Association of estimated glomerular filtration rate and albuminuria with mortality and end-stage renal disease: a collaborative meta-analysis of kidney disease cohorts
By B. Astor, K. Matsushita, R. Gansevoort, Marije van der Velde, M. Woodward, A. Levey, P. D. Jong, Josef Coresh, P. D. de Jong, M. El-Nahas and 46 more. Kidney International, 2011
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Limited data are available on the independent associations of estimated glomerular filtration rate (eGFR) and albuminuria with mortality and end stage renal disease (ESRD) among individuals with chronic kidney disease (CKD). We conducted a collaborative meta-analysis of 21,688 participants selected for CKD from 13 cohorts. After adjustment for potential confounders and albuminuria, a 15 mL/min/1.73 m2 lower eGFR below 45 mL/min/1.73 m2 was significantly associated with mortality (pooled hazard ratio [HR] 1.47 [95% CI: 1.22–1.79]), and ESRD (pooled HR 6.24 [95% CI: 4.84–8.05]). There was significant heterogeneity between studies for both HR estimates. After adjustment for risk factors and eGFR, an eight-fold higher albumin:creatinine ratio (ACR) or protein:creatinine ratio (PCR) was significantly associated with mortality (pooled HR 1.40 [95% CI: 1.27–1.55]), without evidence of significant heterogeneity. An eight-fold higher ACR or PCR was also strongly associated with ESRD (pooled HR 3.04 [95% CI: 2.27–4.08]), with significant heterogeneity between HR estimates. Lower eGFR and more severe albuminuria independently predict mortality and ESRD among individuals selected for CKD. The associations are stronger for ESRD than for mortality. The observed associations are consistent with CKD classification based on eGFR stages, and suggest that albuminuria provides additional prognostic information among individuals with CKD.
Subfields: Nephrology
View Paper: https://www.semanticscholar.org/paper/5d98c1664bffd6c79d2b5e4480213e95b34fcdd9
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Citations in the corpus
- Decline in estimated glomerular filtration rate and subsequent risk of end-stage renal disease and mortality (2014, neutral): “GLOMMS 1 645 2 11 (7-20) 58 0 3 (1) 274 1 3 (1)”
- The contribution of chronic kidney disease to the global burden of major noncommunicable diseases. (2011, background): “A recent meta-analysis of eight cohorts of 845,125 general and highrisk people confirms the marked and graded increased risk for ESRD in those with a GFR less than 60 ml/min (stage 3) and in people with albuminuria at all levels independent of traditional cardiovascular risk factors.(11) Stage 5 CKD”