Lower estimated glomerular filtration rate and higher albuminuria are associated with mortality and end-stage renal disease. A collaborative meta-analysis of kidney disease population cohorts.
Lower estimated glomerular filtration rate and higher albuminuria are associated with mortality and end-stage renal disease. A collaborative meta-analysis of kidney disease population cohorts.
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DOI：
10.1038/ki.2010.550
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发表时间：
2011-06
影响因子：
19.6
通讯作者：
Manley T
中科院分区：
文献类型：
--
作者：
Astor BC;Matsushita K;Gansevoort RT;van der Velde M;Woodward M;Levey AS;Jong PE;Coresh J;Chronic Kidney Disease Prognosis Consortium;Astor BC;Matsushita K;Gansevoort RT;van der Velde M;Woodward M;Levey AS;de Jong PE;Coresh J;El-Nahas M;Eckardt KU;Kasiske BL;Wright J;Appel L;Greene T;Levin A;Djurdjev O;Wheeler DC;Landray MJ;Townend JN;Emberson J;Clark LE;Macleod A;Marks A;Ali T;Fluck N;Prescott G;Smith DH;Weinstein JR;Johnson ES;Thorp ML;Wetzels JF;Blankestijn PJ;van Zuilen AD;Menon V;Sarnak M;Beck G;Kronenberg F;Kollerits B;Froissart M;Stengel B;Metzger M;Remuzzi G;Ruggenenti P;Perna A;Heerspink HJ;Brenner B;de Zeeuw D;Rossing P;Parving HH;Auguste P;Veldhuis K;Wang Y;Camarata L;Thomas B;Manley T
关于估计肾小球滤过率 (eGFR) 和白蛋白尿与慢性肾病 (CKD) 患者死亡率和终末期肾病 (ESRD) 之间独立关联的数据有限。我们对从 13 个队列中选出的 21,688 名 CKD 参与者进行了协作荟萃分析。调整潜在混杂因素和蛋白尿后，eGFR 降低 15 mL/min/1.73 m2 低于 45 mL/min/1.73 m2 与死亡率（汇总风险比 [HR] 1.47 [95% CI: 1.22–1.79]）和 ESRD（汇总 HR 6.24 [95% CI: 4.84–8.05]）显着相关。两项 HR 估计值的研究之间存在显着异质性。调整危险因素和 eGFR 后，白蛋白：肌酐比值 (ACR) 或蛋白质：肌酐比值 (PCR) 高八倍与死亡率显着相关（汇总 HR 1.40 [95% CI：1.27–1.55]），但没有证据表明存在显着异质性。高八倍的 ACR 或 PCR 也与 ESRD 密切相关（汇总 HR 3.04 [95% CI：2.27–4.08]），HR 估计值之间存在显着异质性。较低的 eGFR 和较严重的蛋白尿独立预测选择接受 CKD 的个体的死亡率和 ESRD。 ESRD 的相关性比死亡率的相关性更强。观察到的关联与基于 eGFR 分期的 CKD 分类一致，表明蛋白尿为 CKD 患者提供了额外的预后信息。
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.
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影响因子：
13.6
作者：
Ruggenenti, P;Perna, A;Remuzzi, G
通讯作者：
Remuzzi, G
影响因子：
168.9
作者：
Matsushita, Kunihiro;van der Velde, Marije;Astor, Brad C.;Woodward, Mark;Levey, Andrew S.;de Jong, Paul E.;Coresh, Josef;Gansevoort, Ron T.
通讯作者：
Gansevoort, Ron T.
影响因子：
13.2
作者：
Eckardt, Kai-Uwe;Berns, Jeffrey S.;Kasiske, Bertram L.
通讯作者：
Kasiske, Bertram L.
影响因子：
13.2
作者：
Levin, Adeera;Djurdjev, Ognjenka;Er, Lee
通讯作者：
Er, Lee
影响因子：
19.6
作者：
Menon, V.;Wang, X.;Greene, T.
通讯作者：
Greene, T.