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

Summary Background Chronic kidney disease is characterised by low estimated glomerular filtration rate (eGFR) and high albuminuria, and is associated with adverse outcomes. Whether these risks are modified by diabetes is unknown. Methods We did a meta-analysis of studies selected according to Chroni... Full description

Journal Title: The Lancet (British edition) 2012, Vol.380 (9854), p.1662-1673
Main Author: Fox, Caroline S, MD
Other Authors: Matsushita, Kunihiro, MD , Woodward, Mark, Prof , Bilo, Henk JG, Prof , Chalmers, John, Prof , Heerspink, Hiddo J Lambers, PharmD , Lee, Brian J, MD , Perkins, Robert M, MD , Rossing, Peter, Prof , Sairenchi, Toshimi, PhD , Tonelli, Marcello, Prof , Vassalotti, Joseph A, MD , Yamagishi, Kazumasa, MD , Coresh, Josef, Prof , de Jong, Paul E, Prof , Wen, Chi-Pang, MD , Nelson, Robert G, MD
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 diabetes: a meta-analysis
format: Article
creator:
  • Fox, Caroline S, MD
  • Matsushita, Kunihiro, MD
  • Woodward, Mark, Prof
  • Bilo, Henk JG, Prof
  • Chalmers, John, Prof
  • Heerspink, Hiddo J Lambers, PharmD
  • Lee, Brian J, MD
  • Perkins, Robert M, MD
  • Rossing, Peter, Prof
  • Sairenchi, Toshimi, PhD
  • Tonelli, Marcello, Prof
  • Vassalotti, Joseph A, MD
  • Yamagishi, Kazumasa, MD
  • Coresh, Josef, Prof
  • de Jong, Paul E, Prof
  • Wen, Chi-Pang, MD
  • Nelson, Robert G, MD
subjects:
  • Abridged Index Medicus
  • Aged
  • Albuminuria - mortality
  • Albuminuria - physiopathology
  • Article
  • Australia
  • Biological and medical sciences
  • Cardiovascular Diseases - mortality
  • Cause of Death
  • Chronic kidney failure
  • Clinical Medicine
  • Complications and side effects
  • Demographic aspects
  • Diabetic Nephropathies - mortality
  • Diabetic Nephropathies - physiopathology
  • Diabetic Nephropathies - urine
  • Epidemiology
  • Female
  • General aspects
  • Glomerular Filtration Rate - physiology
  • Humans
  • Hypertension
  • 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
  • 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.1662-1673
description: Summary Background Chronic kidney disease is characterised by low estimated glomerular filtration rate (eGFR) and high albuminuria, and is associated with adverse outcomes. Whether these risks are modified by diabetes 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 end-stage renal disease (ESRD) associated with eGFR and albuminuria in individuals with and without diabetes. Findings We analysed data for 1 024 977 participants (128 505 with diabetes) from 30 general population and high-risk cardiovascular cohorts and 13 chronic kidney disease cohorts. In the combined general population and high-risk cohorts with data for all-cause mortality, 75 306 deaths occurred during a mean follow-up of 8·5 years (SD 5·0). In the 23 studies with data for cardiovascular mortality, 21 237 deaths occurred from cardiovascular disease during a mean follow-up of 9·2 years (SD 4·9). In the general and high-risk cohorts, mortality risks were 1·2–1·9 times higher for participants with diabetes than for those without diabetes across the ranges of eGFR and albumin-to-creatinine ratio (ACR). With fixed eGFR and ACR reference points in the diabetes and no diabetes groups, HR of mortality outcomes according to lower eGFR and higher ACR were much the same in participants with and without diabetes (eg, for all-cause mortality at eGFR 45 mL/min per 1·73 m2 [ vs 95 mL/min per 1·73 m2 ], HR 1·35; 95% CI 1·18–1·55; vs 1·33; 1·19–1·48 and at ACR 30 mg/g [ vs 5 mg/g], 1·50; 1·35–1·65 vs 1·52; 1·38–1·67). The overall interactions were not significant. We identified much the same findings for ESRD in the chronic kidney disease cohorts. Interpretation Despite higher risks for mortality and ESRD in diabetes, the relative risks of these outcomes by eGFR and ACR are much the same irrespective of the presence or absence of diabetes, emphasising the importance of kidney disease as a predictor of clinical outcomes. 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 diabetes: a meta-analysis
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creatorFox, Caroline S, MD ; Matsushita, Kunihiro, MD ; Woodward, Mark, Prof ; Bilo, Henk JG, Prof ; Chalmers, John, Prof ; Heerspink, Hiddo J Lambers, PharmD ; Lee, Brian J, MD ; Perkins, Robert M, MD ; Rossing, Peter, Prof ; Sairenchi, Toshimi, PhD ; Tonelli, Marcello, Prof ; Vassalotti, Joseph A, MD ; Yamagishi, Kazumasa, MD ; Coresh, Josef, Prof ; de Jong, Paul E, Prof ; Wen, Chi-Pang, MD ; Nelson, Robert G, MD
creatorcontribFox, Caroline S, MD ; Matsushita, Kunihiro, MD ; Woodward, Mark, Prof ; Bilo, Henk JG, Prof ; Chalmers, John, Prof ; Heerspink, Hiddo J Lambers, PharmD ; Lee, Brian J, MD ; Perkins, Robert M, MD ; Rossing, Peter, Prof ; Sairenchi, Toshimi, PhD ; Tonelli, Marcello, Prof ; Vassalotti, Joseph A, MD ; Yamagishi, Kazumasa, MD ; Coresh, Josef, Prof ; de Jong, Paul E, Prof ; Wen, Chi-Pang, MD ; Nelson, Robert G, MD ; for the Chronic Kidney Disease Prognosis Consortium ; Chronic Kidney Disease Prognosis Consortium
descriptionSummary Background Chronic kidney disease is characterised by low estimated glomerular filtration rate (eGFR) and high albuminuria, and is associated with adverse outcomes. Whether these risks are modified by diabetes 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 end-stage renal disease (ESRD) associated with eGFR and albuminuria in individuals with and without diabetes. Findings We analysed data for 1 024 977 participants (128 505 with diabetes) from 30 general population and high-risk cardiovascular cohorts and 13 chronic kidney disease cohorts. In the combined general population and high-risk cohorts with data for all-cause mortality, 75 306 deaths occurred during a mean follow-up of 8·5 years (SD 5·0). In the 23 studies with data for cardiovascular mortality, 21 237 deaths occurred from cardiovascular disease during a mean follow-up of 9·2 years (SD 4·9). In the general and high-risk cohorts, mortality risks were 1·2–1·9 times higher for participants with diabetes than for those without diabetes across the ranges of eGFR and albumin-to-creatinine ratio (ACR). With fixed eGFR and ACR reference points in the diabetes and no diabetes groups, HR of mortality outcomes according to lower eGFR and higher ACR were much the same in participants with and without diabetes (eg, for all-cause mortality at eGFR 45 mL/min per 1·73 m2 [ vs 95 mL/min per 1·73 m2 ], HR 1·35; 95% CI 1·18–1·55; vs 1·33; 1·19–1·48 and at ACR 30 mg/g [ vs 5 mg/g], 1·50; 1·35–1·65 vs 1·52; 1·38–1·67). The overall interactions were not significant. We identified much the same findings for ESRD in the chronic kidney disease cohorts. Interpretation Despite higher risks for mortality and ESRD in diabetes, the relative risks of these outcomes by eGFR and ACR are much the same irrespective of the presence or absence of diabetes, emphasising the importance of kidney disease as a predictor of clinical outcomes. Funding US National Kidney Foundation.
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subjectAbridged Index Medicus ; Aged ; Albuminuria - mortality ; Albuminuria - physiopathology ; Article ; Australia ; Biological and medical sciences ; Cardiovascular Diseases - mortality ; Cause of Death ; Chronic kidney failure ; Clinical Medicine ; Complications and side effects ; Demographic aspects ; Diabetic Nephropathies - mortality ; Diabetic Nephropathies - physiopathology ; Diabetic Nephropathies - urine ; Epidemiology ; Female ; General aspects ; Glomerular Filtration Rate - physiology ; Humans ; Hypertension ; 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 ; 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.1662-1673
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1Matsushita, Kunihiro, MD
2Woodward, Mark, Prof
3Bilo, Henk JG, Prof
4Chalmers, John, Prof
5Heerspink, Hiddo J Lambers, PharmD
6Lee, Brian J, MD
7Perkins, Robert M, MD
8Rossing, Peter, Prof
9Sairenchi, Toshimi, PhD
10Tonelli, Marcello, Prof
11Vassalotti, Joseph A, MD
12Yamagishi, Kazumasa, MD
13Coresh, Josef, Prof
14de Jong, Paul E, Prof
15Wen, Chi-Pang, MD
16Nelson, Robert G, MD
17for the Chronic Kidney Disease Prognosis Consortium
18Chronic 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 diabetes: a meta-analysis
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descriptionSummary Background Chronic kidney disease is characterised by low estimated glomerular filtration rate (eGFR) and high albuminuria, and is associated with adverse outcomes. Whether these risks are modified by diabetes 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 end-stage renal disease (ESRD) associated with eGFR and albuminuria in individuals with and without diabetes. Findings We analysed data for 1 024 977 participants (128 505 with diabetes) from 30 general population and high-risk cardiovascular cohorts and 13 chronic kidney disease cohorts. In the combined general population and high-risk cohorts with data for all-cause mortality, 75 306 deaths occurred during a mean follow-up of 8·5 years (SD 5·0). In the 23 studies with data for cardiovascular mortality, 21 237 deaths occurred from cardiovascular disease during a mean follow-up of 9·2 years (SD 4·9). In the general and high-risk cohorts, mortality risks were 1·2–1·9 times higher for participants with diabetes than for those without diabetes across the ranges of eGFR and albumin-to-creatinine ratio (ACR). With fixed eGFR and ACR reference points in the diabetes and no diabetes groups, HR of mortality outcomes according to lower eGFR and higher ACR were much the same in participants with and without diabetes (eg, for all-cause mortality at eGFR 45 mL/min per 1·73 m2 [ vs 95 mL/min per 1·73 m2 ], HR 1·35; 95% CI 1·18–1·55; vs 1·33; 1·19–1·48 and at ACR 30 mg/g [ vs 5 mg/g], 1·50; 1·35–1·65 vs 1·52; 1·38–1·67). The overall interactions were not significant. We identified much the same findings for ESRD in the chronic kidney disease cohorts. Interpretation Despite higher risks for mortality and ESRD in diabetes, the relative risks of these outcomes by eGFR and ACR are much the same irrespective of the presence or absence of diabetes, emphasising the importance of kidney disease as a predictor of clinical outcomes. Funding US National Kidney Foundation.
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0Abridged Index Medicus
1Aged
2Albuminuria - mortality
3Albuminuria - physiopathology
4Article
5Australia
6Biological and medical sciences
7Cardiovascular Diseases - mortality
8Cause of Death
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12Demographic aspects
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14Diabetic Nephropathies - physiopathology
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17Female
18General aspects
19Glomerular Filtration Rate - physiology
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21Hypertension
22Internal Medicine
23Kidney diseases
24Kidney Failure, Chronic - mortality
25Kidney Failure, Chronic - physiopathology
26Kidney Failure, Chronic - urine
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29Medical and Health Sciences
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31Medicin och hälsovetenskap
32Middle Aged
33Mortality
34Nephrology. Urinary tract diseases
35Nephropathies. Renovascular diseases. Renal failure
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37Prognosis
38Public health. Hygiene
39Public health. Hygiene-occupational medicine
40Renal failure
41Research
42Risk Factors
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45Urologi och njurmedicin
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titleAssociations of kidney disease measures with mortality and end-stage renal disease in individuals with and without diabetes: a meta-analysis
authorFox, Caroline S, MD ; Matsushita, Kunihiro, MD ; Woodward, Mark, Prof ; Bilo, Henk JG, Prof ; Chalmers, John, Prof ; Heerspink, Hiddo J Lambers, PharmD ; Lee, Brian J, MD ; Perkins, Robert M, MD ; Rossing, Peter, Prof ; Sairenchi, Toshimi, PhD ; Tonelli, Marcello, Prof ; Vassalotti, Joseph A, MD ; Yamagishi, Kazumasa, MD ; Coresh, Josef, Prof ; de Jong, Paul E, Prof ; Wen, Chi-Pang, MD ; Nelson, Robert G, MD
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8Cause of Death
9Chronic kidney failure
10Clinical Medicine
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13Diabetic Nephropathies - mortality
14Diabetic Nephropathies - physiopathology
15Diabetic Nephropathies - urine
16Epidemiology
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45Urologi och njurmedicin
46Urology and Nephrology
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eissn1474-547X
codenLANCAO
abstractSummary Background Chronic kidney disease is characterised by low estimated glomerular filtration rate (eGFR) and high albuminuria, and is associated with adverse outcomes. Whether these risks are modified by diabetes 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 end-stage renal disease (ESRD) associated with eGFR and albuminuria in individuals with and without diabetes. Findings We analysed data for 1 024 977 participants (128 505 with diabetes) from 30 general population and high-risk cardiovascular cohorts and 13 chronic kidney disease cohorts. In the combined general population and high-risk cohorts with data for all-cause mortality, 75 306 deaths occurred during a mean follow-up of 8·5 years (SD 5·0). In the 23 studies with data for cardiovascular mortality, 21 237 deaths occurred from cardiovascular disease during a mean follow-up of 9·2 years (SD 4·9). In the general and high-risk cohorts, mortality risks were 1·2–1·9 times higher for participants with diabetes than for those without diabetes across the ranges of eGFR and albumin-to-creatinine ratio (ACR). With fixed eGFR and ACR reference points in the diabetes and no diabetes groups, HR of mortality outcomes according to lower eGFR and higher ACR were much the same in participants with and without diabetes (eg, for all-cause mortality at eGFR 45 mL/min per 1·73 m2 [ vs 95 mL/min per 1·73 m2 ], HR 1·35; 95% CI 1·18–1·55; vs 1·33; 1·19–1·48 and at ACR 30 mg/g [ vs 5 mg/g], 1·50; 1·35–1·65 vs 1·52; 1·38–1·67). The overall interactions were not significant. We identified much the same findings for ESRD in the chronic kidney disease cohorts. Interpretation Despite higher risks for mortality and ESRD in diabetes, the relative risks of these outcomes by eGFR and ACR are much the same irrespective of the presence or absence of diabetes, emphasising the importance of kidney disease as a predictor of clinical outcomes. Funding US National Kidney Foundation.
copKidlington
pubElsevier Ltd
pmid23013602
doi10.1016/S0140-6736(12)61350-6
oafree_for_read