Past Decline Versus Current eGFR and Subsequent ESRD Risk.

Détails

ID Serval
serval:BIB_B46868D6ECF2
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Past Decline Versus Current eGFR and Subsequent ESRD Risk.
Périodique
Journal of the American Society of Nephrology
Auteur(s)
Kovesdy C.P., Coresh J., Ballew S.H., Woodward M., Levin A., Naimark D.M., Nally J., Rothenbacher D., Stengel B., Iseki K., Matsushita K., Levey A.S.
Collaborateur(s)
CKD Prognosis Consortium
Contributeur(s)
Wright J., Appel J., Greene T., Astor B., MacMahon S., Chalmers J., Arima H., Tonelli M., Hemmelgarn B.R., James M.T., Chowdhury T., Grams M.E., Sang Y., Zawada A.M., Rogacev K.S., Seiler S., Heine G.H., Navaneethan S.D., Schold J.D., Shlipak M., Sarnak M.J., Katz R., Wheeler D.C., Emberson J., Townsend J.N., Landray M.J., Brenner H., Mueller H., Schoettker B., Green J., Kirchner H.L., Perkins R., Chang A.R., Black C., Fluck N., Prescott G.J., Hallan S., Aasarod K., Oien C.M., Radtke M., Smith D.H., Thorp M.L., Johnson E.S., Lee B.J., Chodick G., Shalev V., Birnbaum Y.C., Shainberg B., Wetzels J.F., Blankestijn P.J., van Zuilen A.D., Sarnak M.J., Inker L.A., Menon V., Ishani A., Neaton J.D., Froissart M., Metzger M., Haymann J.P., Houllier P., Flamant M., Elley C.R., Kenealy T., Moyes S.A., Collins J.F., Drury P.L., Nelson R.G., Knowler W.C., Gansevoort R.T., Bakker S.J., Hillege H.L., van der Harst H., van der Harst P., Jassal S.K., Bergstrom J., Ix J.H., Barrett-Connor E., Lambers Heerspink H.J., Brenner B.J., de Zeeuw D., Tangri N., Sud M., Arnlov J., Lannfelt L., Larsson A., Kalantar-Zadeh K., de Jong P.E., Warnock D.J.
ISSN
1533-3450 (Electronic)
ISSN-L
1046-6673
Statut éditorial
Publié
Date de publication
08/2016
Peer-reviewed
Oui
Volume
27
Numéro
8
Pages
2447-2455
Langue
anglais
Notes
Publication types: Comparative Study ; Journal Article ; Meta-Analysis
Publication Status: ppublish
Résumé
eGFR is a robust predictor of ESRD risk. However, the prognostic information gained from the past trajectory (slope) beyond that of the current eGFR is unclear. We examined 22 cohorts to determine the association of past slopes and current eGFR level with subsequent ESRD. We modeled hazard ratios as a spline function of slopes, adjusting for demographic variables, eGFR, and comorbidities. We used random effects meta-analyses to combine results across studies stratified by cohort type. We calculated the absolute risk of ESRD at 5 years after the last eGFR using the weighted average baseline risk. Overall, 1,080,223 participants experienced 5163 ESRD events during a mean follow-up of 2.0 years. In CKD cohorts, a slope of -6 versus 0 ml/min per 1.73 m(2) per year over the previous 3 years (a decline of 18 ml/min per 1.73 m(2) versus no decline) associated with an adjusted hazard ratio of ESRD of 2.28 (95% confidence interval, 1.88 to 2.76). In contrast, a current eGFR of 30 versus 50 ml/min per 1.73 m(2) (a difference of 20 ml/min per 1.73 m(2)) associated with an adjusted hazard ratio of 19.9 (95% confidence interval, 13.6 to 29.1). Past decline contributed more to the absolute risk of ESRD at lower than higher levels of current eGFR. In conclusion, during a follow-up of 2 years, current eGFR associates more strongly with future ESRD risk than the magnitude of past eGFR decline, but both contribute substantially to the risk of ESRD, especially at eGFR<30 ml/min per 1.73 m(2).

Mots-clé
Disease Progression, Glomerular Filtration Rate, Humans, Kidney Failure, Chronic/epidemiology, Kidney Failure, Chronic/etiology, Kidney Failure, Chronic/physiopathology, Proportional Hazards Models, Risk Factors, Time Factors, end-stage renal disease, epidemiology and outcomes, glomerular filtration rate, progression of chronic renal failure
Pubmed
Web of science
Open Access
Oui
Création de la notice
09/03/2018 18:31
Dernière modification de la notice
21/08/2019 5:35
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