Associations of estimated glomerular filtration rate and albuminuria with mortality and renal failure by sex: a meta-analysis.
Associations of estimated glomerular filtration rate and albuminuria with mortality and renal failure by sex: a meta-analysis.
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DOI：
10.1136/bmj.f324
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发表时间：
2013-01-29
期刊：
影响因子：
--
通讯作者：
Chronic Kidney Disease Prognosis Consortium
中科院分区：
文献类型：
--
作者：
Nitsch D;Grams M;Sang Y;Black C;Cirillo M;Djurdjev O;Iseki K;Jassal SK;Kimm H;Kronenberg F;Oien CM;Levey AS;Levin A;Woodward M;Hemmelgarn BR;Chronic Kidney Disease Prognosis Consortium
目的评估估计肾小球滤过率和蛋白尿与全因死亡率、心血管死亡率和终末期肾病之间是否存在性别相互作用。设计：使用合并的个体参与者数据进行随机效应荟萃分析。设置来自欧洲、北美和南美、亚洲和澳大拉西亚的46个队列。参与者2 051 158名参与者（54%为女性）来自普通人群队列（n=1 861 052）、高风险队列（n=151 494）和慢性肾脏疾病队列（n=38 612）。合格队列（慢性肾脏疾病队列除外）至少有1000例受试者，死亡或终末期肾脏疾病结局≥50起事件，以及根据慢性肾脏疾病流行病学协作组方程估计的肾小球滤过率（mL/min/1.73 m2）和尿白蛋白-肌酐比值（mg/g）的基线测量值。结果在所有估计的肾小球滤过率和白蛋白-肌酐比值水平下，男性的全因死亡率和心血管死亡率风险均较高。虽然在两种性别中，较高的风险与较低的估计肾小球滤过率和较高的白蛋白-肌酐比值相关，但女性全因死亡率和心血管死亡率的风险关系斜率比男性更陡。与肾小球滤过率估计值95相比，肾小球滤过率估计值45时，女性全因死亡率的校正危险比为1.32（95% CI 1.08 ~ 1.61），男性为1.22（1.00 ~ 1.48）（P相互作用<0.01）。与尿白蛋白-肌酐比值为5相比，尿白蛋白-肌酐比值为30时，女性全因死亡率的校正风险比为1.69（1.54 - 1.84），男性为1.43（1.31 - 1.57）（P <0.01）。相反，没有证据表明估计的肾小球滤过率和尿白蛋白-肌酐比值与终末期肾病风险之间存在性别差异。结论：男性和女性都面临着全因死亡率、心血管死亡率和终末期肾病的风险增加，肾小球滤过率估计值较低，白蛋白尿较高。这些发现在一个大型的全球联盟中是可靠的。
Objective To assess for the presence of a sex interaction in the associations of estimated glomerular filtration rate and albuminuria with all-cause mortality, cardiovascular mortality, and end stage renal disease. Design Random effects meta-analysis using pooled individual participant data. Setting 46 cohorts from Europe, North and South America, Asia, and Australasia. Participants 2 051 158 participants (54% women) from general population cohorts (n=1 861 052), high risk cohorts (n=151 494), and chronic kidney disease cohorts (n=38 612). Eligible cohorts (except chronic kidney disease cohorts) had at least 1000 participants, outcomes of either mortality or end stage renal disease of ≥50 events, and baseline measurements of estimated glomerular filtration rate according to the Chronic Kidney Disease Epidemiology Collaboration equation (mL/min/1.73 m2) and urinary albumin-creatinine ratio (mg/g). Results Risks of all-cause mortality and cardiovascular mortality were higher in men at all levels of estimated glomerular filtration rate and albumin-creatinine ratio. While higher risk was associated with lower estimated glomerular filtration rate and higher albumin-creatinine ratio in both sexes, the slope of the risk relationship for all-cause mortality and for cardiovascular mortality were steeper in women than in men. Compared with an estimated glomerular filtration rate of 95, the adjusted hazard ratio for all-cause mortality at estimated glomerular filtration rate 45 was 1.32 (95% CI 1.08 to 1.61) in women and 1.22 (1.00 to 1.48) in men (Pinteraction<0.01). Compared with a urinary albumin-creatinine ratio of 5, the adjusted hazard ratio for all-cause mortality at urinary albumin-creatinine ratio 30 was 1.69 (1.54 to 1.84) in women and 1.43 (1.31 to 1.57) in men (Pinteraction<0.01). Conversely, there was no evidence of a sex difference in associations of estimated glomerular filtration rate and urinary albumin-creatinine ratio with end stage renal disease risk. Conclusions Both sexes face increased risk of all-cause mortality, cardiovascular mortality, and end stage renal disease with lower estimated glomerular filtration rates and higher albuminuria. These findings were robust across a large global consortium.
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DOI：
10.1053/j.ajkd.2009.12.016
发表时间：
2010-04
期刊：
American journal of kidney diseases : the official journal of the National Kidney Foundation
影响因子：
--
作者：
Matsushita K;Selvin E;Bash LD;Astor BC;Coresh J
通讯作者：
Coresh J
影响因子：
2.8
作者：
Jassal, Simerjot Kaur;Langenberg, Claudia;Barrett-Connor, Elizabeth
通讯作者：
Barrett-Connor, Elizabeth
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：
105.7
作者：
Huxley, R;Barzi, F;Woodward, M
通讯作者：
Woodward, M
影响因子：
19.6
作者：
Levey, AS;Eckardt, KU;Eknoyan, G
通讯作者：
Eknoyan, G