Timing of onset of CKD-related metabolic complications

Details

Serval ID
serval:BIB_D30FBF17D360
Type
Article: article from journal or magazin.
Collection
Publications
Title
Timing of onset of CKD-related metabolic complications
Journal
J Am Soc Nephrol
Author(s)
Moranne O., Froissart M., Rossert J., Gauci C., Boffa  J. J., Haymann  J. P., M'Rad M  B., Jacquot C., Houillier P., Stengel B., Fouqueray B.
Working group(s)
NephroTest Study Group
ISSN-L
1533-3450 (Electronic) 1046-6673 (Linking)
Publication state
Published
Issued date
2009
Volume
20
Number
1
Pages
164-71
Notes
Moranne, Olivier
Froissart, Marc
Rossert, Jerome
Gauci, Cedric
Boffa, Jean-Jacques
Haymann, Jean Philippe
M'rad, Mona Ben
Jacquot, Christian
Houillier, Pascal
Stengel, Benedicte
Fouqueray, Bruno
eng
Research Support, Non-U.S. Gov't
2008/11/14 09:00
J Am Soc Nephrol. 2009 Jan;20(1):164-71. doi: 10.1681/ASN.2008020159. Epub 2008 Nov 12.
Abstract
Chronic kidney disease (CKD) guidelines recommend evaluating patients with GFR <60 ml/min per 1.73 m(2) for complications, but little evidence supports the use of a single GFR threshold for all metabolic disorders. We used data from the NephroTest cohort, including 1038 adult patients who had stages 2 through 5 CKD and were not on dialysis, to study the occurrence of metabolic complications. GFR was measured using renal clearance of (51)Cr-EDTA (mGFR) and estimated using two equations derived from the Modification of Diet in Renal Disease study. As mGFR decreased from 60 to 90 to <20 ml/min per 1.73 m(2), the prevalence of hyperparathyroidism increased from 17 to 85%, anemia from 8 to 41%, hyperphosphatemia from 1 to 30%, metabolic acidosis from 2 to 39%, and hyperkalemia from 2 to 42%. Factors most strongly associated with metabolic complications, independent of mGFR, were younger age for acidosis and hyperphosphatemia, presence of diabetes for acidosis, diabetic kidney disease for anemia, and both male gender and the use of inhibitors of the renin-angiotensin system for hyperkalemia. mGFR thresholds for detecting complications with 90% sensitivity were 50, 44, 40, 39, and 37 ml/min per 1.73 m(2) for hyperparathyroidism, anemia, acidosis, hyperkalemia, and hyperphosphatemia, respectively. Analysis using estimated GFR produced similar results. In summary, this study describes the onset of CKD-related complications at different levels of GFR; anemia and hyperparathyroidism occur earlier than acidosis, hyperkalemia, and hyperphosphatemia.
Keywords
Acidosis/epidemiology, Adult, Aged, Anemia/epidemiology, Chronic Disease, Female, Glomerular Filtration Rate, Humans, Hyperkalemia/epidemiology, Hyperparathyroidism/epidemiology, Hyperphosphatemia/epidemiology, Kidney Diseases/*complications/*metabolism, Male, Middle Aged, Odds Ratio, Prevalence, Time Factors
Open Access
Yes
Create date
03/03/2016 16:48
Last modification date
21/08/2019 5:35
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