| Title: |
Relationship of Estimated GFR and Albuminuria to Concurrent Laboratory Abnormalities: An Individual Participant Data Meta-analysis in a Global Consortium |
| Authors: |
Inker, LA; Grams, ME; Levey, AS; Coresh, J; Cirillo, M; Collins, JF; Gansevoort, RT; Gutierrez, OM; Hamano, T; Heine, GH; Ishikawa, S; Jee, SH; Kronenberg, F; Landray, MJ; Miura, K; Nadkarni, GN; Peralta, CA; Rothenbacher, D; Schaeffner, E; Sedaghat, S; Shlipak, MG; Zhang, L; van Zuilen, AD; Hallan, S; Kovesdy, CP; Woodward, M; Levin, A; Astor, B; Appel, LJ; Greene, T; Chen, TK; Chalmers, J; Arima, H; Perkovic, V; Yatsuya, H; Tamakoshi, K; Li, Y; Hirakawa, Y; Matsushita, K; Grams, M; Sang, Y; Polldnghorne, K; Chadban, S; Atkins, R; Djurdjev, O; Liu, L; Zhao, M-H; Wang, F; Wang, J; Ebert, N; Martus, P; Tang, M; Heine, G; Emrich, I; Seiler, S; Zawada, A; Nally, J; Navaneethan, SD; Schold, JD; Zhao, M; Sarnak, MJ; Katz, R; Hiramoto, J; Iso, H; Yamagishi, K; Umesawa, M; Murald, I; Fukagawa, M; Maruyama, S; Hasegawa, T; Fujii, N; Wheeler, DC; Emberson, J; Townend, J; Landray, M; Brenner, H; Schottker, B; Saum, K-U; Fox, C; Hwang, S-J; Kottgen, A; Schneider, MP; Eckardt, K-U; Green, JA; Kirchner, HL; Chang, AR; Ho, K; Ito, S; Miyazaki, M; Nakayama, M; Yamada, G; Irie, F; Sairenchi, T; Yano, Y; Kotani, K; Nakamura, T; Kimm, H; Mok, Y; Chodick, G; Shalev, V; Wetzels, JFM; Blankestijn, PJ; van den Brand, JA; Sarnak, M; Peralta, C; Kollerits, B; Ritz, E; Nitsch, D; Roderick, P; Fletcher, A; Bottinger, E; Ellis, SB; Nadukuru, R; Ueshima, H; Okayama, A; Tanaka, S; Okamura, T; Kadota, A; Kenealy, T; Elley, CR; Drury, PL; Ohkubo, T; Asayama, K; Metold, H; Kikuya, M; Nelson, RG; Knowler, WC; Bakker, SJL; Hak, E; Heerspink, HJL; Brunskill, NJ; Major, RW; Shepherd, D; Medcalf, JF; Bernardo, R; Jassal, SK; Bergstrom, J; Ix, JH; Barrett-Connor, E; Kalantar-Zadeh, K; Sumida, K; Muntner, P; Warnock, D; McClellan, W; de Zeeuw, D; Brenner, B; Ikram, MA; Hoorn, EJ; Dehghan, A; Carrero, JJ; Gasparini, A; Wettermark, B; Elinder, C-G; Wong, TY; Sabanayagam, C; Cheng, C-Y; Sokor, RBBMA; Visseren, FLJ; Evans, M; Segelmark, M; Stendahl, M; Schon, S; Tangri, N; Sud, M; Naimark, DM; Wen, C-P; Tsao, C-K; Tsai, M-K; Chen, C-H; Konta, T; Hirayama, A; Ichikawa, K; Lannfelt, L; Larsson, A; Arnlov, J; Bilo, HJG; Landman, GWD; van Hateren, KJJ; Kleefstra, N; Ballew, SH; Chen, J; Kwak, L; Surapaneni, A |
| Source: |
American Journal of Kidney Diseases , 73 (2) pp. 206-217. (2019) |
| Publisher Information: |
W B SAUNDERS CO-ELSEVIER INC |
| Publication Year: |
2019 |
| Collection: |
University College London: UCL Discovery |
| Subject Terms: |
Science & Technology; Life Sciences & Biomedicine; Urology & Nephrology; CHRONIC KIDNEY-DISEASE; ASSOCIATION; HEALTH; COMPLICATIONS; PROGRESSION; EQUATION |
| Description: |
Rationale & Objective 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. Study Design Cross-sectional individual participant-level analyses in a global consortium. Setting & Study Populations 17 CKD and 38 general population and high-risk cohorts. Selection Criteria for Studies 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. Data Extraction Data were obtained and analyzed between July 2015 and January 2018. Analytical Approach 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. Results 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 59 mL/min/1.73 m2), 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 < 30 mg/g). Limitations Variations in study era, health care delivery system, typical diet, and laboratory assays. Conclusions Lower eGFR was strongly associated ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
text |
| Language: |
English |
| Relation: |
https://discovery.ucl.ac.uk/id/eprint/10071976/ |
| Availability: |
https://discovery.ucl.ac.uk/id/eprint/10071976/1/Wheeler%20Manuscript%20CKD-PC%204%207%20v27_AJKD%20Rv7_final%20peer%20reviewed.pdf; https://discovery.ucl.ac.uk/id/eprint/10071976/7/Wheeler%20Supplement%20CKD-PC%204%207_20180808.pdf; https://discovery.ucl.ac.uk/id/eprint/10071976/ |
| Rights: |
open |
| Accession Number: |
edsbas.FDB204A3 |
| Database: |
BASE |