Language:

Past Decline Versus Current eGFR and Subsequent ESRD Risk

Journal of the American Society of Nephrology, 2016-08, Vol.27 (8), p.2447-2455 [Peer Reviewed Journal]

Copyright © 2016 by the American Society of Nephrology. ;Copyright © 2016 by the American Society of Nephrology 2016 ;ISSN: 1046-6673 ;ISSN: 1533-3450 ;EISSN: 1533-3450 ;DOI: 10.1681/asn.2015060687 ;PMID: 26657867

Full text available

Citations Cited by

Actions
1. Add to My Research
2. Remove from My Research
3. E-mail
4. Print
5. Permalink
6. Citation
7. EasyBib
8. EndNote
9. RefWorks
10. Delicious
11. Export RIS
12. Export BibTeX

Title:
Past Decline Versus Current eGFR and Subsequent ESRD Risk
Author: Kovesdy, Csaba P ; Coresh, Josef ; Ballew, Shoshana H ; Woodward, Mark ; Levin, Adeera ; Naimark, David M J ; Nally, Joseph ; Rothenbacher, Dietrich ; Stengel, Benedicte ; Iseki, Kunitoshi ; Matsushita, Kunihiro ; Levey, Andrew S
Subjects: Clinical Epidemiology ; Disease Progression ; end-stage renal disease ; epidemiology and outcomes ; Glomerular Filtration Rate ; Health and Welfare ; Humans ; Hälsa och välfärd ; Kidney Failure, Chronic - epidemiology ; Kidney Failure, Chronic - etiology ; Kidney Failure, Chronic - physiopathology ; progression of chronic renal failure ; Proportional Hazards Models ; Risk Factors ; Time Factors
Is Part Of: Journal of the American Society of Nephrology, 2016-08, Vol.27 (8), p.2447-2455
Description: 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).
Publisher: United States: American Society of Nephrology
Language: English
Identifier: ISSN: 1046-6673
ISSN: 1533-3450
EISSN: 1533-3450
DOI: 10.1681/asn.2015060687
PMID: 26657867
Source: PubMed
Geneva Foundation Free Medical Journals at publisher websites
MEDLINE
Alma/SFX Local Collection

Back to results list


INSPIRE LIBRARY - TON DUC THANG UNIVERSITY	(84-028) 37 755 057	Feedback
19 Nguyen Huu Tho St. Dist.7, HCM	thuvien@tdtu.edu.vn	Feedback

Past Decline Versus Current eGFR and Subsequent ESRD Risk

Copyright © 2016 by the American Society of Nephrology. ;Copyright © 2016 by the American Society of Nephrology 2016 ;ISSN: 1046-6673 ;ISSN: 1533-3450 ;EISSN: 1533-3450 ;DOI: 10.1681/asn.2015060687 ;PMID: 26657867

Searching Remote Databases, Please Wait