiol. 2008 May 15;167(10):1226-34. PubMed PMID: 18385206.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Glomerular filtration rate, albuminuria, and risk of cardiovascular and all-cause mortality in the US population. AU - Astor,Brad C, AU - Hallan,Stein I, AU - Miller,Edgar R,3rd AU - Yeung,Edwina, AU - Coresh,Josef, Y1 - 2008/04/02/ PY - 2008/4/4/pubmed PY - 2008/5/14/medline PY - 2008/4/4/entrez SP - 1226 EP - 34 JF - American journal of epidemiology JO - Am J Epidemiol VL - 167 IS - 10 N2 - Decreased glomerular filtration rate (GFR) and albuminuria are used in combination to define chronic kidney disease, but their separate and combined effects on cardiovascular and all-cause mortality have not been studied in the general population. The linked mortality file of the Third National Health and Nutrition Examination Survey includes data from 13 years of follow-up (1988-2000) for 14,586 US adults. The authors estimated GFR from standardized serum creatinine levels. Albuminuria was defined by the urinary albumin:creatinine ratio. Incidence rate ratios (IRRs) were adjusted for major cardiovascular disease risk factors and C-reactive protein. Lower estimated GFR was associated with higher risks of cardiovascular and all-cause mortality overall and within every albuminuria category. Likewise, increasing albuminuria was associated with higher risk of estimated GFR overall and within every category. When estimated GFR and albuminuria were examined simultaneously, a 10-ml/minute/1.73 m(2) lower estimated GFR (among persons with estimated GFR <60 ml/minute/1.73 m(2)) was associated with an IRR of 1.29 (95% confidence interval: 1.06, 1.55) for cardiovascular mortality and a doubling of albuminuria was associated with an IRR of 1.06 (95% confidence interval: 1.04, 1.08) for cardiovascular mortality. The authors conclude that moderately decreased estimated GFR and albuminuria independently predict cardiovascular and all-cause mortality in the general population. These data support recent recommendations defining chronic kidney disease and stratifying subsequent risks based on both decreased GFR and albuminuria. SN - 1476-6256 UR - https://www.unboundmedicine.com/medline/citation/18385206/Glomerular_filtration_rate_albuminuria_and_risk_of_cardiovascular_and_all_cause_mortality_in_the_US_population_ L2 - https://academic.oup.com/aje/article-lookup/doi/10.1093/aje/kwn033 DB - PRIME DP - Unbound Medicine ER -