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Past Decline Versus Current eGFR and Subsequent Mortality Risk.

TitlePast Decline Versus Current eGFR and Subsequent Mortality Risk.
Publication TypeJournal Article
Year of Publication2016
AuthorsNaimark DMJ, Grams ME, Matsushita K, Black C, Drion I, Fox CS, Inker LA, Ishani A, Jee SHa, Kitamura A, Lea JP, Nally J, Peralta CAlicia, Rothenbacher D, Ryu S, Tonelli M, Yatsuya H, Coresh JJ, Gansevoort RT, Warnock DG, Woodward M
Secondary Authorsde Jong PE
Corporate AuthorsCKD Prognosis Consortium
JournalJ Am Soc Nephrol
Volume27
Issue8
Pagination2456-66
Date Published2016 08
ISSN1533-3450
KeywordsAged, Cause of Death, Female, Glomerular Filtration Rate, Humans, Male, Middle Aged, Proportional Hazards Models, Renal Insufficiency, Chronic, Risk Factors, Time Factors
Abstract

A single determination of eGFR associates with subsequent mortality risk. Prior decline in eGFR indicates loss of kidney function, but the relationship to mortality risk is uncertain. We conducted an individual-level meta-analysis of the risk of mortality associated with antecedent eGFR slope, adjusting for established risk factors, including last eGFR, among 1.2 million subjects from 12 CKD and 22 other cohorts within the CKD Prognosis Consortium. Over a 3-year antecedent period, 12% of participants in the CKD cohorts and 11% in the other cohorts had an eGFR slope 5 ml/min per 1.73 m(2) per year, respectively. Compared with a slope of 0 ml/min per 1.73 m(2) per year, a slope of -6 ml/min per 1.73 m(2) per year associated with adjusted hazard ratios for all-cause mortality of 1.25 (95% confidence interval [95% CI], 1.09 to 1.44) among CKD cohorts and 1.15 (95% CI, 1.01 to 1.31) among other cohorts during a follow-up of 3.2 years. A slope of +6 ml/min per 1.73 m(2) per year also associated with higher all-cause mortality risk, with adjusted hazard ratios of 1.58 (95% CI, 1.29 to 1.95) among CKD cohorts and 1.43 (95% CI, 1.11 to 1.84) among other cohorts. Results were similar for cardiovascular and noncardiovascular causes of death and stronger for longer antecedent periods (3 versus

DOI10.1681/ASN.2015060688
Alternate JournalJ Am Soc Nephrol
PubMed ID26657865
PubMed Central IDPMC4978054
Grant ListK08 DK092287 / DK / NIDDK NIH HHS / United States
R01 DK100446 / DK / NIDDK NIH HHS / United States