Association of impaired kidney function with mortality in rural Uganda: results of a general population cohort study.
Association of impaired kidney function with mortality in rural Uganda: results of a general population cohort study.
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DOI：
10.1136/bmjopen-2021-051267
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发表时间：
2022-04-26
期刊：
影响因子：
2.9
通讯作者：
Tomlinson, Laurie A.
中科院分区：
文献类型：
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作者：
Kalyesubula, Robert;Sekitoleko, Isaac;Tomlin, Keith;Hansen, Christian Holm;Ssebunya, Billy;Makanga, Ronald;Mbonye, Moses Kwizera;Seeley, Janet;Smeeth, Liam;Newton, Robert;Tomlinson, Laurie A.
确定基线肾功能与随后全因死亡率之间的关联
乌干达农村地区一项基于普通人群的队列研究
年龄在18岁及以上且测量了基线估计肾小球滤过率（eGFR）的人群，这些人是在2011 - 2012年或2014 - 2015年的调查轮次中招募的，并随访至2019年3月
主要结局是全因死亡率，通过社区卫生工作者的报告确定，并通过口头尸检核实。使用多变量Cox回归确定基线eGFR类别与死亡率之间的关联
在两轮的5812名参与者中，我们纳入了5678名（97.7%）有肾功能和死亡率数据的参与者；中位年龄为36岁（四分位距24 - 50），60.7%为女性，10.3%患有高血压，9.8%为艾滋病病毒阳性，1.5%患有糖尿病。在中位随访5.0年（四分位距3.7 - 6.0）期间，有140人死亡。在年龄调整和性别调整分析中，与基线eGFR >90 mL/min/1.73 m²的人群相比，基线eGFR <45 mL/min/1.73 m²与死亡风险增加5.97倍（95%置信区间2.55 - 13.98）相关。在将其他混杂因素（艾滋病病毒、体重指数、糖尿病、高血压、饮酒和吸烟状况）纳入模型后，尽管样本量降至3102，但基线eGFR <45 mL/min/1.73 m²仍然与死亡率密切相关（风险比6.12，95%置信区间2.27 - 16.45）。趋势检验显示有强有力的证据（p<0.001）表明随着基线肾功能类别下降，死亡率逐渐上升。在年龄调整和性别调整分析中，当将极高的eGFR作为一个单独类别纳入时，与90 - 119 mL/min/1.73 m²的参考类别相比，基线eGFR≥120 mL/min/1.73 m²与死亡风险增加相关（风险比2.68，95%置信区间1.7 - 4.87）
在乌干达农村地区的一个前瞻性队列中，我们发现基线肾功能受损与随后的总死亡率增加相关。为了为预防和治疗干预措施提供信息，需要更好地理解肾脏疾病的决定因素及其进展
To determine the association between baseline kidney function and subsequent all-cause mortality. A general population-based cohort study from rural Uganda. People aged 18 years and above with measured baseline estimated glomerular filtration rate (eGFR), recruited from survey rounds in 2011–2012 or 2014–2015 and followed up to March 2019. The primary outcome was all-cause mortality, identified through reports from community health workers and verified by verbal autopsy. The association between baseline eGFR category and mortality was determined using multivariable Cox regression. Of 5812 participants in both rounds, we included 5678 (97.7%) participants with kidney function and mortality data; the median age was 36 years (IQR 24–50), 60.7% were female, 10.3% were hypertensive, 9.8% were HIV-positive and 1.5% were diabetic. During a median follow-up of 5.0 years (IQR 3.7–6.0) there were 140 deaths. In age-adjusted and sex-adjusted analyses, eGFR <45 mL/min/1.73 m2 at baseline was associated with a 5.97 (95% CI 2.55 to 13.98) increased risk of mortality compared with those with baseline eGFR >90 mL/min/1.73 m2. After inclusion of additional confounders (HIV, body mass index, diabetes, hypertension, alcohol and smoking status) into the model, eGFR <45 mL/min/1.73 m2 at baseline remained strongly associated with mortality (HR 6.12, 95% CI 2.27 to 16.45), although the sample size fell to 3102. Test for trend showed strong evidence (p<0.001) that the rate of mortality increased progressively as the category of baseline kidney function decreased. When very high eGFR was included as a separate category in age-adjusted and sex-adjusted analyses, baseline eGFR ≥120 mL/min/1.73 m2 was associated with increased risk of mortality (HR 2.68, 95% CI 1.47 to 4.87) compared with the reference category of 90–119 mL/min/1.73 m2. In a prospective cohort in rural Uganda we found that impaired baseline kidney function was associated with subsequently increased total mortality. Improved understanding of the determinants of kidney disease and its progression is needed in order to inform interventions for prevention and treatment.
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影响因子：
0.7
作者：
Babua C;Kalyesubula R;Okello E;Kakande B;Sebatta E;Mungoma M;Mondo CK
通讯作者：
Mondo CK
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：
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作者：
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通讯作者：
Crampin, Amelia C
影响因子：
3.7
作者：
Guwatudde, David;Mutungi, Gerald;Bahendeka, Silver K.
通讯作者：
Bahendeka, Silver K.
影响因子：
--
作者：
Kalyesubula, Robert;Hau, Jeffrey P;Newton, Robert
通讯作者：
Newton, Robert