Dataset Information

Change of Kidney Function Is Associated With All-Cause Mortality and Cardiovascular Diseases: Results From the Kailuan Study.

ABSTRACT: Background Current evaluation about the relationship of sequential change in estimated glomerular filtration rate ( eGFR ) and clinical outcomes are still inconsistent. We aimed to investigate the association between the change in kidney function over time and the risk of all-cause mortality and cardiovascular disease. Methods and Results This prospective cohort including 37 691 participants aged ?45 years used data from the Kailuan Health Registry. The relationship of the annual percentage and absolute change in eGFR and outcomes were analyzed with Cox proportional regression. The participants were stratified according to the quintiles distribution of the percentage annual change in eGFR (Q1-Q5). After adjusting for baseline covariates including initial eGFR , participants with annual eGFR decline were at significantly greater risk for all-cause mortality (Q1: hazard ratio, 1.22 [95% confidence interval, 1.04-1.43]; Q2: 1.19 [1.01-1.40]) than noted for patients in Q3. Cardiovascular disease risk was also significantly higher in participants with annual eGFR decline (Q1 and Q2). No significantly increased risk of adverse outcomes was noted for patients with annual eGFR increased groups (Q4 and Q5). When considering the absolute eGFR annual change rate (no/mild/rapid decline), we obtained similar results in chronic kidney disease participants, whereas non-chronic kidney disease participants had less pronounced association of eGFR decline with cardiovascular disease, though not with mortality. Conclusions A decline in eGFR over time is associated with higher risk for all-cause mortality and cardiovascular disease independent of initial eGFR and other known risk factors at baseline. Our data support the serial evaluation of change in kidney function as a better prognostic indicator than single eGFR assessments.

SUBMITTER: Guo Y

PROVIDER: S-EPMC6404220 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Change of Kidney Function Is Associated With All-Cause Mortality and Cardiovascular Diseases: Results From the Kailuan Study.

Guo Yidan Y Cui Liufu L Ye Pengpeng P Li Junjuan J Wu Shouling S Luo Yang Y

Journal of the American Heart Association 20181101 21

Background Current evaluation about the relationship of sequential change in estimated glomerular filtration rate ( eGFR ) and clinical outcomes are still inconsistent. We aimed to investigate the association between the change in kidney function over time and the risk of all-cause mortality and cardiovascular disease. Methods and Results This prospective cohort including 37 691 participants aged ≥45 years used data from the Kailuan Health Registry. The relationship of the annual percentage and ...[more]

PMID: 30608199

Similar Datasets

Project description:BACKGROUND:Anemia is thought to increase mortality risks, but the effects of high hemoglobin concentration on survival are unclear. The effect of change in hemoglobin concentrations on survival in the general population is also unknown. This study aimed to examine the effect of hemoglobin concentrations and their changes on cardiovascular and all-cause mortality risks. METHODS AND RESULTS:We retrospectively analyzed a cohort from the NHIS-HEALS (National Health Insurance Service-National Health Screening Cohort) database, including 170 078 men and 122 116 women without cardiovascular diseases, aged >40 years at baseline, with hemoglobin concentrations available for both first and second health examinations. We assessed 2 independent variables: "One-time" hemoglobin concentrations and changes in hemoglobin from first to second examination. Participants were followed up for a median of 8 years to determine mortality related to myocardial infarction, stroke, all cardiovascular diseases, and all causes. Hemoglobin concentrations showed a U- or J-shaped association with cardiovascular and all-cause mortality after adjusting for cardiovascular risk factors. When anemic men achieved normal hemoglobin concentrations, the all-cause mortality risk decreased, with an adjusted hazard ratio of 0.67 (95% confidence interval, 0.59-0.77), in comparison with those whose anemia persisted. Both increases and decreases of hemoglobin concentration outside the normal range elevated all-cause mortality risk (adjusted hazard ratio: 1.39 [95% confidence interval, 1.28-1.49] and 1.10 [95% confidence interval, 1.01-1.20], respectively), compared with persistent normal hemoglobin concentrations. The trend was similar in women but was less significant. CONCLUSIONS:Low or high hemoglobin concentrations were associated with elevated cardiovascular and all-cause mortality. Reaching and maintaining hemoglobin concentrations within the normal range correlated with decreased all-cause mortality.

Dataset Information

Change of Kidney Function Is Associated With All-Cause Mortality and Cardiovascular Diseases: Results From the Kailuan Study.

Publications

Change of Kidney Function Is Associated With All-Cause Mortality and Cardiovascular Diseases: Results From the Kailuan Study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets