Incident chronic kidney disease and the rate of kidney function decline in individuals with hypertension.
Incident chronic kidney disease and the rate of kidney function decline in individuals with hypertension.
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DOI：
10.1093/ndt/gfp534
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发表时间：
2010-03
期刊：
影响因子：
--
通讯作者：
Havranek EP
中科院分区：
文献类型：
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作者：
Hanratty R;Chonchol M;Miriam Dickinson L;Beaty BL;Estacio RO;Mackenzie TD;Hurley LP;Linas SL;Steiner JF;Havranek EP
背景。对于肾功能正常的患者在基线时的肾功能下降情况了解甚少。我们的目标是：(1)确定慢性肾脏疾病（CKD）发生的预测因素；(2)估计肾功能下降的速度。方法。该研究使用了科罗拉多州丹佛市内城卫生保健系统高血压登记处的成年患者的回顾性队列。主要结局是CKD的发生，次要结局是肾小球滤过率（eGFR）随时间的变化率。结果。平均随访45个月后，10420例高血压患者中有429例（4.1%）发展为CKD。在多变量模型中，独立预测CKD发生的因素是基线年龄[比值比（OR） 1.13 / 10年，95%可信区间（CI） 1.03-1.24]、基线eGFR （OR 0.69 / 10单位，95% CI 0.65-0.73）、糖尿病（OR 3.66, 95% CI 2.97-4.51）和血管疾病（OR 1.67, 95% CI 1.32-2.10）。我们没有发现年龄、性别或种族/民族与eGFR斜率之间的独立关联。在没有糖尿病或血管疾病的患者中，eGFR以每年1.5 mL/min/1.73 m2的速度下降。基线时糖尿病与1.38 mL/min/1.73 m2的额外下降相关。结论。糖尿病是CKD和eGFR斜率的最强预测因子。在这个队列中，CKD的发生率或肾功能下降的发生率没有种族或民族的差异。
Background. Little is known about the decline of kidney function in patients with normal kidney function at baseline. Our objectives were to (i) identify predictors of incident chronic kidney disease (CKD) and (ii) to estimate rate of decline in kidney function. Methods. The study used a retrospective cohort of adult patients in a hypertension registry in an inner-city health care delivery system in Denver, Colorado. The primary outcome was development of incident CKD, and the secondary outcome was rate of change of estimated glomerular filtration rate (eGFR) over time. Results. After a mean follow-up of 45 months, 429 (4.1%) of 10 420 patients with hypertension developed CKD. In multivariate models, factors that independently predicted incident CKD were baseline age [odds ratio (OR) 1.13 per 10 years, 95% confidence interval (CI), 1.03–1.24], baseline eGFR (OR 0.69 per 10 units, 95% CI 0.65–0.73), diabetes (OR 3.66, 95% CI 2.97–4.51) and vascular disease (OR 1.67, 95% CI 1.32–2.10). We found no independent association between age, gender or race/ethnicity and eGFR slope. In patients who did not have diabetes or vascular disease, eGFR declined at 1.5 mL/min/1.73 m2 per year. Diabetes at baseline was associated with an additional decline of 1.38 mL/min/1.73 m2. Conclusions. Diabetes was the strongest predictor of both incident CKD as well as eGFR slope. Rates of incident CKD or in decline of kidney function did not differ by race or ethnicity in this cohort.
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影响因子：
--
作者：
Coresh, J;Wei, L;Klag, MJ
通讯作者：
Klag, MJ
影响因子：
13.6
作者：
Peralta, Carmen A.;Shlipak, Michael G.;Go, Alan S.
通讯作者：
Go, Alan S.
影响因子：
13.2
作者：
Coresh, J;Astor, BC;Levey, AS
通讯作者：
Levey, AS
DOI：
10.1097/01.asn.0000091586.46532.b4
发表时间：
2003-11-01
影响因子：
13.6
作者：
Hsu, CY;Lin, F;Shlipak, MG
通讯作者：
Shlipak, MG
影响因子：
120.7
作者：
Coresh, Josef;Selvin, Elizabeth;Levey, Andrew S.
通讯作者：
Levey, Andrew S.