Relationship of Estimated GFR and Albuminuria to Concurrent Laboratory Abnormalities: An Individual Participant Data Meta-analysis in a Global Consortium.
Aged
Albuminuria
/ epidemiology
Blood Chemical Analysis
Creatinine
/ urine
Cross-Sectional Studies
Disease Progression
Female
Global Health
Glomerular Filtration Rate
/ physiology
Humans
Hypertension, Renal
/ epidemiology
Internationality
Kidney Function Tests
Male
Middle Aged
Predictive Value of Tests
Renal Insufficiency, Chronic
/ epidemiology
Retrospective Studies
Sensitivity and Specificity
Severity of Illness Index
Urinalysis
CKD Prognosis Consortium
CKD stage
Chronic kidney disease (CKD)
albuminuria
anemia
diabetes
glomerular filtration rate (GFR)
hematocrit
hemoglobin
hyperparathyroidism
hypertension
individual-level meta-analysis
kidney function
laboratory abnormality
laboratory tests
meta-analysis
serum bicarbonate
serum calcium
serum intact parathyroid hormone
serum phosphorus
serum potassium
staging system
Journal
American journal of kidney diseases : the official journal of the National Kidney Foundation
ISSN: 1523-6838
Titre abrégé: Am J Kidney Dis
Pays: United States
ID NLM: 8110075
Informations de publication
Date de publication:
02 2019
02 2019
Historique:
received:
03
05
2018
accepted:
15
08
2018
pubmed:
24
10
2018
medline:
13
11
2019
entrez:
24
10
2018
Statut:
ppublish
Résumé
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. Cross-sectional individual participant-level analyses in a global consortium. 17 CKD and 38 general population and high-risk cohorts. 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 were obtained and analyzed between July 2015 and January 2018. 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. 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 Variations in study era, health care delivery system, typical diet, and laboratory assays. 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.
Identifiants
pubmed: 30348535
pii: S0272-6386(18)30916-8
doi: 10.1053/j.ajkd.2018.08.013
pmc: PMC6348050
mid: NIHMS1506109
pii:
doi:
Substances chimiques
Creatinine
AYI8EX34EU
Types de publication
Journal Article
Meta-Analysis
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
206-217Subventions
Organisme : NIDDK NIH HHS
ID : K23 DK067303
Pays : United States
Organisme : NINDS NIH HHS
ID : UH3 NS100605
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001079
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268200800007C
Pays : United States
Organisme : NHLBI NIH HHS
ID : N01 HC095164
Pays : United States
Organisme : NIDDK NIH HHS
ID : P30 DK079626
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700004I
Pays : United States
Organisme : NHLBI NIH HHS
ID : N01 HC095169
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700003I
Pays : United States
Organisme : NCRR NIH HHS
ID : M01 RR002719
Pays : United States
Organisme : NHLBI NIH HHS
ID : N01 HC095167
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL080295
Pays : United States
Organisme : NCRR NIH HHS
ID : P20 RR011104
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL130114
Pays : United States
Organisme : NHLBI NIH HHS
ID : N01 HC025195
Pays : United States
Organisme : NHLBI NIH HHS
ID : N01 HC095161
Pays : United States
Organisme : NHLBI NIH HHS
ID : N01 HC095166
Pays : United States
Organisme : NHLBI NIH HHS
ID : N01 HC095160
Pays : United States
Organisme : NHLBI NIH HHS
ID : N01HC55222
Pays : United States
Organisme : NHLBI NIH HHS
ID : N01HC85086
Pays : United States
Organisme : NCRR NIH HHS
ID : M01 RR000071
Pays : United States
Organisme : NCRR NIH HHS
ID : P20 RR011145
Pays : United States
Organisme : NIA NIH HHS
ID : R01 AG007181
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201200036C
Pays : United States
Organisme : NIDDK NIH HHS
ID : R01 DK031801
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700001I
Pays : United States
Organisme : NINDS NIH HHS
ID : U01 NS041588
Pays : United States
Organisme : NCRR NIH HHS
ID : M01 RR000052
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201500003I
Pays : United States
Organisme : NIDDK NIH HHS
ID : R01 DK108803
Pays : United States
Organisme : NCRR NIH HHS
ID : M01 RR000032
Pays : United States
Organisme : NHLBI NIH HHS
ID : N01 HC095165
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL080477
Pays : United States
Organisme : NHLBI NIH HHS
ID : N01HC85082
Pays : United States
Organisme : NHLBI NIH HHS
ID : N01HC85083
Pays : United States
Organisme : NHLBI NIH HHS
ID : N01 HC095168
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL165452
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR000040
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700002I
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700005I
Pays : United States
Organisme : NHLBI NIH HHS
ID : N01 HC095163
Pays : United States
Organisme : NHLBI NIH HHS
ID : N01HC85079
Pays : United States
Organisme : NIDDK NIH HHS
ID : R01 DK100446
Pays : United States
Organisme : NIA NIH HHS
ID : R01 AG023629
Pays : United States
Organisme : NHLBI NIH HHS
ID : N01 HC095162
Pays : United States
Organisme : NIA NIH HHS
ID : R01 AG028507
Pays : United States
Organisme : NCRR NIH HHS
ID : M01 RR000827
Pays : United States
Organisme : NCRR NIH HHS
ID : M01 RR000080
Pays : United States
Organisme : NHLBI NIH HHS
ID : N01HC85080
Pays : United States
Organisme : NHLBI NIH HHS
ID : N01 HC095159
Pays : United States
Organisme : NHLBI NIH HHS
ID : N01HC85081
Pays : United States
Investigateurs
Brad Astor
(B)
Larry Appel
(L)
Tom Greene
(T)
Teresa Chen
(T)
John Chalmers
(J)
Mark Woodward
(M)
Hisatomi Arima
(H)
Vlado Perkovic
(V)
Hiroshi Yatsuya
(H)
Koji Tamakoshi
(K)
Yuanying Li
(Y)
Yoshihisa Hirakawa
(Y)
Josef Coresh
(J)
Kunihiro Matsushita
(K)
Morgan Grams
(M)
Yingying Sang
(Y)
Kevan Polkinghorne
(K)
Steven Chadban
(S)
Robert Atkins
(R)
Adeera Levin
(A)
Ognjenka Djurdjev
(O)
Luxia Zhang
(L)
Lisheng Liu
(L)
Minghui Zhao
(M)
Fang Wang
(F)
Jinwei Wang
(J)
Elke Schaeffner
(E)
Natalie Ebert
(N)
Peter Martus
(P)
Adeera Levin
(A)
Ognjenka Djurdjev
(O)
Mila Tang
(M)
Gunnar Heine
(G)
Insa Emrich
(I)
Sarah Seiler
(S)
Adam Zawada
(A)
Joseph Nally
(J)
Sankar Navaneethan
(S)
Jesse Schold
(J)
Luxia Zhang
(L)
Minghui Zhao
(M)
Fang Wang
(F)
Jinwei Wang
(J)
Michael Shlipak
(M)
Mark Sarnak
(M)
Ronit Katz
(R)
Jade Hiramoto
(J)
Hiroyasu Iso
(H)
Kazumasa Yamagishi
(K)
Mitsumasa Umesawa
(M)
Isao Muraki
(I)
Masafumi Fukagawa
(M)
Shoichi Maruyama
(S)
Takayuki Hamano
(T)
Takeshi Hasegawa
(T)
Naohiko Fujii
(N)
David Wheeler
(D)
John Emberson
(J)
John Townend
(J)
Martin Landray
(M)
Hermann Brenner
(H)
Ben Schöttker
(B)
Kai-Uwe Saum
(KU)
Dietrich Rothenbacher
(D)
Caroline Fox
(C)
Shih-Jen Hwang
(SJ)
Anna Köttgen
(A)
Florian Kronenberg
(F)
Markus P Schneider
(MP)
Kai-Uwe Eckardt
(KU)
Jamie Green
(J)
H Lester Kirchner
(HL)
Alex R Chang
(AR)
Kevin Ho
(K)
Sadayoshi Ito
(S)
Mariko Miyazaki
(M)
Masaaki Nakayama
(M)
Gen Yamada
(G)
Massimo Cirillo
(M)
Fujiko Irie
(F)
Toshimi Sairenchi
(T)
Shizukiyo Ishikawa
(S)
Yuichiro Yano
(Y)
Kazuhiko Kotani
(K)
Takeshi Nakamura
(T)
Sun Ha Jee
(SH)
Heejin Kimm
(H)
Yejin Mok
(Y)
Gabriel Chodick
(G)
Varda Shalev
(V)
Jack F M Wetzels
(JFM)
Peter J Blankestijn
(PJ)
Arjan D van Zuilen
(AD)
Jan van den Brand
(J)
Mark Sarnak
(M)
Lesley Inker
(L)
Carmen Peralta
(C)
Jade Hiramoto
(J)
Ronit Katz
(R)
Mark Sarnak
(M)
Florian Kronenberg
(F)
Barbara Kollerits
(B)
Eberhard Ritz
(E)
Dorothea Nitsch
(D)
Paul Roderick
(P)
Astrid Fletcher
(A)
Erwin Bottinger
(E)
Girish N Nadkarni
(GN)
Stephen B Ellis
(SB)
Rajiv Nadukuru
(R)
Yingying Sang
(Y)
Hirotsugu Ueshima
(H)
Akira Okayama
(A)
Katsuyuki Miura
(K)
Sachiko Tanaka
(S)
Hirotsugu Ueshima
(H)
Tomonori Okamura
(T)
Katsuyuki Miura
(K)
Sachiko Tanaka
(S)
Katsuyuki Miura
(K)
Akira Okayama
(A)
Aya Kadota
(A)
Sachiko Tanaka
(S)
Timothy Kenealy
(T)
C Raina Elley
(CR)
John F Collins
(JF)
Paul L Drury
(PL)
Takayoshi Ohkubo
(T)
Kei Asayama
(K)
Hirohito Metoki
(H)
Masahiro Kikuya
(M)
Masaaki Nakayama
(M)
Robert G Nelson
(RG)
William C Knowler
(WC)
Ron T Gansevoort
(RT)
Stephan Jl Bakker
(SJ)
Eelco Hak
(E)
Hiddo J L Heerspink
(HJL)
Nigel Brunskill
(N)
Rupert Major
(R)
David Shepherd
(D)
James Medcalf
(J)
Simerjot K Jassal
(SK)
Jaclyn Bergstrom
(J)
Joachim H Ix
(JH)
Elizabeth Barrett-Connor
(E)
Csaba Kovesdy
(C)
Kamyar Kalantar-Zadeh
(K)
Keiichi Sumida
(K)
Orlando M Gutierrez
(OM)
Paul Muntner
(P)
David Warnock
(D)
William McClellan
(W)
Hiddo J L Heerspink
(HJL)
Dick de Zeeuw
(D)
Barry Brenner
(B)
Sanaz Sedaghat
(S)
M Arfan Ikram
(MA)
Ewout J Hoorn
(EJ)
Abbas Dehghan
(A)
Juan J Carrero
(JJ)
Alessandro Gasparini
(A)
Björn Wettermark
(B)
Carl-Gustaf Elinder
(CG)
Tien Yin Wong
(TY)
Charumathi Sabanayagam
(C)
Ching-Yu Cheng
(CY)
Frank L J Visseren
(FLJ)
Marie Evans
(M)
Mårten Segelmark
(M)
Maria Stendahl
(M)
Staffan Schön
(S)
Navdeep Tangri
(N)
Maneesh Sud
(M)
David Naimark
(D)
Chi-Pang Wen
(CP)
Chwen-Keng Tsao
(CK)
Min-Kugng Tsai
(MK)
Chien-Hua Chen
(CH)
Tsuneo Konta
(T)
Atsushi Hirayama
(A)
Kazunobu Ichikawa
(K)
Lars Lannfelt
(L)
Anders Larsson
(A)
Johan Ärnlöv
(J)
Henk J G Bilo
(HJG)
Gijs W D Landman
(GWD)
Kornelis J J van Hateren
(KJJ)
Nanne Kleefstra
(N)
Josef Coresh Chair
(J)
Ron T Gansevoort
(RT)
Morgan E Grams
(ME)
Stein Hallan
(S)
Csaba P Kovesdy
(CP)
Andrew S Levey
(AS)
Kunihiro Matsushita
(K)
Varda Shalev
(V)
Mark Woodward
(M)
Shoshana H Ballew
(SH)
Jingsha Chen
(J)
Josef Coresh
(J)
Morgan E Grams
(ME)
Lucia Kwak
(L)
Kunihiro Matsushita
(K)
Yingying Sang
(Y)
Aditya Surapaneni
(A)
Mark Woodward
(M)
Informations de copyright
Copyright © 2018 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
Références
JAMA. 2017 May 9;317(18):1864-1881
pubmed: 28430830
Int J Epidemiol. 2013 Dec;42(6):1660-8
pubmed: 23243116
Lancet. 2013 Jul 13;382(9887):158-69
pubmed: 23727165
JAMA. 2012 May 9;307(18):1941-51
pubmed: 22570462
World Health Organ Tech Rep Ser. 1968;405:5-37
pubmed: 4975372
Ann Intern Med. 2009 May 5;150(9):604-12
pubmed: 19414839
Kidney Int. 2004 Mar;65(3):1031-40
pubmed: 14871424
Clin J Am Soc Nephrol. 2009 Jan;4(1):186-94
pubmed: 19019998
J Am Soc Nephrol. 2011 Dec;22(12):2322-31
pubmed: 21965377
Clin Nephrol. 2013 Jul;80(1):29-39
pubmed: 23803596
Kidney Int Suppl (2011). 2017 Dec;7(3):e1
pubmed: 30681074
JAMA. 2011 Apr 20;305(15):1553-9
pubmed: 21482743
Arch Intern Med. 2002 Jun 24;162(12):1401-8
pubmed: 12076240
Am J Kidney Dis. 2014 Jul;64(1):74-85
pubmed: 24787763
Clin Chem. 2009 Jan;55(1):24-38
pubmed: 19028824
Lancet. 2017 Oct 21;390(10105):1888-1917
pubmed: 28434650
Am J Kidney Dis. 2002 Feb;39(2 Suppl 1):S1-266
pubmed: 11904577
Lancet. 2013 Jul 20;382(9888):260-72
pubmed: 23727169