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Lower estimated glomerular filtration rate and higher albuminuria are associated with all-cause and cardiovascular mortality. A collaborative meta-analysis of high-risk population cohorts.
Kidney Int 2011; 79(12):1341-52KI

Abstract

Screening for chronic kidney disease is recommended in people at high risk, but data on the independent and combined associations of estimated glomerular filtration rate (eGFR) and albuminuria with all-cause and cardiovascular mortality are limited. To clarify this, we performed a collaborative meta-analysis of 10 cohorts with 266,975 patients selected because of increased risk for chronic kidney disease, defined as a history of hypertension, diabetes, or cardiovascular disease. Risk for all-cause mortality was not associated with eGFR between 60-105 ml/min per 1.73 m², but increased at lower levels. Hazard ratios at eGFRs of 60, 45, and 15 ml/min per 1.73 m² were 1.03, 1.38 and 3.11, respectively, compared to an eGFR of 95, after adjustment for albuminuria and cardiovascular risk factors. Log albuminuria was linearly associated with log risk for all-cause mortality without thresholds. Adjusted hazard ratios at albumin-to-creatinine ratios of 10, 30 and 300 mg/g were 1.08, 1.38, and 2.16, respectively compared to a ratio of five. Albuminuria and eGFR were multiplicatively associated with all-cause mortality, without evidence for interaction. Similar associations were observed for cardiovascular mortality. Findings in cohorts with dipstick data were generally comparable to those in cohorts measuring albumin-to-creatinine ratios. Thus, lower eGFR and higher albuminuria are risk factors for all-cause and cardiovascular mortality in high-risk populations, independent of each other and of cardiovascular risk factors.

Authors+Show Affiliations

Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21307840

Citation

van der Velde, Marije, et al. "Lower Estimated Glomerular Filtration Rate and Higher Albuminuria Are Associated With All-cause and Cardiovascular Mortality. a Collaborative Meta-analysis of High-risk Population Cohorts." Kidney International, vol. 79, no. 12, 2011, pp. 1341-52.
van der Velde M, Matsushita K, Coresh J, et al. Lower estimated glomerular filtration rate and higher albuminuria are associated with all-cause and cardiovascular mortality. A collaborative meta-analysis of high-risk population cohorts. Kidney Int. 2011;79(12):1341-52.
van der Velde, M., Matsushita, K., Coresh, J., Astor, B. C., Woodward, M., Levey, A., ... Manley, T. (2011). Lower estimated glomerular filtration rate and higher albuminuria are associated with all-cause and cardiovascular mortality. A collaborative meta-analysis of high-risk population cohorts. Kidney International, 79(12), pp. 1341-52. doi:10.1038/ki.2010.536.
van der Velde M, et al. Lower Estimated Glomerular Filtration Rate and Higher Albuminuria Are Associated With All-cause and Cardiovascular Mortality. a Collaborative Meta-analysis of High-risk Population Cohorts. Kidney Int. 2011;79(12):1341-52. PubMed PMID: 21307840.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lower estimated glomerular filtration rate and higher albuminuria are associated with all-cause and cardiovascular mortality. A collaborative meta-analysis of high-risk population cohorts. AU - van der Velde,Marije, AU - Matsushita,Kunihiro, AU - Coresh,Josef, AU - Astor,Brad C, AU - Woodward,Mark, AU - Levey,Andrew, AU - de Jong,Paul, AU - Gansevoort,Ron T, AU - ,, AU - van der Velde,Marije, AU - Matsushita,Kunihiro, AU - Coresh,Josef, AU - Astor,Brad C, AU - Woodward,Mark, AU - Levey,Andrew S, AU - de Jong,Paul E, AU - Gansevoort,Ron T, AU - Levey,Andrew, AU - El-Nahas,Meguid, AU - Eckardt,Kai-Uwe, AU - Kasiske,Bertram L, AU - Ninomiya,Toshiharu, AU - Chalmers,John, AU - Macmahon,Stephen, AU - Tonelli,Marcello, AU - Hemmelgarn,Brenda, AU - Sacks,Frank, AU - Curhan,Gary, AU - Collins,Allan J, AU - Li,Suying, AU - Chen,Shu-Cheng, AU - Hawaii Cohort,K P, AU - Lee,Brian J, AU - Ishani,Areef, AU - Neaton,James, AU - Svendsen,Ken, AU - Mann,Johannes F E, AU - Yusuf,Salim, AU - Teo,Koon K, AU - Gao,Peggy, AU - Nelson,Robert G, AU - Knowler,William C, AU - Bilo,Henk J, AU - Joosten,Hanneke, AU - Kleefstra,Nanno, AU - Groenier,K H, AU - Auguste,Priscilla, AU - Veldhuis,Kasper, AU - Wang,Yaping, AU - Camarata,Laura, AU - Thomas,Beverly, AU - Manley,Tom, Y1 - 2011/02/09/ PY - 2011/2/11/entrez PY - 2011/2/11/pubmed PY - 2011/9/17/medline SP - 1341 EP - 52 JF - Kidney international JO - Kidney Int. VL - 79 IS - 12 N2 - Screening for chronic kidney disease is recommended in people at high risk, but data on the independent and combined associations of estimated glomerular filtration rate (eGFR) and albuminuria with all-cause and cardiovascular mortality are limited. To clarify this, we performed a collaborative meta-analysis of 10 cohorts with 266,975 patients selected because of increased risk for chronic kidney disease, defined as a history of hypertension, diabetes, or cardiovascular disease. Risk for all-cause mortality was not associated with eGFR between 60-105 ml/min per 1.73 m², but increased at lower levels. Hazard ratios at eGFRs of 60, 45, and 15 ml/min per 1.73 m² were 1.03, 1.38 and 3.11, respectively, compared to an eGFR of 95, after adjustment for albuminuria and cardiovascular risk factors. Log albuminuria was linearly associated with log risk for all-cause mortality without thresholds. Adjusted hazard ratios at albumin-to-creatinine ratios of 10, 30 and 300 mg/g were 1.08, 1.38, and 2.16, respectively compared to a ratio of five. Albuminuria and eGFR were multiplicatively associated with all-cause mortality, without evidence for interaction. Similar associations were observed for cardiovascular mortality. Findings in cohorts with dipstick data were generally comparable to those in cohorts measuring albumin-to-creatinine ratios. Thus, lower eGFR and higher albuminuria are risk factors for all-cause and cardiovascular mortality in high-risk populations, independent of each other and of cardiovascular risk factors. SN - 1523-1755 UR - https://www.unboundmedicine.com/medline/citation/21307840/Lower_estimated_glomerular_filtration_rate_and_higher_albuminuria_are_associated_with_all_cause_and_cardiovascular_mortality__A_collaborative_meta_analysis_of_high_risk_population_cohorts_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0085-2538(15)54740-6 DB - PRIME DP - Unbound Medicine ER -