AustralieFrV1, Main, Exploration, bibRecord, 002A30

Past Decline Versus Current eGFR and Subsequent ESRD Risk

Identifieur interne : 002A30 ( Main/Exploration ); précédent : 002A29; suivant : 002A31

Past Decline Versus Current eGFR and Subsequent ESRD Risk

Auteurs : Csaba P. Kovesdy [États-Unis] ; Josef Coresh [États-Unis] ; Shoshana H. Ballew [États-Unis] ; Mark Woodward [États-Unis, Royaume-Uni, Australie] ; Adeera Levin [Canada] ; David M. J. Naimark [Canada] ; Joseph Nally [États-Unis] ; Dietrich Rothenbacher [Allemagne] ; Benedicte Stengel [France] ; Kunitoshi Iseki [Japon] ; Kunihiro Matsushita [États-Unis] ; Andrew S. Levey [États-Unis]

Source :

Journal of the American Society of Nephrology : JASN [ 1046-6673 ] ; 2015.

RBID : PMC:4978053

Descripteurs français

KwdFr :
- Défaillance rénale chronique (physiopathologie), Défaillance rénale chronique (épidémiologie), Défaillance rénale chronique (étiologie), Facteurs de risque, Facteurs temps, Humains, Modèles de hasards proportionnels, Taux de filtration glomérulaire, Évolution de la maladie.
MESH :
- physiopathologie : Défaillance rénale chronique.
- épidémiologie : Défaillance rénale chronique.
- étiologie : Défaillance rénale chronique.
- Facteurs de risque, Facteurs temps, Humains, Modèles de hasards proportionnels, Taux de filtration glomérulaire, Évolution de la maladie.

English descriptors

KwdEn :
- Disease Progression, Glomerular Filtration Rate, Humans, Kidney Failure, Chronic (epidemiology), Kidney Failure, Chronic (etiology), Kidney Failure, Chronic (physiopathology), Proportional Hazards Models, Risk Factors, Time Factors.
MESH :
- epidemiology : Kidney Failure, Chronic.
- etiology : Kidney Failure, Chronic.
- physiopathology : Kidney Failure, Chronic.
- Disease Progression, Glomerular Filtration Rate, Humans, Proportional Hazards Models, Risk Factors, Time Factors.

Abstract

eGFR is a robust predictor of ESRD risk. However, the prognostic information gained from the past trajectory (slope) beyond that of the current eGFR is unclear. We examined 22 cohorts to determine the association of past slopes and current eGFR level with subsequent ESRD. We modeled hazard ratios as a spline function of slopes, adjusting for demographic variables, eGFR, and comorbidities. We used random effects meta–analyses to combine results across studies stratified by cohort type. We calculated the absolute risk of ESRD at 5 years after the last eGFR using the weighted average baseline risk. Overall, 1,080,223 participants experienced 5163 ESRD events during a mean follow-up of 2.0 years. In CKD cohorts, a slope of −6 versus 0 ml/min per 1.73 m² per year over the previous 3 years (a decline of 18 ml/min per 1.73 m² versus no decline) associated with an adjusted hazard ratio of ESRD of 2.28 (95% confidence interval, 1.88 to 2.76). In contrast, a current eGFR of 30 versus 50 ml/min per 1.73 m² (a difference of 20 ml/min per 1.73 m²) associated with an adjusted hazard ratio of 19.9 (95% confidence interval, 13.6 to 29.1). Past decline contributed more to the absolute risk of ESRD at lower than higher levels of current eGFR. In conclusion, during a follow-up of 2 years, current eGFR associates more strongly with future ESRD risk than the magnitude of past eGFR decline, but both contribute substantially to the risk of ESRD, especially at eGFR<30 ml/min per 1.73 m².

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4978053

DOI: 10.1681/ASN.2015060687
PubMed: 26657867
PubMed Central: 4978053

Affiliations:

Le document en format XML

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<author><name sortKey="Iseki, Kunitoshi" sort="Iseki, Kunitoshi" uniqKey="Iseki K" first="Kunitoshi" last="Iseki">Kunitoshi Iseki</name>
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<author><name sortKey="Matsushita, Kunihiro" sort="Matsushita, Kunihiro" uniqKey="Matsushita K" first="Kunihiro" last="Matsushita">Kunihiro Matsushita</name>
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</placeName>
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</affiliation>
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<author><name sortKey="Levey, Andrew S" sort="Levey, Andrew S" uniqKey="Levey A" first="Andrew S." last="Levey">Andrew S. Levey</name>
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<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Massachusetts</region>
</placeName>
<wicri:cityArea>Division of Nephrology, Tufts Medical Center, Boston</wicri:cityArea>
</affiliation>
</author>
</analytic>
<series><title level="j">Journal of the American Society of Nephrology : JASN</title>
<idno type="ISSN">1046-6673</idno>
<idno type="eISSN">1533-3450</idno>
<imprint><date when="2015">2015</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Disease Progression</term>
<term>Glomerular Filtration Rate</term>
<term>Humans</term>
<term>Kidney Failure, Chronic (epidemiology)</term>
<term>Kidney Failure, Chronic (etiology)</term>
<term>Kidney Failure, Chronic (physiopathology)</term>
<term>Proportional Hazards Models</term>
<term>Risk Factors</term>
<term>Time Factors</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Défaillance rénale chronique (physiopathologie)</term>
<term>Défaillance rénale chronique (épidémiologie)</term>
<term>Défaillance rénale chronique (étiologie)</term>
<term>Facteurs de risque</term>
<term>Facteurs temps</term>
<term>Humains</term>
<term>Modèles de hasards proportionnels</term>
<term>Taux de filtration glomérulaire</term>
<term>Évolution de la maladie</term>
</keywords>
<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Kidney Failure, Chronic</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Kidney Failure, Chronic</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathologie" xml:lang="fr"><term>Défaillance rénale chronique</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Kidney Failure, Chronic</term>
</keywords>
<keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Défaillance rénale chronique</term>
</keywords>
<keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Défaillance rénale chronique</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Disease Progression</term>
<term>Glomerular Filtration Rate</term>
<term>Humans</term>
<term>Proportional Hazards Models</term>
<term>Risk Factors</term>
<term>Time Factors</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Facteurs de risque</term>
<term>Facteurs temps</term>
<term>Humains</term>
<term>Modèles de hasards proportionnels</term>
<term>Taux de filtration glomérulaire</term>
<term>Évolution de la maladie</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><p>eGFR is a robust predictor of ESRD risk. However, the prognostic information gained from the past trajectory (slope) beyond that of the current eGFR is unclear. We examined 22 cohorts to determine the association of past slopes and current eGFR level with subsequent ESRD. We modeled hazard ratios as a spline function of slopes, adjusting for demographic variables, eGFR, and comorbidities. We used random effects meta–analyses to combine results across studies stratified by cohort type. We calculated the absolute risk of ESRD at 5 years after the last eGFR using the weighted average baseline risk. Overall, 1,080,223 participants experienced 5163 ESRD events during a mean follow-up of 2.0 years. In CKD cohorts, a slope of −6 versus 0 ml/min per 1.73 m<sup>2</sup>
 per year over the previous 3 years (a decline of 18 ml/min per 1.73 m<sup>2</sup>
 versus no decline) associated with an adjusted hazard ratio of ESRD of 2.28 (95% confidence interval, 1.88 to 2.76). In contrast, a current eGFR of 30 versus 50 ml/min per 1.73 m<sup>2</sup>
 (a difference of 20 ml/min per 1.73 m<sup>2</sup>
) associated with an adjusted hazard ratio of 19.9 (95% confidence interval, 13.6 to 29.1). Past decline contributed more to the absolute risk of ESRD at lower than higher levels of current eGFR. In conclusion, during a follow-up of 2 years, current eGFR associates more strongly with future ESRD risk than the magnitude of past eGFR decline, but both contribute substantially to the risk of ESRD, especially at eGFR<30 ml/min per 1.73 m<sup>2</sup>
.</p>
</div>
</front>
</TEI>
<affiliations><list><country><li>Allemagne</li>
<li>Australie</li>
<li>Canada</li>
<li>France</li>
<li>Japon</li>
<li>Royaume-Uni</li>
<li>États-Unis</li>
</country>
<region><li>Angleterre</li>
<li>Bade-Wurtemberg</li>
<li>District de Karlsruhe</li>
<li>District de Tübingen</li>
<li>Maryland</li>
<li>Massachusetts</li>
<li>Nouvelle-Galles du Sud</li>
<li>Ohio</li>
<li>Ontario</li>
<li>Oxfordshire</li>
<li>Tennessee</li>
</region>
<settlement><li>Heidelberg</li>
<li>Oxford</li>
<li>Sydney</li>
<li>Toronto</li>
<li>Ulm</li>
</settlement>
<orgName><li>Université d'Oxford</li>
<li>Université de Sydney</li>
<li>Université de Toronto</li>
</orgName>
</list>
<tree><country name="États-Unis"><region name="Tennessee"><name sortKey="Kovesdy, Csaba P" sort="Kovesdy, Csaba P" uniqKey="Kovesdy C" first="Csaba P." last="Kovesdy">Csaba P. Kovesdy</name>
</region>
<name sortKey="Ballew, Shoshana H" sort="Ballew, Shoshana H" uniqKey="Ballew S" first="Shoshana H." last="Ballew">Shoshana H. Ballew</name>
<name sortKey="Coresh, Josef" sort="Coresh, Josef" uniqKey="Coresh J" first="Josef" last="Coresh">Josef Coresh</name>
<name sortKey="Kovesdy, Csaba P" sort="Kovesdy, Csaba P" uniqKey="Kovesdy C" first="Csaba P." last="Kovesdy">Csaba P. Kovesdy</name>
<name sortKey="Levey, Andrew S" sort="Levey, Andrew S" uniqKey="Levey A" first="Andrew S." last="Levey">Andrew S. Levey</name>
<name sortKey="Matsushita, Kunihiro" sort="Matsushita, Kunihiro" uniqKey="Matsushita K" first="Kunihiro" last="Matsushita">Kunihiro Matsushita</name>
<name sortKey="Nally, Joseph" sort="Nally, Joseph" uniqKey="Nally J" first="Joseph" last="Nally">Joseph Nally</name>
<name sortKey="Woodward, Mark" sort="Woodward, Mark" uniqKey="Woodward M" first="Mark" last="Woodward">Mark Woodward</name>
</country>
<country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Woodward, Mark" sort="Woodward, Mark" uniqKey="Woodward M" first="Mark" last="Woodward">Mark Woodward</name>
</region>
</country>
<country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="Woodward, Mark" sort="Woodward, Mark" uniqKey="Woodward M" first="Mark" last="Woodward">Mark Woodward</name>
</region>
</country>
<country name="Canada"><noRegion><name sortKey="Levin, Adeera" sort="Levin, Adeera" uniqKey="Levin A" first="Adeera" last="Levin">Adeera Levin</name>
</noRegion>
<name sortKey="Naimark, David M J" sort="Naimark, David M J" uniqKey="Naimark D" first="David M. J." last="Naimark">David M. J. Naimark</name>
</country>
<country name="Allemagne"><region name="Bade-Wurtemberg"><name sortKey="Rothenbacher, Dietrich" sort="Rothenbacher, Dietrich" uniqKey="Rothenbacher D" first="Dietrich" last="Rothenbacher">Dietrich Rothenbacher</name>
</region>
<name sortKey="Rothenbacher, Dietrich" sort="Rothenbacher, Dietrich" uniqKey="Rothenbacher D" first="Dietrich" last="Rothenbacher">Dietrich Rothenbacher</name>
</country>
<country name="France"><noRegion><name sortKey="Stengel, Benedicte" sort="Stengel, Benedicte" uniqKey="Stengel B" first="Benedicte" last="Stengel">Benedicte Stengel</name>
</noRegion>
<name sortKey="Stengel, Benedicte" sort="Stengel, Benedicte" uniqKey="Stengel B" first="Benedicte" last="Stengel">Benedicte Stengel</name>
</country>
<country name="Japon"><noRegion><name sortKey="Iseki, Kunitoshi" sort="Iseki, Kunitoshi" uniqKey="Iseki K" first="Kunitoshi" last="Iseki">Kunitoshi Iseki</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>

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Serveur d'exploration sur les relations entre la France et l'Australie

Past Decline Versus Current eGFR and Subsequent ESRD Risk

Past Decline Versus Current eGFR and Subsequent ESRD Risk

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