scholarly journals High estimated glomerular filtration rate is associated with increased risk of death

2008 ◽  
Vol 4 (12) ◽  
pp. 644-644
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Risk Of Death ◽  
Increased Risk

scholarly journals Association of Lipoprotein(a)-Associated Mortality and the Estimated Glomerular Filtration Rate Level in Patients Undergoing Coronary Angiography: A 51,500 Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Zhidong Huang ◽  
Yanfang Yang ◽  
Jin Lu ◽  
Jingjing Liang ◽  
Yibo He ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Coronary Angiography ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Lipoprotein A ◽  
Adjusted Risk ◽  
Risk Of Death ◽  
Increased Risk ◽  
All Cause Mortality

Background: High lipoprotein(a) is associated with poor prognosis in patients at high risk for cardiovascular disease. Renal function based on the estimated glomerular filtration rate (eGFR) is a potential risk factor for the change of lipoprotein(a). However, the regulatory effect of eGFR stratification on lipoprotein(a)-associated mortality has not been adequately addressed.Methods: 51,500 patients who underwent coronary angiography (CAG) or percutaneous coronary intervention (PCI) were included from the Cardiorenal ImprovemeNt (CIN) study (ClinicalTrials.gov NCT04407936). These patients were grouped according to lipoprotein(a) quartiles (Q1–Q4) stratified by eGFR categories (<60 and ≥60 mL/min/1.73m2). Cox regression models were used to estimate hazard ratios (HR) for mortality across combined eGFR and lipoprotein(a) categories.Results: The mean age of the study population was 62.3 ± 10.6 years, 31.3% were female (n = 16,112). During a median follow-up of 5.0 years (interquartile range: 3.0–7.6 years), 13.0% (n = 6,695) of patients died. Compared with lipoprotein(a) Q1, lipoprotein(a) Q2–Q4 was associated with 10% increased adjusted risk of death in all patients (HR: 1.10 [95% CI: 1.03–1.17]), and was strongly associated with about 23% increased adjusted risk of death in patients with eGFR <60 mL/min/1.73m2 (HR: 1.23 [95% CI: 1.08–1.39]), while such association was not significant in patients with eGFR ≥60 mL/min/1.73m2 (HR: 1.05 [95% CI: 0.97–1.13]). P for interaction between lipoprotein(a) (Q1 vs. Q2–Q4) and eGFR (≥60 vs. eGFR <60 mL/min/1.73m2) on all-cause mortality was 0.019.Conclusions: Elevated lipoprotein(a) was associated with increased risk of all-cause mortality and such an association was modified by the baseline eGFR in CAG patients. More attention should be paid to the patients with reduced eGFR and elevated lipoprotein(a), and the appropriate lipoprotein(a) intervention is required.

scholarly journals Series: Cardiovascular outcome trials for diabetes drugs Saxagliptin and SAVOR-TIMI 53

2019 ◽  
Vol 19 (1) ◽  
pp. 34-36
Author(s):  
Miles Fisher
Keyword(s):  
Heart Failure ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Cardiovascular Outcome ◽  
Dipeptidyl Peptidase 4 ◽  
Cardiovascular Outcome Trials ◽  
Increased Risk ◽  
Cardiovascular Outcome Trial

SAVOR-TIMI 53 was the first FDA-mandated cardiovascular outcome trial to be presented and published. It compared saxagliptin and placebo in 16,492 patients with type 2 diabetes. SAVOR-TIMI 53 demonstrated non-inferiority for major cardiovascular events (cardiovascular death, myocardial infarction, stroke) but not superiority. An unexpected statistically significant increase in adjudicated hospitalisation for heart failure was seen in the saxagliptin group. Post hoc analysis demonstrated that subjects at greatest risk for hospitalisation for heart failure had previous heart failure, an estimated glomerular filtration rate <60 mL/min, or elevated baseline levels of N-terminal pro-B type natriuretic peptide. As other dipeptidyl peptidase 4 (DPP-4) inhibitors are available which have not been associated with an increased risk of hospitalisation for heart failure, saxagliptin should be avoided in patients with heart failure or a reduced estimated glomerular filtration rate.

scholarly journals Association of the Reproductive Period with Decreased Estimated Glomerular Filtration Rate in Menopausal Women: A Study from the Shanghai Suburban Adult Cohort and Biobank (2016–2020)

2021 ◽  
Vol 18 (19) ◽  
pp. 10451
Author(s):  
Yuting Yu ◽  
Qi Zhao ◽  
Yonggen Jiang ◽  
Na Wang ◽  
Xing Liu ◽  
...  
Keyword(s):  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Lower Risk ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Reproductive Period ◽  
Increased Risk ◽  
Menopausal Women ◽  
Metabolic Equivalent Of Task

In previous studies, it has been documented that a short reproductive period is associated with a higher risk of diabetes, cardiovascular disease, and chronic kidney disease. This study aims to investigate the association of the reproductive period length with decreased renal function. This study obtained data from “the Shanghai Suburban Adult Cohort and Biobank”. An estimated glomerular filtration rate (eGFR) below 60 mL/min/1.73 m2 indicated decreased renal function during follow-up. Participants were grouped into quintiles by reproductive period. Logistic regression analysis was performed to examine the association between the reproductive period and decreased renal function. A total of 5503 menopausal women with baseline eGFR > 60 mL/min/1.73 m2 were included. Age, eGFR, and metabolic equivalent of task (MET) at baseline were 61.0 (range, 36.0–74.0) years, 92.2 (range, 60.1–194.5) mL/min/1.73 m2, and 1386 (range, 160–6678), respectively. A reproductive period of 37–45 years was associated with a lower risk of decreased eGFR (OR: 0.59, 95% CI: 0.35–1.00, p = 0.049) after adjusting for confounding variables. METs decreased the risk of decreased eGFR in women with a reproductive period of 37–45 years (OR: 0.43, 95% CI: 0.23–0.81, p = 0.010). Women with a longer reproductive period have a lower risk of decreased renal function. METs had an opposite influence on renal function in women with longer (decreased risk) or shorter (increased risk) reproductive periods.

Prognostic Significance of Estimated Glomerular Filtration Rate and Cystatin C in Patients with Acute Intracerebral Hemorrhage

2016 ◽  
Vol 42 (5-6) ◽  
pp. 455-463 ◽  
Author(s):  
Shoujiang You ◽  
Luyao Shi ◽  
Chongke Zhong ◽  
Jiaping Xu ◽  
Qiao Han ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Intracerebral Hemorrhage ◽  
Functional Outcome ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Poor Functional Outcome ◽  
Increased Risk ◽  
All Cause Mortality

Background: The effects of the estimated glomerular filtration rate (eGFR) and cystatin C on clinical outcomes on intracerebral hemorrhage (ICH) remain unclear. We investigated the associations of eGFR and cystatin C with 3-month functional outcome and all-cause mortality in acute ICH patients. Methods: A total of 365 patients with acute ICH were enrolled. Serum creatinine and cystatin C levels were measured within 24 h of admission. Outcomes at 3-month were evaluated by interviews with patients or their family members. Poor functional outcome was defined as a modified Rankin Scale score ≥3. Results: During the 3-month follow-up, 154 patients experienced poor functional outcome, and 48 patients died from all causes. Low eGFR level was associated with poor outcome (adjusted OR 8.95; 95% CI 2.13-37.66; p-trend = 0.045) and all-cause mortality (adjusted hazards ratio (HR) 5.10; 95% CI 2.00-13.03; p-trend = 0.001). Additionally, a high cystatin C level was also found to be associated with all-cause mortality (adjusted HR 4.01; 95% CI 1.09-14.72; p-trend = 0.015). However, no significant association between cystatin C and poor functional outcome was observed (p-trend = 0.615). Conclusions: Low eGFR at baseline predicts poor functional outcome and all-cause mortality at 3-month in acute ICH patients. Also, high cystatin C was associated with increased risk of mortality but not with poor functional outcome.

scholarly journals Estimated Glomerular Filtration Rate Is Associated With an Increased Risk of Death in Heart Failure Patients With Preserved Ejection Fraction

2021 ◽  
Vol 8 ◽  
Author(s):  
Zhuo Chen ◽  
Qian Lin ◽  
Jingen Li ◽  
Xinyi Wang ◽  
Jianqing Ju ◽  
...  
Keyword(s):  
Heart Failure ◽  
Glomerular Filtration Rate ◽  
Ejection Fraction ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Cardiovascular Death ◽  
Preserved Ejection Fraction ◽  
Increased Risk ◽  
Patients With Heart Failure

Background: Renal dysfunction is associated with adverse cardiovascular outcomes in patients with heart failure (HF), but its impact on patients with heart failure with preserved ejection fraction (HFpEF) remains unclear.Methods: 3,392 subjects of the TOPCAT (Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist) trial were assigned to two groups by estimated glomerular filtration rate (eGFR) ≥ 60 ml/min/1.73 m2 or 30–59 ml/min/1.73 m2. The outcomes, including all-cause death, cardiovascular death and HF hospitalization, were examined by multivariable cox models.Results: Over a median follow-up of 3.4 ± 1.7 years, a total of 524 all-cause deaths, 334 cardiovascular deaths and 440 HF hospitalizations occurred. Compared with patients with eGFR ≥ 60 ml/min/1.73 m2, those with eGFR 30–59 ml/min/1.73 m2 were associated with an increased risk of the all-cause death [adjusted hazard ratio (HR), 1.47; 95% confidence interval (CI), 1.24–1.76; P &lt; 0.001], cardiovascular death (adjusted HR, 1.53; 95% CI: 1.23–1.91; p &lt; 0.001), and HF hospitalization (adjusted HR: 1.21; 95% CI: 1.00–1.47; p = 0.049) after multivariable adjustment for potential confounders.Conclusions: eGFR 30–59 ml/min/1.73 m2 was related to an increased risk of all-cause death, cardiovascular death and HF hospitalization in HFpEF patients.

scholarly journals Effects of estimated glomerular filtration rate on clinical outcomes in patients with intracerebral hemorrhage

BMC Neurology ◽  
2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Zhaoxia Li ◽  
Zixiao Li ◽  
Qi Zhou ◽  
Hongqiu Gu ◽  
Yongjun Wang ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Intracerebral Hemorrhage ◽  
Hospital Mortality ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Hemorrhagic Stroke ◽  
Estimated Glomerular Filtration Rate ◽  
Stroke Severity ◽  
Hematoma Evacuation ◽  
Increased Risk

Abstract Background The influence of chronic kidney disease (CKD) on the severity and prognosis of spontaneous intracerebral hemorrhage (ICH) has been scarcely investigated. We aimed to explore the association of admission estimated glomerular filtration rate (eGFR) levels with hemorrhagic stroke severity and outcomes in ICH patients. Materials and methods The patients enrolled in this study were from the China Stroke Center Alliance study (CSCA). Patients were divided into four groups according to differences in eGFR at admission (≥90; 60–89; 45–59; < 45). Multivariable logistic regression analysis was used to determine the association of the eGFR at admission with hemorrhagic stroke severity, in-hospital complications, discharge disposition, and in-hospital mortality after ICH. Results A total of 85,167 patients with acute ICH were included in the analysis. Among them, 9493 (11.1%) had a baseline eGFR<60 ml/min/1.73 m2. A low eGFR was associated with an increased risk of in-hospital mortality [eGFR 60–89 ml/min/1.73 m2, odds ratio (OR) 1.36 (95% confidence interval (CI) 1.21–1.53); eGFR 45–59, 2.35 (1.97–2.82); eGFR<45, 4.18 (3.7–4.72); P for trend < 0.0001], non-routine discharge [eGFR 60–89, 1.11 (1.03–1.2); eGFR 45–59, 1.16 (1–1.35); eGFR<45, 1.37 (1.23–1.53); P for trend < 0.0001], hemorrhagic stroke severity [eGFR 60–89, 1 (0.95–1.05); eGFR 45–59, 1.39 (1.26–1.53); eGFR<45, 1.81 (1.67–1.96); P for trend < 0.0001], in-hospital complications of pneumonia [eGFR 60–89, 1.1 (1.05–1.14); eGFR 45–59, 1.3 (1.2–1.4); eGFR<45, 1.66 (1.57–1.76); P for trend < 0.0001] and hydrocephalus [eGFR 60–89, 0.99 (0.87–1.12); eGFR 45–59, 1.37 (1.1–1.7); eGFR<45, 1.54 (1.32–1.8); P for trend = 0.0139] after adjusting for confounding factors. With the decline in eGFR, the risk of hematoma evacuation increased in patients with an eGFR 45 to 59 ml/min/1.73 m2 (OR 1.48; 95% CI 1.37–1.61). No significant association between differences in eGFR at baseline and in-hospital complication of recurrent intracerebral hemorrhage was observed. Conclusions Low eGFR at baseline was associated with an increased risk of in-hospital mortality, non-routine discharge, hemorrhagic stroke severity and in-hospital complications such as pneumonia, hydrocephalus and hematoma evacuation in acute ICH patients.

scholarly journals Glomerular filtration rate in patients with atrial fibrillation and 1-year outcomes

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Giuseppe Boriani ◽  
Cécile Laroche ◽  
Igor Diemberger ◽  
Mircea Ioachim Popescu ◽  
Lars Hvilsted Rasmussen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Research Programme ◽  
Adverse Outcomes ◽  
Mild Renal Impairment ◽  
Risk Of Death ◽  
Mdrd Equation ◽  
Increased Risk

Abstract We assessed 1-year outcomes in patients with atrial fibrillation enrolled in the EurObservational Research Programme AF General Pilot Registry (EORP-AF), in relation to kidney function, as assessed by glomerular filtration rate (eGFR). In a cohort of 2398 patients (median age 69 years; 61% male), eGFR (ml/min/1.73 m2) calculated using the CKD-EPI formula was ≥80 in 35.1%, 50–79 in 47.2%, 30–49 in 13.9% and <30 in 3.7% of patients. In a logistic regression analysis, eGFR category was an independent predictor of stroke/TIA or death, with elevated odds ratios associated with severe to mild renal impairment, ie. eGFR < 30 ml/min/1.73 m2 [OR 3.641, 95% CI 1.572–8.433, p < 0.0001], 30–49 ml/min/1.73 m2 [OR 3.303, 95% CI 1.740–6.270, p = 0.0026] or 50–79 ml/min/1.73 m2 [OR 2.094, 95% CI 1.194–3.672, p = 0.0003]. The discriminant capability for the risk of death was tested among various eGFR calculation algorithms: the best was the Cockcroft-Gault equation adjusted for BSA, followed by Cockcroft-Gault equation, and CKD-EPI equation, while the worst was the MDRD equation. In conclusion in this prospective observational registry, renal function was a major determinant of adverse outcomes at 1 year, and even mild or moderate renal impairments were associated with an increased risk of stroke/TIA/death.

Sign in / Sign up

Export Citation Format

Share Document