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Associations of kidney disease measures with mortality and end-stage renal disease in individuals with and without hypertension: a meta-analysis

Summary Background Hypertension is the most prevalent comorbidity in individuals with chronic kidney disease. However, whether the association of the kidney disease measures, estimated glomerular filtration rate (eGFR) and albuminuria, with mortality or end-stage renal disease (ESRD) differs by hype... Full description

Journal Title: The Lancet (British edition) 2012, Vol.380 (9854), p.1649-1661
Main Author: Mahmoodi, Bakhtawar K, MD
Other Authors: Matsushita, Kunihiro, MD , Woodward, Mark, Prof , Blankestijn, Peter J, Prof , Cirillo, Massimo, MD , Ohkubo, Takayoshi, MD , Rossing, Peter, Prof , Sarnak, Mark J, Prof , Stengel, Bénédicte, MD , Yamagishi, Kazumasa, MD , Yamashita, Kentaro, MD , Zhang, Luxia, MD , Coresh, Josef, Prof Dr , de Jong, Paul E, Prof , Astor, Brad C, PhD
Format: Electronic Article Electronic Article
Language: English
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Quelle: Alma/SFX Local Collection
Publisher: Kidlington: Elsevier Ltd
ID: ISSN: 0140-6736
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title: Associations of kidney disease measures with mortality and end-stage renal disease in individuals with and without hypertension: a meta-analysis
format: Article
creator:
  • Mahmoodi, Bakhtawar K, MD
  • Matsushita, Kunihiro, MD
  • Woodward, Mark, Prof
  • Blankestijn, Peter J, Prof
  • Cirillo, Massimo, MD
  • Ohkubo, Takayoshi, MD
  • Rossing, Peter, Prof
  • Sarnak, Mark J, Prof
  • Stengel, Bénédicte, MD
  • Yamagishi, Kazumasa, MD
  • Yamashita, Kentaro, MD
  • Zhang, Luxia, MD
  • Coresh, Josef, Prof Dr
  • de Jong, Paul E, Prof
  • Astor, Brad C, PhD
subjects:
  • Abridged Index Medicus
  • Aged
  • Aged, 80 and over
  • Albuminuria - etiology
  • Albuminuria - physiopathology
  • Article
  • Australia
  • Biological and medical sciences
  • Blood Pressure - physiology
  • Cause of Death
  • Chronic Disease
  • Chronic kidney failure
  • Clinical Medicine
  • Complications and side effects
  • Demographic aspects
  • Epidemiology
  • Female
  • General aspects
  • Glomerular Filtration Rate - physiology
  • Humans
  • Hypertension
  • Hypertension - mortality
  • Hypertension - physiopathology
  • Hypertension - urine
  • Internal Medicine
  • Kidney diseases
  • Kidney Failure, Chronic - mortality
  • Kidney Failure, Chronic - physiopathology
  • Kidney Failure, Chronic - urine
  • Klinisk medicin
  • Male
  • Medical and Health Sciences
  • Medical sciences
  • Medicin och hälsovetenskap
  • Middle Aged
  • Mortality
  • Nephrology. Urinary tract diseases
  • Nephropathies. Renovascular diseases. Renal failure
  • Netherlands
  • Prognosis
  • Proportional Hazards Models
  • Public health. Hygiene
  • Public health. Hygiene-occupational medicine
  • Renal failure
  • Research
  • Risk Factors
  • UMCG Approved
  • United States
  • Urologi och njurmedicin
  • Urology and Nephrology
ispartof: The Lancet (British edition), 2012, Vol.380 (9854), p.1649-1661
description: Summary Background Hypertension is the most prevalent comorbidity in individuals with chronic kidney disease. However, whether the association of the kidney disease measures, estimated glomerular filtration rate (eGFR) and albuminuria, with mortality or end-stage renal disease (ESRD) differs by hypertensive status is unknown. Methods We did a meta-analysis of studies selected according to Chronic Kidney Disease Prognosis Consortium criteria. Data transfer and analyses were done between March, 2011, and June, 2012. We used Cox proportional hazards models to estimate the hazard ratios (HR) of mortality and ESRD associated with eGFR and albuminuria in individuals with and without hypertension. Findings We analysed data for 45 cohorts (25 general population, seven high-risk, and 13 chronic kidney disease) with 1 127 656 participants, 364 344 of whom had hypertension. Low eGFR and high albuminuria were associated with mortality irrespective of hypertensive status in the general population and high-risk cohorts. All-cause mortality risk was 1·1–1·2 times higher in individuals with hypertension than in those without hypertension at preserved eGFR. A steeper relative risk gradient in individuals without hypertension than in those with hypertension at eGFR range 45–75 mL/min per 1·73 m2 led to much the same mortality risk at lower eGFR. With a reference eGFR of 95 mL/min per 1·73 m2 in each group to explicitly assess interaction, adjusted HR for all-cause mortality at eGFR 45 mL/min per 1·73 m2 was 1·77 (95% CI 1·57–1·99) in individuals without hypertension versus 1·24 (1·11–1·39) in those with hypertension (p for overall interaction=0·0003). Similarly, for albumin-creatinine ratio of 300 mg/g ( vs 5 mg/g), HR was 2·30 (1·98–2·68) in individuals without hypertension versus 2·08 (1·84–2·35) in those with hypertension (p for overall interaction=0·019). We recorded much the same results for cardiovascular mortality. The associations of eGFR and albuminuria with ESRD, however, did not differ by hypertensive status. Results for chronic kidney disease cohorts were similar to those for general and high-risk population cohorts. Interpretation Chronic kidney disease should be regarded as at least an equally relevant risk factor for mortality and ESRD in individuals without hypertension as it is in those with hypertension. Funding US National Kidney Foundation.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0140-6736
fulltext: fulltext
issn:
  • 0140-6736
  • 1474-547X
  • 1474-547X
url: Link


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titleAssociations of kidney disease measures with mortality and end-stage renal disease in individuals with and without hypertension: a meta-analysis
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creatorMahmoodi, Bakhtawar K, MD ; Matsushita, Kunihiro, MD ; Woodward, Mark, Prof ; Blankestijn, Peter J, Prof ; Cirillo, Massimo, MD ; Ohkubo, Takayoshi, MD ; Rossing, Peter, Prof ; Sarnak, Mark J, Prof ; Stengel, Bénédicte, MD ; Yamagishi, Kazumasa, MD ; Yamashita, Kentaro, MD ; Zhang, Luxia, MD ; Coresh, Josef, Prof Dr ; de Jong, Paul E, Prof ; Astor, Brad C, PhD
creatorcontribMahmoodi, Bakhtawar K, MD ; Matsushita, Kunihiro, MD ; Woodward, Mark, Prof ; Blankestijn, Peter J, Prof ; Cirillo, Massimo, MD ; Ohkubo, Takayoshi, MD ; Rossing, Peter, Prof ; Sarnak, Mark J, Prof ; Stengel, Bénédicte, MD ; Yamagishi, Kazumasa, MD ; Yamashita, Kentaro, MD ; Zhang, Luxia, MD ; Coresh, Josef, Prof Dr ; de Jong, Paul E, Prof ; Astor, Brad C, PhD ; for the Chronic Kidney Disease Prognosis Consortium ; Chronic Kidney Disease Prognosis Consortium
descriptionSummary Background Hypertension is the most prevalent comorbidity in individuals with chronic kidney disease. However, whether the association of the kidney disease measures, estimated glomerular filtration rate (eGFR) and albuminuria, with mortality or end-stage renal disease (ESRD) differs by hypertensive status is unknown. Methods We did a meta-analysis of studies selected according to Chronic Kidney Disease Prognosis Consortium criteria. Data transfer and analyses were done between March, 2011, and June, 2012. We used Cox proportional hazards models to estimate the hazard ratios (HR) of mortality and ESRD associated with eGFR and albuminuria in individuals with and without hypertension. Findings We analysed data for 45 cohorts (25 general population, seven high-risk, and 13 chronic kidney disease) with 1 127 656 participants, 364 344 of whom had hypertension. Low eGFR and high albuminuria were associated with mortality irrespective of hypertensive status in the general population and high-risk cohorts. All-cause mortality risk was 1·1–1·2 times higher in individuals with hypertension than in those without hypertension at preserved eGFR. A steeper relative risk gradient in individuals without hypertension than in those with hypertension at eGFR range 45–75 mL/min per 1·73 m2 led to much the same mortality risk at lower eGFR. With a reference eGFR of 95 mL/min per 1·73 m2 in each group to explicitly assess interaction, adjusted HR for all-cause mortality at eGFR 45 mL/min per 1·73 m2 was 1·77 (95% CI 1·57–1·99) in individuals without hypertension versus 1·24 (1·11–1·39) in those with hypertension (p for overall interaction=0·0003). Similarly, for albumin-creatinine ratio of 300 mg/g ( vs 5 mg/g), HR was 2·30 (1·98–2·68) in individuals without hypertension versus 2·08 (1·84–2·35) in those with hypertension (p for overall interaction=0·019). We recorded much the same results for cardiovascular mortality. The associations of eGFR and albuminuria with ESRD, however, did not differ by hypertensive status. Results for chronic kidney disease cohorts were similar to those for general and high-risk population cohorts. Interpretation Chronic kidney disease should be regarded as at least an equally relevant risk factor for mortality and ESRD in individuals without hypertension as it is in those with hypertension. Funding US National Kidney Foundation.
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subjectAbridged Index Medicus ; Aged ; Aged, 80 and over ; Albuminuria - etiology ; Albuminuria - physiopathology ; Article ; Australia ; Biological and medical sciences ; Blood Pressure - physiology ; Cause of Death ; Chronic Disease ; Chronic kidney failure ; Clinical Medicine ; Complications and side effects ; Demographic aspects ; Epidemiology ; Female ; General aspects ; Glomerular Filtration Rate - physiology ; Humans ; Hypertension ; Hypertension - mortality ; Hypertension - physiopathology ; Hypertension - urine ; Internal Medicine ; Kidney diseases ; Kidney Failure, Chronic - mortality ; Kidney Failure, Chronic - physiopathology ; Kidney Failure, Chronic - urine ; Klinisk medicin ; Male ; Medical and Health Sciences ; Medical sciences ; Medicin och hälsovetenskap ; Middle Aged ; Mortality ; Nephrology. Urinary tract diseases ; Nephropathies. Renovascular diseases. Renal failure ; Netherlands ; Prognosis ; Proportional Hazards Models ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Renal failure ; Research ; Risk Factors ; UMCG Approved ; United States ; Urologi och njurmedicin ; Urology and Nephrology
ispartofThe Lancet (British edition), 2012, Vol.380 (9854), p.1649-1661
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1Matsushita, Kunihiro, MD
2Woodward, Mark, Prof
3Blankestijn, Peter J, Prof
4Cirillo, Massimo, MD
5Ohkubo, Takayoshi, MD
6Rossing, Peter, Prof
7Sarnak, Mark J, Prof
8Stengel, Bénédicte, MD
9Yamagishi, Kazumasa, MD
10Yamashita, Kentaro, MD
11Zhang, Luxia, MD
12Coresh, Josef, Prof Dr
13de Jong, Paul E, Prof
14Astor, Brad C, PhD
15for the Chronic Kidney Disease Prognosis Consortium
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0Associations of kidney disease measures with mortality and end-stage renal disease in individuals with and without hypertension: a meta-analysis
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descriptionSummary Background Hypertension is the most prevalent comorbidity in individuals with chronic kidney disease. However, whether the association of the kidney disease measures, estimated glomerular filtration rate (eGFR) and albuminuria, with mortality or end-stage renal disease (ESRD) differs by hypertensive status is unknown. Methods We did a meta-analysis of studies selected according to Chronic Kidney Disease Prognosis Consortium criteria. Data transfer and analyses were done between March, 2011, and June, 2012. We used Cox proportional hazards models to estimate the hazard ratios (HR) of mortality and ESRD associated with eGFR and albuminuria in individuals with and without hypertension. Findings We analysed data for 45 cohorts (25 general population, seven high-risk, and 13 chronic kidney disease) with 1 127 656 participants, 364 344 of whom had hypertension. Low eGFR and high albuminuria were associated with mortality irrespective of hypertensive status in the general population and high-risk cohorts. All-cause mortality risk was 1·1–1·2 times higher in individuals with hypertension than in those without hypertension at preserved eGFR. A steeper relative risk gradient in individuals without hypertension than in those with hypertension at eGFR range 45–75 mL/min per 1·73 m2 led to much the same mortality risk at lower eGFR. With a reference eGFR of 95 mL/min per 1·73 m2 in each group to explicitly assess interaction, adjusted HR for all-cause mortality at eGFR 45 mL/min per 1·73 m2 was 1·77 (95% CI 1·57–1·99) in individuals without hypertension versus 1·24 (1·11–1·39) in those with hypertension (p for overall interaction=0·0003). Similarly, for albumin-creatinine ratio of 300 mg/g ( vs 5 mg/g), HR was 2·30 (1·98–2·68) in individuals without hypertension versus 2·08 (1·84–2·35) in those with hypertension (p for overall interaction=0·019). We recorded much the same results for cardiovascular mortality. The associations of eGFR and albuminuria with ESRD, however, did not differ by hypertensive status. Results for chronic kidney disease cohorts were similar to those for general and high-risk population cohorts. Interpretation Chronic kidney disease should be regarded as at least an equally relevant risk factor for mortality and ESRD in individuals without hypertension as it is in those with hypertension. Funding US National Kidney Foundation.
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2Aged, 80 and over
3Albuminuria - etiology
4Albuminuria - physiopathology
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8Blood Pressure - physiology
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14Demographic aspects
15Epidemiology
16Female
17General aspects
18Glomerular Filtration Rate - physiology
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20Hypertension
21Hypertension - mortality
22Hypertension - physiopathology
23Hypertension - urine
24Internal Medicine
25Kidney diseases
26Kidney Failure, Chronic - mortality
27Kidney Failure, Chronic - physiopathology
28Kidney Failure, Chronic - urine
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30Male
31Medical and Health Sciences
32Medical sciences
33Medicin och hälsovetenskap
34Middle Aged
35Mortality
36Nephrology. Urinary tract diseases
37Nephropathies. Renovascular diseases. Renal failure
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41Public health. Hygiene
42Public health. Hygiene-occupational medicine
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44Research
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48Urologi och njurmedicin
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titleAssociations of kidney disease measures with mortality and end-stage renal disease in individuals with and without hypertension: a meta-analysis
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abstractSummary Background Hypertension is the most prevalent comorbidity in individuals with chronic kidney disease. However, whether the association of the kidney disease measures, estimated glomerular filtration rate (eGFR) and albuminuria, with mortality or end-stage renal disease (ESRD) differs by hypertensive status is unknown. Methods We did a meta-analysis of studies selected according to Chronic Kidney Disease Prognosis Consortium criteria. Data transfer and analyses were done between March, 2011, and June, 2012. We used Cox proportional hazards models to estimate the hazard ratios (HR) of mortality and ESRD associated with eGFR and albuminuria in individuals with and without hypertension. Findings We analysed data for 45 cohorts (25 general population, seven high-risk, and 13 chronic kidney disease) with 1 127 656 participants, 364 344 of whom had hypertension. Low eGFR and high albuminuria were associated with mortality irrespective of hypertensive status in the general population and high-risk cohorts. All-cause mortality risk was 1·1–1·2 times higher in individuals with hypertension than in those without hypertension at preserved eGFR. A steeper relative risk gradient in individuals without hypertension than in those with hypertension at eGFR range 45–75 mL/min per 1·73 m2 led to much the same mortality risk at lower eGFR. With a reference eGFR of 95 mL/min per 1·73 m2 in each group to explicitly assess interaction, adjusted HR for all-cause mortality at eGFR 45 mL/min per 1·73 m2 was 1·77 (95% CI 1·57–1·99) in individuals without hypertension versus 1·24 (1·11–1·39) in those with hypertension (p for overall interaction=0·0003). Similarly, for albumin-creatinine ratio of 300 mg/g ( vs 5 mg/g), HR was 2·30 (1·98–2·68) in individuals without hypertension versus 2·08 (1·84–2·35) in those with hypertension (p for overall interaction=0·019). We recorded much the same results for cardiovascular mortality. The associations of eGFR and albuminuria with ESRD, however, did not differ by hypertensive status. Results for chronic kidney disease cohorts were similar to those for general and high-risk population cohorts. Interpretation Chronic kidney disease should be regarded as at least an equally relevant risk factor for mortality and ESRD in individuals without hypertension as it is in those with hypertension. Funding US National Kidney Foundation.
copKidlington
pubElsevier Ltd
pmid23013600
doi10.1016/S0140-6736(12)61272-0
oafree_for_read