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1. Estimated Kidney Tubular Secretion and Kidney, Cardiovascular, and Mortality Outcomes in CKD: The Systolic Blood Pressure Intervention Trial

Author

Ascher, Simon B, Shlipak, Michael G, Katz, Ronit, Bullen, Alexander L, Scherzer, Rebecca, Hallan, Stein I, Cheung, Alfred K, Raphael, Kalani L, Estrella, Michelle M, Jotwani, Vasantha K, Seegmiller, Jesse C, Ix, Joachim H, and Garimella, Pranav S

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Kidney Disease, Clinical Research, Clinical Trials and Supportive Activities, Prevention, Heart Disease, Cardiovascular, 4.1 Discovery and preclinical testing of markers and technologies, Detection, screening and diagnosis, Renal and urogenital, Good Health and Well Being, CKD progression, CVD, hypertension, kidney function decline, mortality, tubular secretion, Clinical sciences
Abstract

Rational & objectiveMany drugs, metabolites, and toxins are cleared by the kidneys via tubular secretion. Whether novel endogenous measures of tubular secretion provide information about kidney, cardiovascular, and mortality risk is uncertain.Study designLongitudinal subgroup analysis of clinical trial participants.Setting & participants2,089 Systolic Blood Pressure Intervention Trial participants with estimated glomerular filtration rate (eGFR) 1 g/d were excluded.ConclusionsAmong SPRINT participants with CKD, lower estimated tubular secretion was associated with faster eGFR decline, independent of baseline eGFR and albuminuria, but not with CKD progression, CVD, or mortality.

Published
2022

4. Relationship of Estimated GFR and Albuminuria to Concurrent Laboratory Abnormalities: An Individual Participant Data Meta-analysis in a Global Consortium

Author

Inker, Lesley A, Grams, Morgan E, Levey, Andrew S, Coresh, Josef, Cirillo, Massimo, Collins, John F, Gansevoort, Ron T, Gutierrez, Orlando M, Hamano, Takayuki, Heine, Gunnar H, Ishikawa, Shizukiyo, Jee, Sun Ha, Kronenberg, Florian, Landray, Martin J, Miura, Katsuyuki, Nadkarni, Girish N, Peralta, Carmen A, Rothenbacher, Dietrich, Schaeffner, Elke, Sedaghat, Sanaz, Shlipak, Michael G, Zhang, Luxia, van Zuilen, Arjan D, Hallan, Stein I, Kovesdy, Csaba P, Woodward, Mark, Levin, Adeera, Astor, Brad, Appel, Larry, Greene, Tom, Chen, Teresa, Chalmers, John, Arima, Hisatomi, Perkovic, Vlado, Yatsuya, Hiroshi, Tamakoshi, Koji, Li, Yuanying, Hirakawa, Yoshihisa, Matsushita, Kunihiro, Grams, Morgan, Sang, Yingying, Polkinghorne, Kevan, Chadban, Steven, Atkins, Robert, Djurdjev, Ognjenka, Liu, Lisheng, Zhao, Minghui, Wang, Fang, Wang, Jinwei, Ebert, Natalie, Martus, Peter, Tang, Mila, Heine, Gunnar, Emrich, Insa, Seiler, Sarah, Zawada, Adam, Nally, Joseph, Navaneethan, Sankar, Schold, Jesse, Shlipak, Michael, Sarnak, Mark, Katz, Ronit, Hiramoto, Jade, Iso, Hiroyasu, Yamagishi, Kazumasa, Umesawa, Mitsumasa, Muraki, Isao, Fukagawa, Masafumi, Maruyama, Shoichi, Hasegawa, Takeshi, Fujii, Naohiko, Wheeler, David, Emberson, John, Townend, John, Landray, Martin, Brenner, Hermann, Schöttker, Ben, Saum, Kai-Uwe, Fox, Caroline, Hwang, Shih-Jen, Köttgen, Anna, Schneider, Markus P, Eckardt, Kai-Uwe, Green, Jamie, Kirchner, H Lester, and Chang, Alex R

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Kidney Disease, Women's Health, Clinical Research, Renal and urogenital, Good Health and Well Being, Aged, Albuminuria, Blood Chemical Analysis, Creatinine, Cross-Sectional Studies, Disease Progression, Female, Global Health, Glomerular Filtration Rate, Humans, Hypertension, Renal, Internationality, Kidney Function Tests, Male, Middle Aged, Predictive Value of Tests, Renal Insufficiency, Chronic, Retrospective Studies, Sensitivity and Specificity, Severity of Illness Index, Urinalysis, CKD Prognosis Consortium, CKD stage, Chronic kidney disease, albuminuria, anemia, diabetes, glomerular filtration rate, 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, Public Health and Health Services, Urology & Nephrology, Clinical sciences
Abstract

Rationale & objectiveChronic 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.Study designCross-sectional individual participant-level analyses in a global consortium.Setting & study populations17 CKD and 38 general population and high-risk cohorts.Selection criteria for studiesCohorts 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 extractionData were obtained and analyzed between July 2015 and January 2018.Analytical approachWe 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.ResultsThe 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/1.73m2), whereas albuminuria had equivocal or weak associations with abnormalities (ORs ranging from 0.77 [95% CI, 0.60-0.99] to 1.92 [95% CI, 1.65-2.24] comparing urinary albumin-creatinine ratio > 300 vs < 30mg/g).LimitationsVariations in study era, health care delivery system, typical diet, and laboratory assays.ConclusionsLower 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.

Published
2019

6. Adiposity and risk of decline in glomerular filtration rate: meta-analysis of individual participant data in a global consortium

Author

Chang, Alex R, Grams, Morgan E, Ballew, Shoshana H, Bilo, Henk, Correa, Adolfo, Evans, Marie, Gutierrez, Orlando M, Hosseinpanah, Farhad, Iseki, Kunitoshi, Kenealy, Timothy, Klein, Barbara, Kronenberg, Florian, Lee, Brian J, Li, Yuanying, Miura, Katsuyuki, Navaneethan, Sankar D, Roderick, Paul J, Valdivielso, Jose M, Visseren, Frank LJ, Zhang, Luxia, Gansevoort, Ron T, Hallan, Stein I, Levey, Andrew S, Matsushita, Kunihiro, Shalev, Varda, Woodward, Mark, Astor, Brad, Appel, Larry, Greene, Tom, Chen, Teresa, Chalmers, John, Arima, Hisatomi, Perkovic, Vlado, Yatsuya, Hiroshi, Tamakoshi, Koji, Hirakawa, Yoshihisa, Coresh, Josef, Sang, Yingying, Polkinghorne, Kevan, Chadban, Steven, Atkins, Robert, Levin, Adeera, Djurdjev, Ognjenka, Klein, Ron, Lee, Kristine, Liu, Lisheng, Zhao, Minghui, Wang, Fang, Wang, Jinwei, Tang, Mila, Heine, Gunnar, Emrich, Insa, Zawada, Adam, Bauer, Lucie, Nally, Joseph, Schold, Jesse, Shlipak, Michael, Sarnak, Mark, Katz, Ronit, Hiramoto, Jade, Iso, Hiroyasu, Yamagishi, Kazumasa, Umesawa, Mitsumasa, Muraki, Isao, Fukagawa, Masafumi, Maruyama, Shoichi, Hamano, Takayuki, Hasegawa, Takeshi, Fujii, Naohiko, Jafar, Tazeen, Hatcher, Juanita, Poulter, Neil, Chaturvedi, Nish, Wheeler, David, Emberson, John, Townend, John, Landray, Martin, Brenner, Hermann, Schöttker, Ben, Saum, Kai-Uwe, Rothenbacher, Dietrich, Fox, Caroline, Hwang, Shih-Jen, Köttgen, Anna, Schneider, Markus P, Eckardt, Kai-Uwe, Green, Jamie, Kirchner, H Lester, Ito, Sadayoshi, Miyazaki, Mariko, Nakayama, Masaaki, Yamada, Cirillo, Massimo, Romundstad, Solfrid, Øvrehus, Marius, Langlo, Knut Asbjørn, Irie, Fujiko, Sairenchi, Toshimi, Rebholz, Casey M, and Young, Bessie

Subjects
Epidemiology, Health Sciences, Obesity, Kidney Disease, Cardiovascular, Aging, Prevention, Nutrition, Clinical Research, Good Health and Well Being, Adiposity, Adult, Aged, Aged, 80 and over, Body Height, Body Mass Index, Cohort Studies, Female, Glomerular Filtration Rate, Humans, Kidney Failure, Chronic, Male, Middle Aged, Mortality, Risk Factors, Waist Circumference, CKD Prognosis Consortium, Clinical Sciences, Public Health and Health Services, General & Internal Medicine, Biomedical and clinical sciences, Health sciences, Psychology
Abstract

ObjectiveTo evaluate the associations between adiposity measures (body mass index, waist circumference, and waist-to-height ratio) with decline in glomerular filtration rate (GFR) and with all cause mortality.DesignIndividual participant data meta-analysis.SettingCohorts from 40 countries with data collected between 1970 and 2017.ParticipantsAdults in 39 general population cohorts (n=5 459 014), of which 21 (n=594 496) had data on waist circumference; six cohorts with high cardiovascular risk (n=84 417); and 18 cohorts with chronic kidney disease (n=91 607).Main outcome measuresGFR decline (estimated GFR decline ≥40%, initiation of kidney replacement therapy or estimated GFR

Published
2019

7. Serum potassium and adverse outcomes across the range of kidney function: a CKD Prognosis Consortium meta-analysis.

Author

Kovesdy, Csaba P, Matsushita, Kunihiro, Sang, Yingying, Brunskill, Nigel J, Carrero, Juan J, Chodick, Gabriel, Hasegawa, Takeshi, Heerspink, Hiddo L, Hirayama, Atsushi, Landman, Gijs WD, Levin, Adeera, Nitsch, Dorothea, Wheeler, David C, Coresh, Josef, Hallan, Stein I, Shalev, Varda, Grams, Morgan E, Astor, Brad, Appel, Larry, Greene, Tom, Chen, Teresa, Chalmers, John, Woodward, Mark, Arima, Hisatomi, Perkovic, Vlado, Djurdjev, Ognjenka, Zhang, Luxia, Liu, Lisheng, Zhao, Minghui, Wang, Fang, Wang, Jinwei, Tang, Mila, Iso, Hiroyasu, Yamagishi, Kazumasa, Umesawa, Mitsumasa, Muraki, Isao, Fukagawa, Masafumi, Maruyama, Shoichi, Hamano, Takayuki, Fujii, Naohiko, Wheeler, David, Emberson, John, Townend, John, Landray, Martin, Green, Jamie, Kirchner, H Lester, Chang, Alex R, Cirillo, Massimo, Jee, Sun Ha, Kimm, Heejin, Mok, Yejin, Wetzels, Jack FM, Blankestijn, Peter J, van Zuilen, Arjan D, Bots, M, Sarnak, Mark, Inker, Lesley, Roderick, Paul, Fletcher, Astrid, Bottinger, Erwin, Nadkarni, Girish N, Ellis, Stephen B, Nadukuru, Rajiv, Brunskill, Nigel, Major, Rupert, Shepherd, David, Medcalf, James, Gansevoort, Ron T, Bakker, Stephan JL, Heerspink, Hiddo J Lambers, Jassal, Simerjot K, Bergstrom, Jaclyn, Ix, Joachim H, Barrett-Connor, Elizabeth, Kovesdy, Csaba, Kalantar-Zadeh, Kamyar, de Zeeuw, Dick, Brenner, Barry, Gasparini, Alessandro, Elinder, Carl-Gustaf, Barany, Peter, Evans, Marie, Segelmark, Mårten, Stendahl, Maria, Schön, Staffan, Tangri, Navdeep, Sud, Maneesh, Naimark, David, Wen, Chi-Pang, and Tsao, Chwen-Keng

Subjects
Kidney Disease, Prevention, Clinical Research, Evaluation of treatments and therapeutic interventions, 6.1 Pharmaceuticals, Renal and urogenital, Cardiovascular, Good Health and Well Being, Adult, Aged, Albuminuria, Cardiovascular Diseases, Cause of Death, Comorbidity, Glomerular Filtration Rate, Humans, Hyperkalemia, Hypokalemia, Kidney Failure, Chronic, Middle Aged, Prognosis, Renal Insufficiency, Chronic, Risk Factors, Potassium, Estimated glomerular filtration rate, End-stage renal disease, Mortality, CKD Prognosis Consortium, Cardiorespiratory Medicine and Haematology, Clinical Sciences, Cardiovascular System & Hematology
Abstract

AimsBoth hypo- and hyperkalaemia can have immediate deleterious physiological effects, and less is known about long-term risks. The objective was to determine the risks of all-cause mortality, cardiovascular mortality, and end-stage renal disease associated with potassium levels across the range of kidney function and evaluate for consistency across cohorts in a global consortium.Methods and resultsWe performed an individual-level data meta-analysis of 27 international cohorts [10 general population, 7 high cardiovascular risk, and 10 chronic kidney disease (CKD)] in the CKD Prognosis Consortium. We used Cox regression followed by random-effects meta-analysis to assess the relationship between baseline potassium and adverse outcomes, adjusted for demographic and clinical characteristics, overall and across strata of estimated glomerular filtration rate (eGFR) and albuminuria. We included 1 217 986 participants followed up for a mean of 6.9 years. The average age was 55 ± 16 years, average eGFR was 83 ± 23 mL/min/1.73 m2, and 17% had moderate- to-severe increased albuminuria levels. The mean baseline potassium was 4.2 ± 0.4 mmol/L. The risk of serum potassium of >5.5 mmol/L was related to lower eGFR and higher albuminuria. The risk relationship between potassium levels and adverse outcomes was U-shaped, with the lowest risk at serum potassium of 4-4.5 mmol/L. Compared with a reference of 4.2 mmol/L, the adjusted hazard ratio for all-cause mortality was 1.22 [95% confidence interval (CI) 1.15-1.29] at 5.5 mmol/L and 1.49 (95% CI 1.26-1.76) at 3.0 mmol/L. Risks were similar by eGFR, albuminuria, renin-angiotensin-aldosterone system inhibitor use, and across cohorts.ConclusionsOutpatient potassium levels both above and below the normal range are consistently associated with adverse outcomes, with similar risk relationships across eGFR and albuminuria.

Published
2018

11. Potassium homeostasis and management of dyskalemia in kidney diseases: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

Author

Ashuntantang, Gloria E., Bakker, Stephan J.L., Bakris, George L., Bhandari, Sunil, Burdmann, Emmanuel A., Campbell, Katrina L., Charytan, David M., Clegg, Deborah J., Cuppari, Lilian, Goldsmith, David, Hallan, Stein I., He, Jiang, Herzog, Charles A., Hoenig, Melanie P., Hoorn, Ewout J., Leipziger, Jens Georg, Leonberg-Yoo, Amanda K., Lerma, Edgar V., Lopez-Almaraz, Jose Ernesto, Małyszko, Jolanta, Mann, Johannes F.E., Marklund, Matti, McDonough, Alicia A., Nagahama, Masahiko, Navaneethan, Sankar D., Pitt, Bertram, Pochynyuk, Oleh M., Proença de Moraes, Thyago, Rafique, Zubaid, Robinson, Bruce M., Roger, Simon D., Rossignol, Patrick, Singer, Adam J., Smyth, Andrew, Sood, Manish M., Walsh, Michael, Weir, Matthew R., Wingo, Charles S., Clase, Catherine M., Carrero, Juan-Jesus, Ellison, David H., Grams, Morgan E., Hemmelgarn, Brenda R., Jardine, Meg J., Kovesdy, Csaba P., Kline, Gregory A., Lindner, Gregor, Obrador, Gregorio T., Palmer, Biff F., Cheung, Michael, Wheeler, David C., Winkelmayer, Wolfgang C., and Pecoits-Filho, Roberto

Published
2020
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12. Multinational Assessment of Accuracy of Equations for Predicting Risk of Kidney Failure: A Meta-analysis

Author

Tangri, Navdeep, Grams, Morgan E, Levey, Andrew S, Coresh, Josef, Appel, Lawrence J, Astor, Brad C, Chodick, Gabriel, Collins, Allan J, Djurdjev, Ognjenka, Elley, C Raina, Evans, Marie, Garg, Amit X, Hallan, Stein I, Inker, Lesley A, Ito, Sadayoshi, Jee, Sun Ha, Kovesdy, Csaba P, Kronenberg, Florian, Heerspink, Hiddo JL, Marks, Angharad, Nadkarni, Girish N, Navaneethan, Sankar D, Nelson, Robert G, Titze, Stephanie, Sarnak, Mark J, Stengel, Benedicte, Woodward, Mark, and Iseki, Kunitoshi

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Prevention, Kidney Disease, Renal and urogenital, Cohort Studies, Disease Progression, Humans, Prognosis, Proportional Hazards Models, Renal Insufficiency, Renal Insufficiency, Chronic, Risk Assessment, CKD Prognosis Consortium, Medical and Health Sciences, General & Internal Medicine, Biomedical and clinical sciences, Health sciences
Abstract

ImportanceIdentifying patients at risk of chronic kidney disease (CKD) progression may facilitate more optimal nephrology care. Kidney failure risk equations, including such factors as age, sex, estimated glomerular filtration rate, and calcium and phosphate concentrations, were previously developed and validated in 2 Canadian cohorts. Validation in other regions and in CKD populations not under the care of a nephrologist is needed.ObjectiveTo evaluate the accuracy of the risk equations across different geographic regions and patient populations through individual participant data meta-analysis.Data sourcesThirty-one cohorts, including 721,357 participants with CKD stages 3 to 5 in more than 30 countries spanning 4 continents, were studied. These cohorts collected data from 1982 through 2014.Study selectionCohorts participating in the CKD Prognosis Consortium with data on end-stage renal disease.Data extraction and synthesisData were obtained and statistical analyses were performed between July 2012 and June 2015. Using the risk factors from the original risk equations, cohort-specific hazard ratios were estimated and combined using random-effects meta-analysis to form new pooled kidney failure risk equations. Original and pooled kidney failure risk equation performance was compared, and the need for regional calibration factors was assessed.Main outcomes and measuresKidney failure (treatment by dialysis or kidney transplant).ResultsDuring a median follow-up of 4 years of 721,357 participants with CKD, 23,829 cases kidney failure were observed. The original risk equations achieved excellent discrimination (ability to differentiate those who developed kidney failure from those who did not) across all cohorts (overall C statistic, 0.90; 95% CI, 0.89-0.92 at 2 years; C statistic at 5 years, 0.88; 95% CI, 0.86-0.90); discrimination in subgroups by age, race, and diabetes status was similar. There was no improvement with the pooled equations. Calibration (the difference between observed and predicted risk) was adequate in North American cohorts, but the original risk equations overestimated risk in some non-North American cohorts. Addition of a calibration factor that lowered the baseline risk by 32.9% at 2 years and 16.5% at 5 years improved the calibration in 12 of 15 and 10 of 13 non-North American cohorts at 2 and 5 years, respectively (P = .04 and P = .02).Conclusions and relevanceKidney failure risk equations developed in a Canadian population showed high discrimination and adequate calibration when validated in 31 multinational cohorts. However, in some regions the addition of a calibration factor may be necessary.

Published
2016

15. Change in albuminuria and subsequent risk of end-stage kidney disease: an individual participant-level consortium meta-analysis of observational studies

Author

Appel, Lawrence J, Greene, Tom, Chen, Teresa K, Chalmers, John, Arima, Hisatomi, Perkovic, Vlado, Levin, Adeera, Djurdjev, Ognjenka, Tang, Mila, Nally, Joseph, Navaneethan, Sankar D, Schold, Jesse D, Weldegiorgis, Misghina, Herrington, William G, Smith, Margaret, Hsu, C Yenchih, Hwang, Shih-Jen, Chang, Alex R, Kirchner, H. Lester, Green, Jamie A, Ho, Kevin, Marks, Angharad, Prescott, Gordon, Clark, Laura E, Fluck, Nick, Shalev, Varda, Chodick, Gabriel, Blankestijn, Peter J, Van Zuilen, Arjan, Van den Brand, Jan A, Sarnak, Mark J, Bottinger, Erwin, Nadkarni, Girish N, Ellis, Stephen G, Nadukuru, Rajiv, Metzger, Marie, Flamant, Martin, Houillier, Pascal, Haymann, Jean-Philippe, Froissart, Marc, Kenealy, Timothy, Elley, Raina C, Collins, John F, Drury, Paul L, Cuddeback, John K, Ciemins, Elizabeth L, Stempniewicz, Rich, Nelson, Robert G, Knowler, William C, Bakker, Stephen J, Major, Rupert W, Medcalf, James F, Shepherd, David, Barrett-Connor, Elizabeth, Bergstrom, Jaclyn, Ix, Joachim H, Molnar, Miklos Z, Sumida, Keiichi, de Zeeuw, Dick, Brenner, Barry, Qureshi, Abdul R, Elinder, Carl-Gustaf, Runesson, Bjorn, Evans, Marie, Segelmark, Marten, Stendahl, Maria, Schön, Staffan, Naimark, David M, Tangri, Navdeep, Sud, Maneesh, Hirayama, Atsushi, Ichikawa, Kazunobu, Bilo, Henk JG, Landman, Gijs WD, Van Hateren, Kornelis JJ, Kleefstra, Nanne, Hallan, Stein I, Ballew, Shoshana H, Chen, Jingsha, Kwak, Lucia, Surapaneni, Aditya, Parving, Hans-Henrik, Rodby, Roger A., Rohde, Richard D, Lewis, Julia B, Lewis, Edmund, Perrone, Ronald D, Abebe, Kaleab Z, Hou, Fan F, Xie, Di, Hunsicker, Lawrence G, Imai, Enyu, Kobayashi, Fumiaki, Makino, Hirofumi, Ito, Sadayoshi, Remuzzi, Giuseppe, Ruggenenti, Piero, Eckardt, Kai-Uwe, Gudmundsdottir, Hrefna, Maciulaitis, Romaldas, Manley, Tom, Smith, Kimberly, Stockbridge, Norman, Thompson, Aliza, Vetter, Thorsten, Willis, Kerry, Zhang, Luxia, Coresh, Josef, Heerspink, Hiddo J L, Sang, Yingying, Matsushita, Kunihiro, Arnlov, Johan, Astor, Brad C, Black, Corri, Brunskill, Nigel J, Carrero, Juan-Jesus, Feldman, Harold I, Fox, Caroline S, Inker, Lesley A, Ishani, Areef, Jassal, Simerjot, Konta, Tsuneo, Polkinghorne, Kevan, Romundstad, Solfrid, Solbu, Marit D, Stempniewicz, Nikita, Stengel, Benedicte, Tonelli, Marcello, Umesawa, Mitsumasa, Waikar, Sushrut S, Wen, Chi-Pang, Wetzels, Jack F M, Woodward, Mark, Grams, Morgan E, Kovesdy, Csaba P, Levey, Andrew S, and Gansevoort, Ron T

Published
2019
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16. Relationship of Estimated GFR and Albuminuria to Concurrent Laboratory Abnormalities: An Individual Participant Data Meta-analysis in a Global Consortium

Author

Astor, Brad, Appel, Larry, Greene, Tom, Chen, Teresa, Chalmers, John, Woodward, Mark, Arima, Hisatomi, Perkovic, Vlado, Yatsuya, Hiroshi, Tamakoshi, Koji, Li, Yuanying, Hirakawa, Yoshihisa, Coresh, Josef, Matsushita, Kunihiro, Grams, Morgan, Sang, Yingying, Polkinghorne, Kevan, Chadban, Steven, Atkins, Robert, Levin, Adeera, Djurdjev, Ognjenka, Zhang, Luxia, Liu, Lisheng, Zhao, Minghui, Wang, Fang, Wang, Jinwei, Schaeffner, Elke, Ebert, Natalie, Martus, Peter, Tang, Mila, Heine, Gunnar, Emrich, Insa, Seiler, Sarah, Zawada, Adam, Nally, Joseph, Navaneethan, Sankar, Schold, Jesse, Shlipak, Michael, Sarnak, Mark, Katz, Ronit, Hiramoto, Jade, Iso, Hiroyasu, Yamagishi, Kazumasa, Umesawa, Mitsumasa, Muraki, Isao, Fukagawa, Masafumi, Maruyama, Shoichi, Hamano, Takayuki, Hasegawa, Takeshi, Fujii, Naohiko, Wheeler, David, Emberson, John, Townend, John, Landray, Martin, Brenner, Hermann, Schöttker, Ben, Saum, Kai-Uwe, Rothenbacher, Dietrich, Fox, Caroline, Hwang, Shih-Jen, Köttgen, Anna, Kronenberg, Florian, Schneider, Markus P., Eckardt, Kai-Uwe, Green, Jamie, Kirchner, H Lester, Chang, Alex R., Ho, Kevin, Ito, Sadayoshi, Miyazaki, Mariko, Nakayama, Masaaki, Yamada, Gen, Cirillo, Massimo, Irie, Fujiko, Sairenchi, Toshimi, Ishikawa, Shizukiyo, Yano, Yuichiro, Kotani, Kazuhiko, Nakamura, Takeshi, Jee, Sun Ha, Kimm, Heejin, Mok, Yejin, Chodick, Gabriel, Shalev, Varda, Wetzels, Jack F.M., Blankestijn, Peter J., van Zuilen, Arjan D., van den Brand, Jan, Inker, Lesley, Peralta, Carmen, Kollerits, Barbara, Ritz, Eberhard, Nitsch, Dorothea, Roderick, Paul, Fletcher, Astrid, Bottinger, Erwin, Nadkarni, Girish N., Ellis, Stephen B., Nadukuru, Rajiv, Ueshima, Hirotsugu, Okayama, Akira, Miura, Katsuyuki, Tanaka, Sachiko, Okamura, Tomonori, Kadota, Aya, Kenealy, Timothy, Elley, C Raina, Collins, John F., Drury, Paul L., Ohkubo, Takayoshi, Asayama, Kei, Metoki, Hirohito, Kikuya, Masahiro, Nelson, Robert G., Knowler, William C., Gansevoort, Ron T., Bakker, Stephan JL., Hak, Eelco, Heerspink, Hiddo J.L., Brunskill, Nigel, Major, Rupert, Shepherd, David, Medcalf, James, Jassal, Simerjot K., Bergstrom, Jaclyn, Ix, Joachim H., Barrett-Connor, Elizabeth, Kovesdy, Csaba, Kalantar-Zadeh, Kamyar, Sumida, Keiichi, Gutierrez, Orlando M., Muntner, Paul, Warnock, David, McClellan, William, de Zeeuw, Dick, Brenner, Barry, Sedaghat, Sanaz, Ikram, M Arfan, Hoorn, Ewout J., Dehghan, Abbas, Carrero, Juan J., Gasparini, Alessandro, Wettermark, Björn, Elinder, Carl-Gustaf, Wong, Tien Yin, Sabanayagam, Charumathi, Cheng, Ching-Yu, Visseren, Frank L.J., Evans, Marie, Segelmark, Mårten, Stendahl, Maria, Schön, Staffan, Tangri, Navdeep, Sud, Maneesh, Naimark, David, Wen, Chi-Pang, Tsao, Chwen-Keng, Tsai, Min-Kugng, Chen, Chien-Hua, Konta, Tsuneo, Hirayama, Atsushi, Ichikawa, Kazunobu, Lannfelt, Lars, Larsson, Anders, Ärnlöv, Johan, Bilo, Henk J.G., Landman, Gijs W.D., van Hateren, Kornelis J.J., Kleefstra, Nanne, Coresh (Chair, Josef, Grams, Morgan E., Hallan, Stein, Kovesdy, Csaba P., Levey, Andrew S., Ballew, Shoshana H., Chen, Jingsha, Kwak, Lucia, Surapaneni, Aditya, Inker, Lesley A., Heine, Gunnar H., Landray, Martin J., Peralta, Carmen A., Shlipak, Michael G., and Hallan, Stein I.

Published
2019
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17. Changes in Natriuretic Peptide Levels and Subsequent Kidney Function Decline in SPRINT

Author

Ascher, Simon B., primary, Berry, Jarett D., additional, Katz, Ronit, additional, de Lemos, James A., additional, Bansal, Nisha, additional, Garimella, Pranav S., additional, Hallan, Stein I., additional, Wettersten, Nicholas, additional, Jotwani, Vasantha K., additional, Killeen, Anthony A., additional, Ix, Joachim H., additional, and Shlipak, Michael G., additional

Published
2023
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20. Markers of Kidney Tubular Secretion and Risk of Adverse Events in SPRINT Participants with CKD

Author

Bullen, Alexander L., primary, Ascher, Simon B., additional, Scherzer, Rebecca, additional, Garimella, Pranav S., additional, Katz, Ronit, additional, Hallan, Stein I., additional, Cheung, Alfred K., additional, Raphael, Kalani L., additional, Estrella, Michelle M., additional, Jotwani, Vasantha K., additional, Malhotra, Rakesh, additional, Seegmiller, Jesse C., additional, Shlipak, Michael G., additional, and Ix, Joachim H., additional

Published
2022
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32. Relationship of Estimated GFR and Albuminuria to Concurrent Laboratory Abnormalities : An Individual Participant Data Meta-analysis in a Global Consortium

Author

Inker, Lesley A., Grams, Morgan E., Levey, Andrew S., Coresh, Josef, Cirillo, Massimo, Collins, John F., Gansevoort, Ron T., Gutierrez, Orlando M., Hamano, Takayuki, Heine, Gunnar, Ishikawa, Shizukiyo, Jee, Sun Ha, Kronenberg, Florian, Landray, Martin, Miura, Katsuyuki, Nadkarni, Girish N., Peralta, Carmen, Rothenbacher, Dietrich, Schaeffner, Elke, Sedaghat, Sanaz, Shlipak, Michael G., Zhang, Luxia, van Zuilen, Arjan D., Hallan, Stein I., Kovesdy, Csaba P., Woodward, Mark, Levin, Adeera, Astor, Brad, Appel, Larry, Greene, Tom, Chen, Teresa, Chalmers, John, Arima, Hisatomi, Perkovic, Vlado, Yatsuya, Hiroshi, Tamakoshi, Koji, Li, Yuanying, Hirakawa, Yoshihisa, Matsushita, Kunihiro, Sang, Yingying, Polkinghorne, Kevan, Chadban, Steven, Atkins, Robert, Blankestijn, Peter J., Visseren, Frank L.J., and CKD Prognosis Consortium

Subjects
Male, hypertension, Internationality, hematocrit, Chronic kidney disease (CKD), laboratory tests, Urinalysis, Kidney Function Tests, Hypertension, Renal/epidemiology, Global Health, Sensitivity and Specificity, Severity of Illness Index, albuminuria, hyperparathyroidism, serum phosphorus, Research Support, N.I.H., Extramural, Predictive Value of Tests, Creatinine/urine, Glomerular Filtration Rate/physiology, staging system, Albuminuria/epidemiology, Journal Article, Humans, serum intact parathyroid hormone, kidney function, Renal Insufficiency, Chronic/epidemiology, CKD Prognosis Consortium, laboratory abnormality, Retrospective Studies, Aged, diabetes, Research Support, Non-U.S. Gov't, individual-level meta-analysis, serum calcium, hemoglobin, serum potassium, Middle Aged, serum bicarbonate, anemia, meta-analysis, Multicenter Study, Cross-Sectional Studies, CKD stage, Nephrology, Disease Progression, Female, glomerular filtration rate (GFR), Blood Chemical Analysis
Abstract

Rationale & Objective: 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. Study Design: Cross-sectional individual participant-level analyses in a global consortium. Setting & Study Populations: 17 CKD and 38 general population and high-risk cohorts. Selection Criteria for Studies: 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 Extraction: Data were obtained and analyzed between July 2015 and January 2018. Analytical Approach: 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. Results: 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 59 mL/min/1.73 m2), whereas albuminuria had equivocal or weak associations with abnormalities (ORs ranging from 0.77 [95% CI, 0.60-0.99] to 1.92 [95% CI, 1.65-2.24] comparing urinary albumin-creatinine ratio > 300 vs < 30 mg/g). Limitations: Variations in study era, health care delivery system, typical diet, and laboratory assays. Conclusions: 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.

Published
2019

36. Potassium homeostasis and management of dyskalemia in kidney diseases: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

Author

Clase, Catherine M., primary, Carrero, Juan-Jesus, additional, Ellison, David H., additional, Grams, Morgan E., additional, Hemmelgarn, Brenda R., additional, Jardine, Meg J., additional, Kovesdy, Csaba P., additional, Kline, Gregory A., additional, Lindner, Gregor, additional, Obrador, Gregorio T., additional, Palmer, Biff F., additional, Cheung, Michael, additional, Wheeler, David C., additional, Winkelmayer, Wolfgang C., additional, Pecoits-Filho, Roberto, additional, Ashuntantang, Gloria E., additional, Bakker, Stephan J.L., additional, Bakris, George L., additional, Bhandari, Sunil, additional, Burdmann, Emmanuel A., additional, Campbell, Katrina L., additional, Charytan, David M., additional, Clegg, Deborah J., additional, Cuppari, Lilian, additional, Goldsmith, David, additional, Hallan, Stein I., additional, He, Jiang, additional, Herzog, Charles A., additional, Hoenig, Melanie P., additional, Hoorn, Ewout J., additional, Leipziger, Jens Georg, additional, Leonberg-Yoo, Amanda K., additional, Lerma, Edgar V., additional, Lopez-Almaraz, Jose Ernesto, additional, Małyszko, Jolanta, additional, Mann, Johannes F.E., additional, Marklund, Matti, additional, McDonough, Alicia A., additional, Nagahama, Masahiko, additional, Navaneethan, Sankar D., additional, Pitt, Bertram, additional, Pochynyuk, Oleh M., additional, Proença de Moraes, Thyago, additional, Rafique, Zubaid, additional, Robinson, Bruce M., additional, Roger, Simon D., additional, Rossignol, Patrick, additional, Singer, Adam J., additional, Smyth, Andrew, additional, Sood, Manish M., additional, Walsh, Michael, additional, Weir, Matthew R., additional, and Wingo, Charles S., additional

Published
2020
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37. Serum potassium and adverse outcomes across the range of kidney function: a CKD Prognosis Consortium meta-analysis : a CKD Prognosis Consortium meta-analysis

Author

Kovesdy, Csaba P, Matsushita, Kunihiro, Sang, Yingying, Brunskill, Nigel J, Carrero, Juan J, Chodick, Gabriel, Hasegawa, Takeshi, Heerspink, Hiddo L, Hirayama, Atsushi, Landman, Gijs W D, Levin, Adeera, Nitsch, Dorothea, Wheeler, David C, Coresh, Josef, Hallan, Stein I, Shalev, Varda, Grams, Morgan E, and CKD Prognosis Consortium

Subjects
End-stage renal disease, Potassium, Journal Article, Albuminuria, Estimated glomerular filtration rate, Mortality
Abstract

Aims: Both hypo- and hyperkalaemia can have immediate deleterious physiological effects, and less is known about long-term risks. The objective was to determine the risks of all-cause mortality, cardiovascular mortality, and end-stage renal disease associated with potassium levels across the range of kidney function and evaluate for consistency across cohorts in a global consortium. Methods and results: We performed an individual-level data meta-analysis of 27 international cohorts [10 general population, 7 high cardiovascular risk, and 10 chronic kidney disease (CKD)] in the CKD Prognosis Consortium. We used Cox regression followed by random-effects meta-analysis to assess the relationship between baseline potassium and adverse outcomes, adjusted for demographic and clinical characteristics, overall and across strata of estimated glomerular filtration rate (eGFR) and albuminuria. We included 1 217 986 participants followed up for a mean of 6.9 years. The average age was 55 ± 16 years, average eGFR was 83 ± 23 mL/min/1.73 m2, and 17% had moderate- to-severe increased albuminuria levels. The mean baseline potassium was 4.2 ± 0.4 mmol/L. The risk of serum potassium of >5.5 mmol/L was related to lower eGFR and higher albuminuria. The risk relationship between potassium levels and adverse outcomes was U-shaped, with the lowest risk at serum potassium of 4-4.5 mmol/L. Compared with a reference of 4.2 mmol/L, the adjusted hazard ratio for all-cause mortality was 1.22 [95% confidence interval (CI) 1.15-1.29] at 5.5 mmol/L and 1.49 (95% CI 1.26-1.76) at 3.0 mmol/L. Risks were similar by eGFR, albuminuria, renin-angiotensin-aldosterone system inhibitor use, and across cohorts. Conclusions: Outpatient potassium levels both above and below the normal range are consistently associated with adverse outcomes, with similar risk relationships across eGFR and albuminuria.

Published
2018

38. Change in albuminuria and subsequent risk of end-stage kidney disease: an individual participant-level consortium meta-analysis of observational studies

Author

Coresh, Josef, primary, Heerspink, Hiddo J L, additional, Sang, Yingying, additional, Matsushita, Kunihiro, additional, Arnlov, Johan, additional, Astor, Brad C, additional, Black, Corri, additional, Brunskill, Nigel J, additional, Carrero, Juan-Jesus, additional, Feldman, Harold I, additional, Fox, Caroline S, additional, Inker, Lesley A, additional, Ishani, Areef, additional, Ito, Sadayoshi, additional, Jassal, Simerjot, additional, Konta, Tsuneo, additional, Polkinghorne, Kevan, additional, Romundstad, Solfrid, additional, Solbu, Marit D, additional, Stempniewicz, Nikita, additional, Stengel, Benedicte, additional, Tonelli, Marcello, additional, Umesawa, Mitsumasa, additional, Waikar, Sushrut S, additional, Wen, Chi-Pang, additional, Wetzels, Jack F M, additional, Woodward, Mark, additional, Grams, Morgan E, additional, Kovesdy, Csaba P, additional, Levey, Andrew S, additional, Gansevoort, Ron T, additional, Appel, Lawrence J, additional, Greene, Tom, additional, Chen, Teresa K, additional, Chalmers, John, additional, Arima, Hisatomi, additional, Perkovic, Vlado, additional, Levin, Adeera, additional, Djurdjev, Ognjenka, additional, Tang, Mila, additional, Nally, Joseph, additional, Navaneethan, Sankar D, additional, Schold, Jesse D, additional, Weldegiorgis, Misghina, additional, Herrington, William G, additional, Smith, Margaret, additional, Hsu, C Yenchih, additional, Hwang, Shih-Jen, additional, Chang, Alex R, additional, Kirchner, H. Lester, additional, Green, Jamie A, additional, Ho, Kevin, additional, Marks, Angharad, additional, Prescott, Gordon, additional, Clark, Laura E, additional, Fluck, Nick, additional, Shalev, Varda, additional, Chodick, Gabriel, additional, Blankestijn, Peter J, additional, Van Zuilen, Arjan, additional, Van den Brand, Jan A, additional, Sarnak, Mark J, additional, Bottinger, Erwin, additional, Nadkarni, Girish N, additional, Ellis, Stephen G, additional, Nadukuru, Rajiv, additional, Metzger, Marie, additional, Flamant, Martin, additional, Houillier, Pascal, additional, Haymann, Jean-Philippe, additional, Froissart, Marc, additional, Kenealy, Timothy, additional, Elley, Raina C, additional, Collins, John F, additional, Drury, Paul L, additional, Cuddeback, John K, additional, Ciemins, Elizabeth L, additional, Stempniewicz, Rich, additional, Nelson, Robert G, additional, Knowler, William C, additional, Bakker, Stephen J, additional, Major, Rupert W, additional, Medcalf, James F, additional, Shepherd, David, additional, Barrett-Connor, Elizabeth, additional, Bergstrom, Jaclyn, additional, Ix, Joachim H, additional, Molnar, Miklos Z, additional, Sumida, Keiichi, additional, de Zeeuw, Dick, additional, Brenner, Barry, additional, Qureshi, Abdul R, additional, Elinder, Carl-Gustaf, additional, Runesson, Bjorn, additional, Evans, Marie, additional, Segelmark, Marten, additional, Stendahl, Maria, additional, Schön, Staffan, additional, Naimark, David M, additional, Tangri, Navdeep, additional, Sud, Maneesh, additional, Hirayama, Atsushi, additional, Ichikawa, Kazunobu, additional, Bilo, Henk JG, additional, Landman, Gijs WD, additional, Van Hateren, Kornelis JJ, additional, Kleefstra, Nanne, additional, Hallan, Stein I, additional, Ballew, Shoshana H, additional, Chen, Jingsha, additional, Kwak, Lucia, additional, Surapaneni, Aditya, additional, Parving, Hans-Henrik, additional, Rodby, Roger A., additional, Rohde, Richard D, additional, Lewis, Julia B, additional, Lewis, Edmund, additional, Perrone, Ronald D, additional, Abebe, Kaleab Z, additional, Hou, Fan F, additional, Xie, Di, additional, Hunsicker, Lawrence G, additional, Imai, Enyu, additional, Kobayashi, Fumiaki, additional, Makino, Hirofumi, additional, Remuzzi, Giuseppe, additional, Ruggenenti, Piero, additional, Eckardt, Kai-Uwe, additional, Gudmundsdottir, Hrefna, additional, Maciulaitis, Romaldas, additional, Manley, Tom, additional, Smith, Kimberly, additional, Stockbridge, Norman, additional, Thompson, Aliza, additional, Vetter, Thorsten, additional, Willis, Kerry, additional, and Zhang, Luxia, additional

Published
2019
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39. Adiposity and risk of decline in glomerular filtration rate : Meta-analysis of individual participant data in a global consortium

Author

Chang, Alex R., Grams, Morgan E., Ballew, Shoshana H., Bilo, Henk, Correa, Adolfo, Evans, Marie, Gutierrez, Orlando M., Hosseinpanah, Farhad, Iseki, Kunitoshi, Kenealy, Timothy, Klein, Barbara, Kronenberg, Florian, Lee, Brian J., Li, Yuanying, Miura, Katsuyuki, Navaneethan, Sankar D., Roderick, Paul J., Valdivielso, Jose M., Visseren, Frank L.J., Zhang, Luxia, Gansevoort, Ron T., Hallan, Stein I., Levey, Andrew S., Matsushita, Kunihiro, Shalev, Varda, Woodward, Mark, Chang, Alex R., Grams, Morgan E., Ballew, Shoshana H., Bilo, Henk, Correa, Adolfo, Evans, Marie, Gutierrez, Orlando M., Hosseinpanah, Farhad, Iseki, Kunitoshi, Kenealy, Timothy, Klein, Barbara, Kronenberg, Florian, Lee, Brian J., Li, Yuanying, Miura, Katsuyuki, Navaneethan, Sankar D., Roderick, Paul J., Valdivielso, Jose M., Visseren, Frank L.J., Zhang, Luxia, Gansevoort, Ron T., Hallan, Stein I., Levey, Andrew S., Matsushita, Kunihiro, Shalev, Varda, and Woodward, Mark

Published
2019

40. Relationship of Estimated GFR and Albuminuria to Concurrent Laboratory Abnormalities: An Individual Participant Data Meta-analysis in a Global Consortium

Author

MS Nefrologie, Circulatory Health, Interne Geneeskunde Vasculaire, Inker, Lesley A., Grams, Morgan E., Levey, Andrew S., Coresh, Josef, Cirillo, Massimo, Collins, John F., Gansevoort, Ron T., Gutierrez, Orlando M., Hamano, Takayuki, Heine, Gunnar, Ishikawa, Shizukiyo, Jee, Sun Ha, Kronenberg, Florian, Landray, Martin, Miura, Katsuyuki, Nadkarni, Girish N., Peralta, Carmen, Rothenbacher, Dietrich, Schaeffner, Elke, Sedaghat, Sanaz, Shlipak, Michael G., Zhang, Luxia, van Zuilen, Arjan D., Hallan, Stein I., Kovesdy, Csaba P., Woodward, Mark, Levin, Adeera, Astor, Brad, Appel, Larry, Greene, Tom, Chen, Teresa, Chalmers, John, Arima, Hisatomi, Perkovic, Vlado, Yatsuya, Hiroshi, Tamakoshi, Koji, Li, Yuanying, Hirakawa, Yoshihisa, Matsushita, Kunihiro, Sang, Yingying, Polkinghorne, Kevan, Chadban, Steven, Atkins, Robert, Blankestijn, Peter J., Visseren, Frank L.J., CKD Prognosis Consortium, MS Nefrologie, Circulatory Health, Interne Geneeskunde Vasculaire, Inker, Lesley A., Grams, Morgan E., Levey, Andrew S., Coresh, Josef, Cirillo, Massimo, Collins, John F., Gansevoort, Ron T., Gutierrez, Orlando M., Hamano, Takayuki, Heine, Gunnar, Ishikawa, Shizukiyo, Jee, Sun Ha, Kronenberg, Florian, Landray, Martin, Miura, Katsuyuki, Nadkarni, Girish N., Peralta, Carmen, Rothenbacher, Dietrich, Schaeffner, Elke, Sedaghat, Sanaz, Shlipak, Michael G., Zhang, Luxia, van Zuilen, Arjan D., Hallan, Stein I., Kovesdy, Csaba P., Woodward, Mark, Levin, Adeera, Astor, Brad, Appel, Larry, Greene, Tom, Chen, Teresa, Chalmers, John, Arima, Hisatomi, Perkovic, Vlado, Yatsuya, Hiroshi, Tamakoshi, Koji, Li, Yuanying, Hirakawa, Yoshihisa, Matsushita, Kunihiro, Sang, Yingying, Polkinghorne, Kevan, Chadban, Steven, Atkins, Robert, Blankestijn, Peter J., Visseren, Frank L.J., and CKD Prognosis Consortium

Published
2019

41. Adiposity and risk of decline in glomerular filtration rate: Meta-analysis of individual participant data in a global consortium

Author

UMC Utrecht, Interne Geneeskunde Vasculaire, Circulatory Health, Chang, Alex R., Grams, Morgan E., Ballew, Shoshana H., Bilo, Henk, Correa, Adolfo, Evans, Marie, Gutierrez, Orlando M., Hosseinpanah, Farhad, Iseki, Kunitoshi, Kenealy, Timothy, Klein, Barbara, Kronenberg, Florian, Lee, Brian J., Li, Yuanying, Miura, Katsuyuki, Navaneethan, Sankar D., Roderick, Paul J., Valdivielso, Jose M., Visseren, Frank L.J., Zhang, Luxia, Gansevoort, Ron T., Hallan, Stein I., Levey, Andrew S., Matsushita, Kunihiro, Shalev, Varda, Woodward, Mark, UMC Utrecht, Interne Geneeskunde Vasculaire, Circulatory Health, Chang, Alex R., Grams, Morgan E., Ballew, Shoshana H., Bilo, Henk, Correa, Adolfo, Evans, Marie, Gutierrez, Orlando M., Hosseinpanah, Farhad, Iseki, Kunitoshi, Kenealy, Timothy, Klein, Barbara, Kronenberg, Florian, Lee, Brian J., Li, Yuanying, Miura, Katsuyuki, Navaneethan, Sankar D., Roderick, Paul J., Valdivielso, Jose M., Visseren, Frank L.J., Zhang, Luxia, Gansevoort, Ron T., Hallan, Stein I., Levey, Andrew S., Matsushita, Kunihiro, Shalev, Varda, and Woodward, Mark

Published
2019

42. Relationship of Estimated GFR and Albuminuria to Concurrent Laboratory Abnormalities:An Individual Participant Data Meta-analysis in a Global Consortium

Author

Inker, Lesley A., Grams, Morgan E., Levey, Andrew S., Coresh, Josef, Cirillo, Massimo, Collins, John F., Gansevoort, Ron T., Gutierrez, Orlando M., Hamano, Takayuki, Heine, Gunnar H., Ishikawa, Shizukiyo, Jee, Sun Ha, Kronenberg, Florian, Landray, Martin J., Miura, Katsuyuki, Nadkarni, Girish N., Peralta, Carmen A., Rothenbacher, Dietrich, Schaeffner, Elke, Sedaghat, Sanaz, Shlipak, Michael G., Zhang, Luxia, van Zuilen, Arjan D., Hallan, Stein I., Kovesdy, Csaba P., Woodward, Mark, Levin, Adeera, Inker, Lesley A., Grams, Morgan E., Levey, Andrew S., Coresh, Josef, Cirillo, Massimo, Collins, John F., Gansevoort, Ron T., Gutierrez, Orlando M., Hamano, Takayuki, Heine, Gunnar H., Ishikawa, Shizukiyo, Jee, Sun Ha, Kronenberg, Florian, Landray, Martin J., Miura, Katsuyuki, Nadkarni, Girish N., Peralta, Carmen A., Rothenbacher, Dietrich, Schaeffner, Elke, Sedaghat, Sanaz, Shlipak, Michael G., Zhang, Luxia, van Zuilen, Arjan D., Hallan, Stein I., Kovesdy, Csaba P., Woodward, Mark, and Levin, Adeera

Abstract

Rationale & Objective: 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. Study Design: Cross-sectional individual participant-level analyses in a global consortium. Setting & Study Populations: 17 CKD and 38 general population and high-risk cohorts. Selection Criteria for Studies: 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 Extraction: Data were obtained and analyzed between July 2015 and January 2018. Analytical Approach: 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. Results: 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 59 mL/min/1.73 m2), whereas albuminuria had equivocal or weak associations with abnormalities (ORs ranging from 0.77 [95% CI, 0.60-0.99] to 1.92 [95% CI, 1.65-2.24] comparing urinary albumin-creatinine ratio > 300 vs < 30 mg/g). Limitations: Variations in study era, health care delivery system, typical diet, and

Published
2019

43. Adiposity and risk of decline in glomerular filtration rate: meta-analysis of individual participant data in a global consortium

Author

Chang, Alex R, primary, Grams, Morgan E, additional, Ballew, Shoshana H, additional, Bilo, Henk, additional, Correa, Adolfo, additional, Evans, Marie, additional, Gutierrez, Orlando M, additional, Hosseinpanah, Farhad, additional, Iseki, Kunitoshi, additional, Kenealy, Timothy, additional, Klein, Barbara, additional, Kronenberg, Florian, additional, Lee, Brian J, additional, Li, Yuanying, additional, Miura, Katsuyuki, additional, Navaneethan, Sankar D, additional, Roderick, Paul J, additional, Valdivielso, Jose M, additional, Visseren, Frank L J, additional, Zhang, Luxia, additional, Gansevoort, Ron T, additional, Hallan, Stein I, additional, Levey, Andrew S, additional, Matsushita, Kunihiro, additional, Shalev, Varda, additional, and Woodward, Mark, additional

Published
2019
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44. Serum potassium and adverse outcomes across the range of kidney function: a CKD Prognosis Consortium meta-analysis: a CKD Prognosis Consortium meta-analysis

Author

MS Nefrologie, Circulatory Health, Kovesdy, Csaba P, Matsushita, Kunihiro, Sang, Yingying, Brunskill, Nigel J, Carrero, Juan J, Chodick, Gabriel, Hasegawa, Takeshi, Heerspink, Hiddo L, Hirayama, Atsushi, Landman, Gijs W D, Levin, Adeera, Nitsch, Dorothea, Wheeler, David C, Coresh, Josef, Hallan, Stein I, Shalev, Varda, Grams, Morgan E, CKD Prognosis Consortium, MS Nefrologie, Circulatory Health, Kovesdy, Csaba P, Matsushita, Kunihiro, Sang, Yingying, Brunskill, Nigel J, Carrero, Juan J, Chodick, Gabriel, Hasegawa, Takeshi, Heerspink, Hiddo L, Hirayama, Atsushi, Landman, Gijs W D, Levin, Adeera, Nitsch, Dorothea, Wheeler, David C, Coresh, Josef, Hallan, Stein I, Shalev, Varda, Grams, Morgan E, and CKD Prognosis Consortium

Published
2018

49. Abstract 553: High-Intensity Interval Training Partly Restores Thrombotic Microangiopathy in an Experimental Model of Hypertensive Renal Injury

Author

Silva, Gustavo J, primary, Langlo, Knut A, additional, Rolim, Natale, additional, Moreira, Jose B, additional, Medeiros, Alessandra, additional, Alves, Marcia, additional, Yang, Xiaojuan, additional, Gusky, Till, additional, Lesko, Paulina, additional, Bækkerud, Fredrik H, additional, Ness, Henning O, additional, Aasarød, Knut, additional, Hallan, Stein I, additional, and Wisløff, Ulrik, additional

Published
2014
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50. Age and association of kidney measures with mortality and end-stage renal disease.

Author

Hallan, Stein I, Matsushita, Kunihiro, Sang, Yingying, Mahmoodi, Bakhtawar K, Black, Corri, Ishani, Areef, Kleefstra, Nanne, Naimark, David, Roderick, Paul, Tonelli, Marcello, Wetzels, Jack F M, Astor, Brad C, Gansevoort, Ron T, Levin, Adeera, Wen, Chi-Pang, Coresh, Josef, Hallan, Stein I, Matsushita, Kunihiro, Sang, Yingying, Mahmoodi, Bakhtawar K, Black, Corri, Ishani, Areef, Kleefstra, Nanne, Naimark, David, Roderick, Paul, Tonelli, Marcello, Wetzels, Jack F M, Astor, Brad C, Gansevoort, Ron T, Levin, Adeera, Wen, Chi-Pang, and Coresh, Josef

Abstract

CONTEXT: Chronic kidney disease (CKD) is prevalent in older individuals, but the risk implications of low estimated glomerular filtration rate (eGFR) and high albuminuria across the full age range are controversial. OBJECTIVE: To evaluate possible effect modification (interaction) by age of the association of eGFR and albuminuria with clinical risk, examining both relative and absolute risks. DESIGN, SETTING, AND PARTICIPANTS: Individual-level meta-analysis including 2,051,244 participants from 33 general population or high-risk (of vascular disease) cohorts and 13 CKD cohorts from Asia, Australasia, Europe, and North/South America, conducted in 1972-2011 with a mean follow-up time of 5.8 years (range, 0-31 years). MAIN OUTCOME MEASURES: Hazard ratios (HRs) of mortality and end-stage renal disease (ESRD) according to eGFR and albuminuria were meta-analyzed across age categories after adjusting for sex, race, cardiovascular disease, diabetes, systolic blood pressure, cholesterol, body mass index, and smoking. Absolute risks were estimated using HRs and average incidence rates. RESULTS: Mortality (112,325 deaths) and ESRD (8411 events) risks were higher at lower eGFR and higher albuminuria in every age category. In general and high-risk cohorts, relative mortality risk for reduced eGFR decreased with increasing age; eg, adjusted HRs at an eGFR of 45 mL/min/1.73 m2 vs 80 mL/min/1.73 m2 were 3.50 (95% CI, 2.55-4.81), 2.21 (95% CI, 2.02-2.41), 1.59 (95% CI, 1.42-1.77), and 1.35 (95% CI, 1.23-1.48) in age categories 18-54, 55-64, 65-74, and ≥75 years, respectively (P <.05 for age interaction). Absolute risk differences for the same comparisons were higher at older age (9.0 [95% CI, 6.0-12.8], 12.2 [95% CI, 10.3-14.3], 13.3 [95% CI, 9.0-18.6], and 27.2 [95% CI, 13.5-45.5] excess deaths per 1000 person-years, respectively). For increased albuminuria, reduction of relative risk with increasing age was less evident, while differences in absolute risk were higher in older a

Published
2012
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