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Relationship of Estimated GFR and Albuminuria to Concurrent Laboratory Abnormalities: An Individual Participant Data Meta-analysis in a Global Consortium.
Wednesday,2019-01-09 12:51 America/Los_Angeles — ecterry
| Title | Relationship of Estimated GFR and Albuminuria to Concurrent Laboratory Abnormalities: An Individual Participant Data Meta-analysis in a Global Consortium. |
| Publication Type | Journal Article |
| Year of Publication | 2018 |
| Authors | Inker, LA, Grams, ME, Levey, AS, Coresh, J, Cirillo, M, Collins, JF, Gansevoort, RT, Gutierrez, OM, Hamano, T, Heine, GH, Ishikawa, S, Jee, SHa, Kronenberg, F, Landray, MJ, Miura, K, Nadkarni, GN, Peralta, CA, Rothenbacher, D, Schaeffner, E, Sedaghat, S, Shlipak, MG, Zhang, L, van Zuilen, AD, Hallan, SI, Kovesdy, CP, Woodward, M, Levin, A |
| Corporate/Institutional Authors | CKD Prognosis Consortium |
| Journal | Am J Kidney Dis |
| Date Published | 2018 Oct 19 |
| ISSN | 1523-6838 |
| Abstract | <p><b>RATIONALE & OBJECTIVE: </b>Chronic kidney disease (CKD) is complicated by abnormalities that reflect disruption in filtration, tubular, and endocrine functions of the kidney. Our aim was to explore the relationship of specific laboratory result abnormalities and hypertension with the estimated glomerular filtration rate (eGFR) and albuminuria CKD staging framework.</p><p><b>STUDY DESIGN: </b>Cross-sectional individual participant-level analyses in a global consortium.</p><p><b>SETTING & STUDY POPULATIONS: </b>17 CKD and 38 general population and high-risk cohorts.</p><p><b>SELECTION CRITERIA FOR STUDIES: </b>Cohorts in the CKD Prognosis Consortium with data for eGFR and albuminuria, as well as a measurement of hemoglobin, bicarbonate, phosphorus, parathyroid hormone, potassium, or calcium, or hypertension.</p><p><b>DATA EXTRACTION: </b>Data were obtained and analyzed between July 2015 and January 2018.</p><p><b>ANALYTICAL APPROACH: </b>We modeled the association of eGFR and albuminuria with hemoglobin, bicarbonate, phosphorus, parathyroid hormone, potassium, and calcium values using linear regression and with hypertension and categorical definitions of each abnormality using logistic regression. Results were pooled using random-effects meta-analyses.</p><p><b>RESULTS: </b>The CKD cohorts (n=254,666 participants) were 27% women and 10% black, with a mean age of 69 (SD, 12) years. The general population/high-risk cohorts (n=1,758,334) were 50% women and 2% black, with a mean age of 50 (16) years. There was a strong graded association between lower eGFR and all laboratory result abnormalities (ORs ranging from 3.27 [95% CI, 2.68-3.97] to 8.91 [95% CI, 7.22-10.99] comparing eGFRs of 15 to 29 with eGFRs of 45 to 59mL/min/1.73m), whereas albuminuria had equivocal or weak associations with abnormalities (ORs ranging from 0.77 [95% CI, 0.60-0.99] to 1.92 [95% CI, 1.65-2.24] comparing urinary albumin-creatinine ratio > 300 vs < 30mg/g).</p><p><b>LIMITATIONS: </b>Variations in study era, health care delivery system, typical diet, and laboratory assays.</p><p><b>CONCLUSIONS: </b>Lower eGFR was strongly associated with higher odds of multiple laboratory result abnormalities. Knowledge of risk associations might help guide management in the heterogeneous group of patients with CKD.</p> |
| DOI | 10.1053/j.ajkd.2018.08.013 |
| Alternate Journal | Am. J. Kidney Dis. |
| PubMed ID | 30348535 |
| Grant List | N01 HC095166 / HC / WHI NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States UL1 TR001079 / TR / NCATS NIH HHS / United States P20 RR011104 / RR / NCRR NIH HHS / United States N01 HC095164 / HC / WHI NIH HHS / United States U01 HL130114 / HL / NHLBI NIH HHS / United States N01 HC095160 / HC / WHI NIH HHS / United States P20 RR011145 / RR / NCRR NIH HHS / United States R01 AG007181 / AG / NIA NIH HHS / United States R01 DK031801 / DK / NIDDK NIH HHS / United States HHSN268201700001I / HL / NHLBI NIH HHS / United States HHSN268201700004I / HL / NHLBI NIH HHS / United States U01 NS041588 / NS / NINDS NIH HHS / United States N01 HC095165 / HC / WHI NIH HHS / United States N01 HC095161 / HC / WHI NIH HHS / United States R01 HL080477 / HL / NHLBI NIH HHS / United States UL1 TR000040 / TR / NCATS NIH HHS / United States HHSN268201700002I / HL / NHLBI NIH HHS / United States HHSN268201700005I / HL / NHLBI NIH HHS / United States R01 DK100446 / DK / NIDDK NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States R01 AG028507 / AG / NIA NIH HHS / United States M01 RR000827 / RR / NCRR NIH HHS / United States M01 RR000080 / RR / NCRR NIH HHS / United States HHSN268201700003I / HL / NHLBI NIH HHS / United States N01 HC025195 / HC / WHI NIH HHS / United States N01 HC095163 / HC / WHI NIH HHS / United States N01 HC095159 / HC / WHI NIH HHS / United States |
ePub date:
18/10