Combined Association of Creatinine, Albuminuria, and Cystatin C with All-Cause Mortality and Cardiovascular and Kidney Outcomes
Combined Association of Creatinine, Albuminuria, and Cystatin C with All-Cause Mortality and Cardiovascular and Kidney Outcomes
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DOI：
10.2215/cjn.04960512
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发表时间：
2013-03-01
影响因子：
9.8
通讯作者：
Coresh, Josef
中科院分区：
文献类型：
--
作者：
Waheed, Salman;Matsushita, Kunihiro;Coresh, Josef
背景通过血清肌酐（eGFR（肌酐））估计的GFR是临床实践中肾功能的关键指标，但可能受到几个非GFR决定因素的影响，导致错误分类。结合多种肾脏标志物来预测风险是一个非常感兴趣的领域。设计，设置，参与者和测量本研究随访了9489名成年人，从第4次访问（1996-1998年）的动脉粥样硬化风险的社区研究的中位数为11.2年，并评估了联合关联的eGFR使用考克斯比例风险模型，分析尿蛋白（肌酐）、eGFR（半胱氨酸蛋白酶抑制剂）和尿白蛋白/肌酐比值（ACR）与死亡率、冠心病、心力衰竭、阿基和ESRD的关系。结果eGFR（creatinine）、eGFR（cystatin）较低以及ACR升高与所有结局的风险独立相关。eGFR（肌酐）= 60，ACR = 60 eGFR（肌酐）>= 60，ACR
Background Estimated GFR by serum creatinine (eGFR(creatinine)) is a pivotal measure of kidney function in clinical practice but can be affected by several non-GFR determinants, resulting in misclassification. Combining multiple kidney markers to predict risk is an area of substantial interest.Design, setting, participants, & measurements This study followed 9489 adults from visit 4 (1996-1998) of the Atherosclerosis Risk in Communities Study for a median of 11.2 years, and assessed joint association of eGFR(creatinine), eGFR(cystatin), and urinary albumin/creatinine ratio (ACR) with mortality, coronary heart disease, heart failure, AKI, and ESRD using Cox proportional hazards models. The predictive ability of ACR and eGFR(cystatin) beyond eGFR(creatinine) was also investigated.Results Lower eGFR(creatinine) and eGFR(cystatin) as well as elevated ACR were independently associated with risk for all outcomes. eGFR(creatinine) = 60 with ACR = 60 eGFR(creatinine) >= 60 and ACR