scholarly journals Contribution of cardiometabolic risk factors to estimated glomerular filtration rate decline in Indigenous Australians with and without albuminuria - the eGFR Follow-up Study

Nephrology ◽  
2018 ◽  
Vol 23 (7) ◽  
pp. 682-689 ◽  
Author(s):  
Elizabeth LM Barr ◽  
Federica Barzi ◽  
Jaquelyne T Hughes ◽  
George Jerums ◽  
Kerin O'Dea ◽  
...  
Keyword(s):  
Risk Factors ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Cardiometabolic Risk ◽  
Estimated Glomerular Filtration Rate ◽  
Indigenous Australians ◽  
Follow Up Study ◽  
Glomerular Filtration Rate Decline

Prognostic usefulness of an age-adapted equation for renal function assessment in older patients with acute coronary syndrome

2017 ◽  
Vol 7 (8) ◽  
pp. 703-709 ◽  
Author(s):  
Lucía Rioboo Lestón ◽  
Emad Abu-Assi ◽  
Sergio Raposeiras-Roubin ◽  
Rafael Cobas-Paz ◽  
Berenice Caneiro-Queija ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Risk Prediction ◽  
Older Patients ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Coronary Syndrome ◽  
Function Assessment

Background: Renal dysfunction negatively impacts survival in acute coronary syndrome patients. The Berlin Initiative Study creatinine-based (BIScrea) equation has recently been proposed for renal function assessment in older persons. However, up to now it is unknown if the superiority of the new BIScrea equation, with respect to the most recommended chronic kidney disease epidemiology collaboration creatinine-based (CKD-EPIcrea) formula, would translate into better risk prediction of adverse events in older patients with acute coronary syndrome. Objectives: To study the impact of using estimated glomerular filtration rate calculated according to the BIScrea and CKD-EPIcrea equations on mortality in acute coronary syndrome patients aged 70 years and over. Methods: Retrospectively, between 2011 and 2016, a total of 2008 patients with acute coronary syndrome (64% men; age 79±7 years) were studied. Follow-up was 18±10 months. Measures of performance were evaluated using continuous data and stratifying patients into three estimated glomerular filtration rate subgroups: ≥60, 59.9–30 and <30 mL/min/1.73 m2. Results: The two formulas afforded independent prognostic information over follow-up. However, risk prediction was most accurate using the BIScrea formula as evaluated by Cox proportional hazards models (hazard ratio (for each 10 mL/min/1.73 m2 decrease) 1.47 vs. 1.27 with the CKD-EPI equation; P<0.001 for comparison), c-statistic values (0.69 vs. 0.65, respectively; P=0.04 for comparison) and Bayesian information criterion. Net reclassification improvement based on the estimated glomerular filtration rate categories significantly favoured BIScrea +9 (95% confidence interval 2–16%; P=0.02). Conclusions: Our findings suggest that the BIScrea formula may improve death risk prediction more than the CKD-EPIcrea formula in older patients with acute coronary syndrome.

scholarly journals Rationale and population-based prospective cohort protocol for the disadvantaged populations at risk of decline in eGFR (CO-DEGREE)

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e031169 ◽  
Author(s):  
Marvin Gonzalez-Quiroz ◽  
Dorothea Nitsch ◽  
Sophie Hamilton ◽  
Cristina O'Callaghan Gordo ◽  
Rajiv Saran ◽  
...  
Keyword(s):  
Risk Factors ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Population Based ◽  
Local Health ◽  
Populations At Risk ◽  
High Prevalence ◽  
Egfr Decline

IntroductionA recently recognised form of chronic kidney disease (CKD) of unknown origin (CKDu) is afflicting communities, mostly in rural areas in several regions of the world. Prevalence studies are being conducted in a number of countries, using a standardised protocol, to estimate the distribution of estimated glomerular filtration rate (eGFR), and thus identify communities with a high prevalence of reduced glomerular filtration rate (GFR). In this paper, we propose a standardised minimum protocol for cohort studies in high-risk communities aimed at investigating the incidence of, and risk factors for, early kidney dysfunction.Methods and analysisThis generic cohort protocol provides the information to establish a prospective population-based cohort study in low-income settings with a high prevalence of CKDu. This involves a baseline survey that included key elements from the DEGREE survey (eg, using the previously published DEGREE methodology) of a population-representative sample, and subsequent follow-up visits in young adults (without a pre-existing diagnosis of CKD (eGFR<60 mL/min/1.73m2), proteinuria or risk factors for CKD at baseline) over several years. Each visit involves a core questionnaire, and collection and storage of biological samples. Local capacity to measure serum creatinine will be required so that immediate feedback on kidney function can be provided to participants. After completion of follow-up, repeat measures of creatinine should be conducted in a central laboratory, using reference standards traceable to isotope dilution mass spectrometry (IDMS) quality control material to quantify the main outcome of eGFR decline over time, alongside a description of the early evolution of disease and risk factors for eGFR decline.Ethics and disseminationEthical approval will be obtained by local researchers, and participants will provide informed consent before the study commences. Participants will typically receive feedback and advice on their laboratory results, and referral to a local health system where appropriate.

Abstract P526: Bariatric Surgery is Associated With Slower Decline in Kidney Function, Estimated by Multiple Filtration Markers

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Alex R CHANG ◽  
G. C Wood ◽  
Adam Cook ◽  
Xin Chu ◽  
Morgan Grams
Keyword(s):  
Bariatric Surgery ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Kidney Function ◽  
Cystatin C ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Morbidly Obese ◽  
Surgery Group

Background: Persons with morbid obesity are at increased risk for end-stage kidney disease, and prior studies have shown an association between bariatric surgery and improvements in creatinine-based estimated glomerular filtration rate (eGFR cr ). However, eGFR cr could be biased by loss of muscle mass after surgery, and creatinine-cystatin C estimated glomerular filtration rate (eGFR cr-cyc ) has been shown to be more accurate in this setting. Methods: We matched 144 patients who underwent bariatric surgery on pre-surgery age, sex, race, body mass index (BMI), and eGFR cr with 144 morbidly obese non-surgery patients at Geisinger with serial biobanked serum samples. We measured filtration markers (creatinine, cystatin C, beta-2 microglobulin [B2M] and beta-trace protein [BTP], and calculated eGFR cr-cyc using the CKD-EPI combined equation. Using mixed effects models with random intercepts, we compared changes in filtration markers and eGFR cr-cyc between surgery and non-surgery groups. Results: Mean (SD) values for age, BMI, and eGFR cr were 48.2 (10.4) years, 45.2 (6.3) kg/m 2 , and 91.7 (17.5) ml/min/1.73m 2 ; 87.5% were female, 0.7% were black, 50.3% had hypertension, and 41.0% had type 2 diabetes. Mean eGFR cr-cyc slope in the surgery group was -0.41 ml/min/1.73m 2 /yr (95% CI: -0.74, -0.08) over a mean follow-up of 9.2 (1.4) years, compared to -1.43 ml/min/1.73m 2 /yr in the non-surgery group over a mean follow-up of 8.2 (1.1) years. Bariatric surgery was associated with a 1.02 ml/min/1.73m 2 /yr slower decline in eGFR cr-cyc , and smaller increase in all 4 filtration markers (p< 0.02 for all comparisons). Conclusions: Bariatric surgery is associated with slower decline in kidney function, as assessed by eGFR cr-cyc , B2M and BTP.

scholarly journals Variability in estimated glomerular filtration rate and the incidence of type 2 diabetes: a nationwide population-based study

2020 ◽  
Vol 8 (1) ◽  
pp. e001187
Author(s):  
You-Bin Lee ◽  
Da Hye Kim ◽  
Eun Roh ◽  
So-Hyeon Hong ◽  
Jung A Kim ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Diabetes Risk ◽  
Incident Type ◽  
Incident Type 2 Diabetes

ObjectiveVariability in estimated glomerular filtration rate (eGFR) has been associated with adverse outcomes in patients with diabetes or chronic kidney disease (CKD). However, no previous study has explored the relationship between eGFR variability and type 2 diabetes incidence.Research design and methodsIn this nationwide, longitudinal, cohort study, we investigated the association between eGFR variability and type 2 diabetes risk using the Korean National Health Insurance Service datasets from 2002 to 2017. eGFR variability was calculated using the variability independent of the mean (eGFR-VIM), coefficient of variation (eGFR-CV), standard deviation (eGFR-SD) and average real variability (eGFR-ARV).ResultsWithin 7 673 905.58 person-years of follow-up (mean follow-up: 3.19 years; n=2 402 668), 11 981 cases of incident type 2 diabetes were reported. The HRs and 95% CIs for incident type 2 diabetes increased according to advance in quartiles of eGFR-VIM (HR (95% CI): Q2, 1.068 (1.009 to 1.130); Q3, 1.077 (1.018 to 1.138); Q4, 1.203 (1.139 to 1.270)) even after adjusting for confounding factors including mean eGFR and mean fasting plasma glucose levels. The subgroup analyses according to risk factors as well as analyses using eGFR-CV, eGFR-SD and eGFR-ARV showed consistent results. The association between increased eGFR variability and type 2 diabetes risk was more prominent in men, individuals with dyslipidemia and those with CKD as shown in the subgroup analysis (p for interaction <0.001).ConclusionsIncreased eGFR variability may be an independent predictor of type 2 diabetes and might be useful for risk stratification of individuals without diabetes.

scholarly journals Microalbuminuria risks and glomerular filtration in children with sickle cell anaemia in Nigeria

2019 ◽  
Vol 45 (1) ◽  
Author(s):  
I. E. Ocheke ◽  
S. Mohamed ◽  
E. S. Okpe ◽  
F. Bode-Thomas ◽  
M. I. McCullouch
Keyword(s):  
Risk Factors ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Sickle Cell ◽  
Filtration Rate ◽  
Sickle Cell Anaemia ◽  
Estimated Glomerular Filtration Rate ◽  
Kidney Damage ◽  
Strong Positive Correlation ◽  
Cross Sectional

Abstract Introduction Evidence of kidney damage is observed in children with sickle cell anaemia (SCA) and this continues through adulthood with progression to severe functional impairment in some. One of the earliest features of kidney damage associated with SCA is microalbuminuria. Our objective was to determine the risk factors of microalbuminuria in these children and its relationship with estimated glomerular filtration rate. Methods This was a cross-sectional and comparative study involving three hundred and twenty three children with SCA in steady state and equal numbers of apparently healthy age and sex matched haemoglobin AA (HbAA) control, aged 6 months to 18 years. They were consecutively recruited over a 6 month period. Result Microalbuminuria was present in 26% of the study subjects compared with 1.85% of control P = 0.001). Anaemia and high estimated glomerular filtration rate (eGFR) showed strong positive correlation with microalbuminuria (OR = 3.19, CI 0.953–1.116, p = 0.003 and OR = 1.7, CI 1.042–1.066, p = 0.001 respectively). Similarly, eGFR was higher in subjects with SCA than in controls and as well as in those with microalbuminuria compared with those who do not (p = < 0.01). Conclusions The two most important risk factors for microalbuminuria were anaemia and high eGFR. Age category was associated more with microalbuminuria than just age as a variable. Glomerular filtration rate was higher in children with microalbuminuria than those who do not and it was also higher in children with SCA than in control.

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