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1. Circulating Metabolomic Associations with Neurocognitive Outcomes in Pediatric CKD

Author

Lee, Arthur M., Xu, Yunwen, Hooper, Stephen R., Abraham, Alison G., Hu, Jian, Xiao, Rui, Matheson, Matthew B., Brunson, Celina, Rhee, Eugene P., Coresh, Josef, Vasan, Ramachandran S., Schrauben, Sarah, Kimmel, Paul L., Warady, Bradley A., Furth, Susan L., Hartung, Erum A., Denburg, Michelle R., Abraham, Alison, Anderson, Amanda, Ballard, Shawn, Bonventre, Joseph, Clish, Clary, Collins, Heather, Coca, Steven, Coresh, Josef, Deo, Rajat, Denburg, Michelle, Dubin, Ruth, Feldman, Harold I., Ferket, Bart S., Foster, Meredith, Furth, Susan, Ganz, Peter, Gossett, Daniel, Grams, Morgan, Greenberg, Jason, Gutiérrez, Orlando M., Hostetter, Tom, Inker, Lesley A., Ix, Joachim, Kimmel, Paul L., Klein, Jon, Levey, Andrew S., Massaro, Joseph, McMahon, Gearoid, Mifflin, Theodore, Nadkarni, Girish N., Parikh, Chirag, Ramachandran, Vasan S., Rebholz, Casey, Rhee, Eugene, Rovin, Brad, Sarnak, M., Sabbisetti, Venkata, Schelling, Jeffrey, Seegmiller, Jesse, Shlipak, Michael G., Shou, Haochang, Tin, Adriene, Waikar, Sushrut, Warady, Bradley, Whitehead, Krista, and Xie, Dawei

Published
2024
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2. Urinary Markers of Fibrosis and Risk of Cardiovascular Events and Death in Kidney Transplant Recipients: The FAVORIT Trial

Author

Park, M, Katz, R, Shlipak, MG, Weiner, D, Tracy, R, Jotwani, V, Hughes-Austin, J, Gabbai, F, Hsu, CY, Pfeffer, M, Bansal, N, Bostom, A, Gutierrez, O, Sarnak, M, Levey, A, and Ix, JH

Subjects
Organ Transplantation, Cardiovascular, Kidney Disease, Transplantation, Prevention, Heart Disease, Detection, screening and diagnosis, 4.1 Discovery and preclinical testing of markers and technologies, Renal and urogenital, Good Health and Well Being, Aged, Biomarkers, Cardiovascular Diseases, Case-Control Studies, Female, Fibrosis, Folic Acid, Humans, Kidney Transplantation, Male, Middle Aged, Nephritis, Interstitial, Risk Factors, biomarker, cardiovascular disease, clinical research/practice, kidney disease, kidney transplantation/nephrology, Medical and Health Sciences, Surgery
Abstract

Cardiovascular risk remains high in kidney transplant recipients (KTRs) despite improved kidney function after transplant. Urinary markers of kidney fibrosis and injury may help to reveal mechanisms of this risk. In a case-cohort study among stable KTRs who participated in the FAVORIT trial, we measured four urinary proteins known to correlate with kidney tubulointerstitial fibrosis on biopsy (urine alpha 1 microglobulin [α1m], monocyte chemoattractant protein-1 [MCP-1], procollagen type I [PINP] and type III [PIIINP] N-terminal amino peptide) and evaluated associations with cardiovascular disease (CVD) events (n = 300) and death (n = 371). In adjusted models, higher urine α1m (hazard ratio [HR] per doubling of biomarker 1.40 [95% confidence interval [CI] 1.21, 1.62]), MCP-1 (HR 1.18 [1.03, 1.36]), and PINP (HR 1.13 [95% CI 1.03, 1.23]) were associated with CVD events. These three markers were also associated with death (HR per doubling α1m 1.51 [95% CI 1.32, 1.72]; MCP-1 1.31 [95% CI 1.13, 1.51]; PINP 1.11 [95% CI 1.03, 1.20]). Higher concentrations of urine α1m, MCP-1, and PINP may identify KTRs at higher risk for CVD events and death. These markers may identify a systemic process of fibrosis involving both the kidney and cardiovascular system, and give new insights into mechanisms linking the kidney with CVD.

Published
2017

4. Association of Integrated Proteomic and Metabolomic Modules with Risk of Kidney Disease Progression

Author

Schlosser, Pascal, Surapaneni, Aditya L., Borisov, Oleg, Schmidt, Insa M., Zhou, Linda, Anderson, Amanda, Deo, Rajat, Dubin, Ruth, Ganz, Peter, He, Jiang, Kimmel, Paul L., Li, Hongzhe, Nelson, Robert G., Porter, Anna C., Rahman, Mahboob, Rincon-Choles, Hernan, Shah, Vallabh, Unruh, Mark L., Vasan, Ramachandran S., Zheng, Zihe, Feldman, Harold I., Waikar, Sushrut S., Köttgen, Anna, Rhee, Eugene P., Coresh, Josef, Grams, Morgan E., Anderson, Amanda H., Appel, Lawrence J., Chen, Jing, Cohen, Debbie L., Dember, Laura M., Go, Alan S., Lash, James P., Rao, Panduranga S., Waikar, Sushrut, Schelling, Jeffrey, Denburg, Michelle, Furth, Susan, Warady, Bradley, Bonventre, Joseph, McMahon, Gearoid, Sabbisetti, Venkata, Coresh, Josef, Grams, Morgan, Rebholz, Casey, Abraham, Alison, Tin, Adriene, Parikh, Chirag, Klein, Jon, Coca, Steven, Ferket, Bart S., Nadkarni, Girish N., Rhee, Eugene, Kimmel, Paul L., Gossett, Daniel, Rovin, Brad, Shlipak, Michael G., Sarnak, M., Levey, Andrew S., Inker, Lesley A., Foster, Meredith, Gutiérrez, Orlando M., Ix, Joachim, Dubin, Ruth, Seegmiller, Jesse, Hostetter, Tom, Deo, Rajat, Li, Hongzhe, Ren, Yue, Schrauben, Sarah J., Feldman, Harold I., Anderson, Amanda, Mifflin, Theodore, Xie, Dawei, Shou, Haochang, Ballard, Shawn, Whitehead, Krista, Collins, Heather, Ramachandran, Vasan S., Greenberg, Jason, and Ganz, Peter

Published
2024
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5. Cystatin-C and mortality in elderly persons with heart failure

Author

Shlipak, M G, Katz, R, Fried, L, Jenny, N S, Stehman-Breen, C, Newman, A, Siscovick, D, Psaty, B, and Sarnak, M J

Subjects
Cystatin-C, heart failure, chronic kidney disease, epidemiology
Abstract

OBJECTIVES We sought to evaluate cystatin-C, a novel measure of renal function, as a predictor of mortality in elderly persons with heart failure (HF) and to compare it with creatinine. BACKGROUND Renal function is an important prognostic factor in patients with HF, but creatinine levels, which partly reflect muscle mass, may be insensitive for detecting renal insufficiency. METHODS A total of 279 Cardiovascular Health Study participants with prevalent HF and measures of serum cystatin-C and creatinine were followed for mortality outcomes over a median of 6.5 years. RESULTS Median creatinine and cystatin-C levels were 1.05 mg/dl and 1.26 mg/l. Each standard deviation increase in cystatin-C (0.35 mg/l) was associated with a 31% greater adjusted mortality risk (95% confidence interval [CI] 20% to 43%, p < 0.001), whereas each standard deviation increase in creatinine (0.39 mg/dl) was associated with a 17% greater adjusted mortality risk (95% CI 1% to 36%, p = 0.04). When both measures were combined in a single adjusted model, cystatin-C remained associated with elevated mortality risk (hazard ratio 1.60, 95% CI 1.32 to 1.94), whereas creatinine levels appeared associated with lower risk (hazard ratio 0.73, 95% CI 0.57 to 0.95). CONCLUSIONS Cystatin-C is a stronger predictor of mortality than creatinine in elderly persons with HF. If confirmed in future studies, this new marker of renal function could improve risk stratification in patients with HF. (C) 2005 by the American College of Cardiology Foundation

Published
2005

6. Major cardiovascular events and subsequent risk of kidney failure with replacement therapy: a CKD Prognosis Consortium study

Author

Mark, P.B., Carrero, J.J., Matsushita, K., Sang, Y., Ballew, S.H., Grams, M.E., Coresh, J., Surapaneni, A., Brunskill, N.J., Chalmers, J., Chan, L., Chang, A.R., Chinnadurai, R., Chodick, G., Cirillo, M., Zeeuw, D. de, Evans, M., Garg, A.X., Gutierrez, O.M., Heerspink, H.J.L., Heine, G.H., Herrington, W.G., Ishigami, J., Kronenberg, F., Lee, J.Y., Levin, A., Major, R.W., Marks, A., Nadkarni, G.N., Naimark, D.M.J., Nowak, C., Rahman, M., Sabanayagam, C., Sarnak, M., Sawhney, S., Schneider, M.P., Shalev, V., Shin, J.I., Siddiqui, M.K., Stempniewicz, N., Sumida, K., Valdivielso, J.M., Brand, J. van den, Yee-Moon Wang, A, Wheeler, D.C., Zhang, L., Visseren, F.L.J., Stengel, B., Mark, P.B., Carrero, J.J., Matsushita, K., Sang, Y., Ballew, S.H., Grams, M.E., Coresh, J., Surapaneni, A., Brunskill, N.J., Chalmers, J., Chan, L., Chang, A.R., Chinnadurai, R., Chodick, G., Cirillo, M., Zeeuw, D. de, Evans, M., Garg, A.X., Gutierrez, O.M., Heerspink, H.J.L., Heine, G.H., Herrington, W.G., Ishigami, J., Kronenberg, F., Lee, J.Y., Levin, A., Major, R.W., Marks, A., Nadkarni, G.N., Naimark, D.M.J., Nowak, C., Rahman, M., Sabanayagam, C., Sarnak, M., Sawhney, S., Schneider, M.P., Shalev, V., Shin, J.I., Siddiqui, M.K., Stempniewicz, N., Sumida, K., Valdivielso, J.M., Brand, J. van den, Yee-Moon Wang, A, Wheeler, D.C., Zhang, L., Visseren, F.L.J., and Stengel, B.

Abstract

Item does not contain fulltext, AIMS: Chronic kidney disease (CKD) increases risk of cardiovascular disease (CVD). Less is known about how CVD associates with future risk of kidney failure with replacement therapy (KFRT). METHODS AND RESULTS: The study included 25 903 761 individuals from the CKD Prognosis Consortium with known baseline estimated glomerular filtration rate (eGFR) and evaluated the impact of prevalent and incident coronary heart disease (CHD), stroke, heart failure (HF), and atrial fibrillation (AF) events as time-varying exposures on KFRT outcomes. Mean age was 53 (standard deviation 17) years and mean eGFR was 89 mL/min/1.73 m2, 15% had diabetes and 8.4% had urinary albumin-to-creatinine ratio (ACR) available (median 13 mg/g); 9.5% had prevalent CHD, 3.2% prior stroke, 3.3% HF, and 4.4% prior AF. During follow-up, there were 269 142 CHD, 311 021 stroke, 712 556 HF, and 605 596 AF incident events and 101 044 (0.4%) patients experienced KFRT. Both prevalent and incident CVD were associated with subsequent KFRT with adjusted hazard ratios (HRs) of 3.1 [95% confidence interval (CI): 2.9-3.3], 2.0 (1.9-2.1), 4.5 (4.2-4.9), 2.8 (2.7-3.1) after incident CHD, stroke, HF and AF, respectively. HRs were highest in first 3 months post-CVD incidence declining to baseline after 3 years. Incident HF hospitalizations showed the strongest association with KFRT [HR 46 (95% CI: 43-50) within 3 months] after adjustment for other CVD subtype incidence. CONCLUSION: Incident CVD events strongly and independently associate with future KFRT risk, most notably after HF, then CHD, stroke, and AF. Optimal strategies for addressing the dramatic risk of KFRT following CVD events are needed.

Published
2023

7. Blood pressure in chronic kidney disease: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

Author

Cheung, A, Chang, T, Cushman, W, Furth, S, Ix, J, Pecoits-Filho, R, Perkovic, V, Sarnak, M, Tobe, S, Tomson, C, Cheung, M, Wheeler, D, Winkelmayer, W, Mann, J, Bakris, G, Damasceno, A, Dwyer, J, Fried, L, Haynes, R, Hirawa, N, Holdaas, H, Ibrahim, H, Ingelfinger, J, Iseki, K, Khwaja, A, Kimmel, P, Kovesdy, C, Ku, E, Lerma, E, Luft, F, Lv, J, Mcfadden, C, Muntner, P, Myers, M, Navaneethan, S, Parati, G, Peixoto, A, Prasad, R, Rahman, M, Rocco, M, Rodrigues, C, Roger, S, Stergiou, G, Tomlinson, L, Tonelli, M, Toto, R, Tsukamoto, Y, Walker, R, Wang, A, Wang, J, Warady, B, Whelton, P, Williamson, J, Cheung A. K., Chang T. I., Cushman W. C., Furth S. L., Ix J. H., Pecoits-Filho R., Perkovic V., Sarnak M. J., Tobe S. W., Tomson C. R. V., Cheung M., Wheeler D. C., Winkelmayer W. C., Mann J. F. E., Bakris G. L., Damasceno A., Dwyer J. P., Fried L. F., Haynes R., Hirawa N., Holdaas H., Ibrahim H. N., Ingelfinger J. R., Iseki K., Khwaja A., Kimmel P. L., Kovesdy C. P., Ku E., Lerma E. V., Luft F. C., Lv J., McFadden C. B., Muntner P., Myers M. G., Navaneethan S. D., Parati G., Peixoto A. J., Prasad R., Rahman M., Rocco M. V., Rodrigues C. I. S., Roger S. D., Stergiou G. S., Tomlinson L. A., Tonelli M., Toto R. D., Tsukamoto Y., Walker R., Wang A. Y. -M., Wang J., Warady B. A., Whelton P. K., Williamson J. D., Cheung, A, Chang, T, Cushman, W, Furth, S, Ix, J, Pecoits-Filho, R, Perkovic, V, Sarnak, M, Tobe, S, Tomson, C, Cheung, M, Wheeler, D, Winkelmayer, W, Mann, J, Bakris, G, Damasceno, A, Dwyer, J, Fried, L, Haynes, R, Hirawa, N, Holdaas, H, Ibrahim, H, Ingelfinger, J, Iseki, K, Khwaja, A, Kimmel, P, Kovesdy, C, Ku, E, Lerma, E, Luft, F, Lv, J, Mcfadden, C, Muntner, P, Myers, M, Navaneethan, S, Parati, G, Peixoto, A, Prasad, R, Rahman, M, Rocco, M, Rodrigues, C, Roger, S, Stergiou, G, Tomlinson, L, Tonelli, M, Toto, R, Tsukamoto, Y, Walker, R, Wang, A, Wang, J, Warady, B, Whelton, P, Williamson, J, Cheung A. K., Chang T. I., Cushman W. C., Furth S. L., Ix J. H., Pecoits-Filho R., Perkovic V., Sarnak M. J., Tobe S. W., Tomson C. R. V., Cheung M., Wheeler D. C., Winkelmayer W. C., Mann J. F. E., Bakris G. L., Damasceno A., Dwyer J. P., Fried L. F., Haynes R., Hirawa N., Holdaas H., Ibrahim H. N., Ingelfinger J. R., Iseki K., Khwaja A., Kimmel P. L., Kovesdy C. P., Ku E., Lerma E. V., Luft F. C., Lv J., McFadden C. B., Muntner P., Myers M. G., Navaneethan S. D., Parati G., Peixoto A. J., Prasad R., Rahman M., Rocco M. V., Rodrigues C. I. S., Roger S. D., Stergiou G. S., Tomlinson L. A., Tonelli M., Toto R. D., Tsukamoto Y., Walker R., Wang A. Y. -M., Wang J., Warady B. A., Whelton P. K., and Williamson J. D.

Abstract

In September 2017, KDIGO (Kidney Disease: Improving Global Outcomes) convened a Controversies Conference titled Blood Pressure in Chronic Kidney Disease (CKD). The purpose of the meeting was to consider which recommendations from the 2012 KDIGO Clinical Practice Guideline for the Management of Blood Pressure in CKD should be reevaluated based on new evidence from clinical trials. Participants included a multidisciplinary panel of clinical and scientific experts. Discussions focused on the optimal means for measuring blood pressure (BP) as well as managing BP in CKD patients. Consistent with the 2012 Guideline, the conference did not address BP management in patients on maintenance dialysis.

Published
2019

8. Measures of chronic kidney disease and risk of incident peripheral artery disease: a collaborative meta-analysis of individual participant data

Author

Matsushita, K, Ballew, Sh, Coresh, J, Arima, H, Ärnlöv, J, Cirillo, Massimo, Ebert, N, Hiramoto, Js, Kimm, H, Shlipak, Mg, Visseren, Flj, Gansevoort, Rt, Kovesdy, Cp, Shalev, V, Woodward, M, Kronenberg, F, Chronic Kidney Disease Prognosis Consortium: Chalmers, J, Perkovic, V, Grams, Me, Sang, Y, Schaeffner, E, Martus, P, Levin, A, Djurdjev, O, Tang, M, Heine, G, Seiler, S, Zawada, A, Emrich, I, Sarnak, M, Katz, R, Brenner, H, Schöttker, B, Rothenbacher, D, Saum, Ku, Köttgen, A, Schneider, M, Eckardt, Ku, Green, J, Kirchner, Hl, Chang, Ar, Black, C, Marks, A, Prescott, G, Clark, L, Fluck, N, Jee, Sh, Mok, Y, Chodick, G, Wetzels, Jfm, Blankestijn, Pj, Van, Zuilen, Bots, M, Peralta, C, Hiromoto, J, Bottinger, E, Nadkarni, Gn, Ellis, Sb, Nadukuru, R, Kenealy, T, Elley, Cr, Collins, Jf, Drury, Pl, Bakker, Sj, Heerspink, Hjl, Jassal, Sk, Bergstrom, J, Jh, Ix, Barrett Connor, E, Kalantar Zadeh, K, Carrero, Jj, Gasparini, A, Qureshi, Ar, Barany, P, Algra, A, Van, Der, Graaf, Y, Evans, M, Segelmark, M, Stendahl, M, Schön, S, Tangri, N, Sud, M, Naimark, D, Lannfelt, L, Larsson, A, Hallan, S, Levey, As, Chen, J, Kwak, L, Sang, Y., Cardiovascular Centre (CVC), Groningen Kidney Center (GKC), Matsushita, K, Ballew, Sh, Coresh, J, Arima, H, Ärnlöv, J, Cirillo, Massimo, Ebert, N, Hiramoto, J, Kimm, H, Shlipak, Mg, Visseren, Flj, Gansevoort, Rt, Kovesdy, Cp, Shalev, V, Woodward, M, Kronenberg, F, Chronic Kidney Disease Prognosis Consortium: Chalmers, J, Perkovic, V, Grams, Me, Sang, Y, Schaeffner, E, Martus, P, Levin, A, Djurdjev, O, Tang, M, Heine, G, Seiler, S, Zawada, A, Emrich, I, Sarnak, M, Katz, R, Brenner, H, Schöttker, B, Rothenbacher, D, Saum, Ku, Köttgen, A, Schneider, M, Eckardt, Ku, Green, J, Kirchner, Hl, Chang, Ar, Black, C, Marks, A, Prescott, G, Clark, L, Fluck, N, Jee, Sh, Mok, Y, Chodick, G, Wetzels, Jfm, Blankestijn, Pj, Van, Zuilen, Ad, Bots, M, Peralta, C, Hiromoto, J, Bottinger, E, Nadkarni, Gn, Ellis, Sb, Nadukuru, R, Kenealy, T, Elley, Cr, Collins, Jf, Drury, Pl, Bakker, Sj, Heerspink, Hjl, Jassal, Sk, Bergstrom, J, Ix, Jh, Barrett Connor, E, Kalantar Zadeh, K, Carrero, Jj, Gasparini, A, Qureshi, Ar, Barany, P, Algra, A, Van, Der, Graaf, Y, Evans, M, Segelmark, M, Stendahl, M, Schön, S, Tangri, N, Sud, M, Naimark, D, Lannfelt, L, Larsson, A, Hallan, S, Levey, A, Chen, J, Kwak, L, and Sang, Y.

Subjects
Male, Databases, Factual, Endocrinology, Diabetes and Metabolism, nefropatia, arteriopatia periferica, epidemiologia, 030204 cardiovascular system & hematology, GLOMERULAR-FILTRATION-RATE, arteriopatia periferica, 0302 clinical medicine, Endocrinology, Risk Factors, CRITICAL LIMB ISCHEMIA, 030212 general & internal medicine, epidemiologia, POPULATION, biology, CYSTATIN C, Incidence, Middle Aged, PREVALENCE, Diabetes and Metabolism, nefropatia, Creatinine, Female, medicine.symptom, Glomerular Filtration Rate, Adult, medicine.medical_specialty, Renal function, ATHEROSCLEROSIS RISK, HEART-ASSOCIATION, CARDIOVASCULAR OUTCOMES, 03 medical and health sciences, Peripheral Arterial Disease, Internal medicine, Diabetes mellitus, medicine, Internal Medicine, Albuminuria, Humans, Risk factor, Renal Insufficiency, Chronic, Aged, business.industry, Critical limb ischemia, medicine.disease, Intermittent claudication, Surgery, Cystatin C, biology.protein, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11], business, Kidney disease
Abstract

BACKGROUND: Some evidence suggests that chronic kidney disease is a risk factor for lower-extremity peripheral artery disease. We aimed to quantify the independent and joint associations of two measures of chronic kidney disease (estimated glomerular filtration rate [eGFR] and albuminuria) with the incidence of peripheral artery disease.METHODS: In this collaborative meta-analysis of international cohorts included in the Chronic Kidney Disease Prognosis Consortium (baseline measurements obtained between 1972 and 2014) with baseline measurements of eGFR and albuminuria, at least 1000 participants (this criterion not applied to cohorts exclusively enrolling patients with chronic kidney disease), and at least 50 peripheral artery disease events, we analysed adult participants without peripheral artery disease at baseline at the individual patient level with Cox proportional hazards models to quantify associations of creatinine-based eGFR, urine albumin-to-creatinine ratio (ACR), and dipstick proteinuria with the incidence of peripheral artery disease (including hospitalisation with a diagnosis of peripheral artery disease, intermittent claudication, leg revascularisation, and leg amputation). We assessed discrimination improvement through c-statistics.FINDINGS: We analysed 817 084 individuals without a history of peripheral artery disease at baseline from 21 cohorts. 18 261 cases of peripheral artery disease were recorded during follow-up across cohorts (median follow-up was 7·4 years [IQR 5·7-8·9], range 2·0-15·8 years across cohorts). Both chronic kidney disease measures were independently associated with the incidence of peripheral artery disease. Compared with an eGFR of 95 mL/min per 1·73 m(2), adjusted hazard ratios (HRs) for incident study-specific peripheral artery disease was 1·22 (95% CI 1·14-1·30) at an eGFR of 45 mL/min per 1·73 m(2) and 2·06 (1·70-2·48) at an eGFR of 15 mL/min per 1·73 m(2). Compared with an ACR of 5 mg/g, the adjusted HR for incident study-specific peripheral artery disease was 1·50 (1·41-1·59) at an ACR of 30 mg/g and 2·28 (2·12-2·44) at an ACR of 300 mg/g. The adjusted HR at an ACR of 300 mg/g versus 5 mg/g was 3·68 (95% CI 3·00-4·52) for leg amputation. eGFR and albuminuria contributed multiplicatively (eg, adjusted HR 5·76 [4·90-6·77] for incident peripheral artery disease and 10·61 [5·70-19·77] for amputation in eGFR INTERPRETATION: Even mild-to-moderate chronic kidney disease conferred increased risk of incident peripheral artery disease, with a strong association between albuminuria and amputation. Clinical attention should be paid to the development of peripheral artery disease symptoms and signs in people with any stage of chronic kidney disease.FUNDING: American Heart Association, US National Kidney Foundation, and US National Institute of Diabetes and Digestive and Kidney Diseases.

Published
2017

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

Author

Chang AR, Grams ME, Ballew SH, Bilo H, Correa A, Evans M, Gutierrez OM, Hosseinpanah F, Iseki K, Kenealy T, Klein B, Kronenberg F, Lee BJ, Li Y, Miura K, Navaneethan SD, Roderick PJ, Valdivielso JM, Visseren FLJ, Zhang L, Gansevoort RT, Hallan SI, Levey AS, Matsushita K, Shalev V, Woodward M, Astor B, Appel L, Greene T, Chen T, Chalmers J, Arima H, Perkovic V, Yatsuya H, Tamakoshi K, Hirakawa Y, Coresh J, Sang Y, Polkinghorne K, Chadban S, Atkins R, Levin A, Djurdjev O, Klein R, Lee K, Liu L, Zhao M, Wang F, Wang J, Tang M, Heine G, Emrich I, Zawada A, Bauer L, Nally J, Schold J, Shlipak M, Sarnak M, Katz R, Hiramoto J, Iso H, Yamagishi K, Umesawa M, Muraki I, Fukagawa M, Maruyama S, Hamano T, Hasegawa T, Fujii N, Jafar T, Hatcher J, Poulter N, Chaturvedi N, Wheeler D, Emberson J, Townend J, Landray M, Brenner H, Schöttker B, Saum KU, Rothenbacher D, Fox C, Hwang SJ, Köttgen A, Schneider MP, Eckardt KU, Green J, Kirchner HL, Ito S, Miyazaki M, Nakayama M, Yamada G, Cirillo M, Romundstad S, Øvrehus M, Langlo KA, Irie F, Sairenchi T, Rebholz CM, Young B, Boulware LE, Ishikawa S, Yano Y, Kotani K, Nakamura T, Jee SH, Kimm H, Mok Y, Chodick G, Wetzels JFM, Blankestijn PJ, van Zuilen AD, Bots M, Inker L, Peralta C, Kollerits B, Ritz E, Nitsch D, Fletcher A, Bottinger E, Nadkarni GN, Ellis SB, Nadukuru R, Fernandez E, Betriu A, Bermudez-Lopez M, Stengel B, Metzger M, Flamant M, Houillier P, Haymann JP, Froissart M, Ueshima H, Okayama A, Tanaka S, Okamura T, Elley CR, Collins JF, Drury PL, Ohkubo T, Asayama K, Metoki H, Kikuya M, Iseki C, Nelson RG, Knowler WC, Bakker SJL, Heerspink HJL, Brunskill N, Major R, Shepherd D, Medcalf J, Jassal SK, Bergstrom J, Ix JH, Barrett-Connor E, Kovesdy C, Kalantar-Zadeh K, Sumida K, Muntner P, Warnock D, Judd S, Panwar B, de Zeeuw D, Brenner B, Sedaghat S, Ikram MA, Hoorn EJ, Dehghan A, Wong TY, Sabanayagam C, Cheng CY, Banu R, Segelmark M, Stendahl M, Schön S, Tangri N, Sud M, Naimark D, Wen CP, Tsao CK, Tsai MK, Chen CH, Konta T, Hirayama A, Ichikawa K, Hadaegh F, Mirbolouk M, Azizi F, Solbu MD, Jenssen TG, Eriksen BO, Eggen AE, Lannfelt L, Larsson A, Ärnlöv J, Landman GWD, van Hateren KJJ, Kleefstra N, Chen J, Kwak L, Surapaneni A., Chang, Ar, Grams, Me, Ballew, Sh, Bilo, H, Correa, A, Evans, M, Gutierrez, Om, Hosseinpanah F, Iseki K, Kenealy, T, Klein, B, Kronenberg, F, Lee, Bj, Li, Y, Miura, K, Navaneethan, Sd, Roderick, Pj, Valdivielso, Jm, Visseren, Flj, Zhang, L, Gansevoort, Rt, Hallan, Si, Levey, A, Matsushita, K, Shalev, V, Woodward, M, Astor, B, Appel, L, Greene, T, Chen, T, Chalmers, J, Arima, H, Perkovic, V, Yatsuya, H, Tamakoshi, K, Hirakawa, Y, Coresh, J, Sang, Y, Polkinghorne, K, Chadban, S, Atkins, R, Levin, A, Djurdjev, O, Klein, R, Lee, K, Liu, L, Zhao, M, Wang, F, Wang, J, Tang, M, Heine, G, Emrich, I, Zawada, A, Bauer, L, Nally, J, Schold, J, Shlipak, M, Sarnak, M, Katz, R, Hiramoto, J, Iso, H, Yamagishi, K, Umesawa, M, Muraki, I, Fukagawa, M, Maruyama, S, Hamano, T, Hasegawa, T, Fujii, N, Jafar, T, Hatcher, J, Poulter, N, Chaturvedi, N, Wheeler, D, Emberson, J, Townend, J, Landray, M, Brenner, H, Schöttker, B, Saum, Ku, Rothenbacher, D, Fox, C, Hwang, Sj, Köttgen, A, Schneider, Mp, Eckardt, Ku, Green, J, Kirchner, Hl, Ito, S, Miyazaki, M, Nakayama, M, Yamada, G, Cirillo, M, Romundstad, S, Øvrehus, M, Langlo, Ka, Irie, F, Sairenchi, T, Rebholz, Cm, Young, B, Boulware, Le, Ishikawa, S, Yano, Y, Kotani, K, Nakamura, T, Jee, Sh, Kimm, H, Mok, Y, Chodick, G, Wetzels, Jfm, Blankestijn, Pj, van Zuilen, Ad, Bots, M, Inker, L, Peralta, C, Kollerits, B, Ritz, E, Nitsch, D, Fletcher, A, Bottinger, E, Nadkarni, Gn, Ellis, Sb, Nadukuru, R, Fernandez, E, Betriu, A, Bermudez-Lopez, M, Stengel, B, Metzger, M, Flamant, M, Houillier, P, Haymann, Jp, Froissart, M, Ueshima, H, Okayama, A, Tanaka, S, Okamura, T, Elley, Cr, Collins, Jf, Drury, Pl, Ohkubo, T, Asayama, K, Metoki, H, Kikuya, M, Iseki, C, Nelson, Rg, Knowler, Wc, Bakker, Sjl, Heerspink, Hjl, Brunskill, N, Major, R, Shepherd, D, Medcalf, J, Jassal, Sk, Bergstrom, J, Ix, Jh, Barrett-Connor, E, Kovesdy, C, Kalantar-Zadeh, K, Sumida, K, Muntner, P, Warnock, D, Judd, S, Panwar, B, de Zeeuw, D, Brenner, B, Sedaghat, S, Ikram, Ma, Hoorn, Ej, Dehghan, A, Wong, Ty, Sabanayagam, C, Cheng, Cy, Banu, R, Segelmark, M, Stendahl, M, Schön, S, Tangri, N, Sud, M, Naimark, D, Wen, Cp, Tsao, Ck, Tsai, Mk, Chen, Ch, Konta, T, Hirayama, A, Ichikawa, K, Hadaegh, F, Mirbolouk, M, Azizi, F, Solbu, Md, Jenssen, Tg, Eriksen, Bo, Eggen, Ae, Lannfelt, L, Larsson, A, Ärnlöv, J, Landman, Gwd, van Hateren, Kjj, Kleefstra, N, Chen, J, Kwak, L, Surapaneni, A., Lifestyle Medicine (LM), Cardiovascular Centre (CVC), Groningen Kidney Center (GKC), Groningen Institute for Organ Transplantation (GIOT), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Asayama, Kei, and Sedaghat, SeyyedMah

Subjects
CHRONIC KIDNEY-DISEASE, Male, 030232 urology & nephrology, 030204 cardiovascular system & hematology, OBESITY PARADOX, Body Mass Index, BMI, eGFR, CKD-PC, Cohort Studies, 0302 clinical medicine, Risk Factors, Urologi och njurmedicin, Medicine, ALL-CAUSE MORTALITY, Adiposity, 2. Zero hunger, Aged, 80 and over, Medicine(all), education.field_of_study, Hazard ratio, ASSOCIATION, General Medicine, Middle Aged, 3. Good health, Cohort, Female, Waist Circumference, Life Sciences & Biomedicine, WAIST CIRCUMFERENCE, Obesity paradox, Glomerular Filtration Rate, Adult, Waist, Population, Renal function, 03 medical and health sciences, Medicine, General & Internal, General & Internal Medicine, CKD, Urology and Nephrology, Humans, Mortality, education, Aged, Science & Technology, business.industry, Research, medicine.disease, Body Height, BODY-MASS INDEX, Kidney Failure, Chronic, WEIGHT, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11], business, Body mass index, Demography, Kidney disease
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 2) and all cause mortality.ResultsOver a mean follow-up of eight years, 246 607 (5.6%) individuals in the general population cohorts had GFR decline (18 118 (0.4%) end stage kidney disease events) and 782 329 (14.7%) died. Adjusting for age, sex, race, and current smoking, the hazard ratios for GFR decline comparing body mass indices 30, 35, and 40 with body mass index 25 were 1.18 (95% confidence interval 1.09 to 1.27), 1.69 (1.51 to 1.89), and 2.02 (1.80 to 2.27), respectively. Results were similar in all subgroups of estimated GFR. Associations weakened after adjustment for additional comorbidities, with respective hazard ratios of 1.03 (0.95 to 1.11), 1.28 (1.14 to 1.44), and 1.46 (1.28 to 1.67). The association between body mass index and death was J shaped, with the lowest risk at body mass index of 25. In the cohorts with high cardiovascular risk and chronic kidney disease (mean follow-up of six and four years, respectively), risk associations between higher body mass index and GFR decline were weaker than in the general population, and the association between body mass index and death was also J shaped, with the lowest risk between body mass index 25 and 30. In all cohort types, associations between higher waist circumference and higher waist-to-height ratio with GFR decline were similar to that of body mass index; however, increased risk of death was not associated with lower waist circumference or waist-to-height ratio, as was seen with body mass index.ConclusionsElevated body mass index, waist circumference, and waist-to-height ratio are independent risk factors for GFR decline and death in individuals who have normal or reduced levels of estimated GFR.

Published
2019

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

Author

Kovesdy, CP, Matsushita, K, Sang, Y, Brunskill, NJ, Carrero, JJ, Chodick, G, Hasegawa, T, Heerspink, HL, Hirayama, A, Landman, GWD, Levin, A, Nitsch, D, Wheeler, DC, Coresh, J, Hallan, SI, Shalev, V, Grams, ME, Astor, B, Appel, L, Greene, T, Chen, T, Chalmers, J, Woodward, M, Arima, H, Perkovic, V, Djurdjev, O, Zhang, L, Liu, L, Zhao, M, Wang, F, Wang, J, Tang, M, Iso, H, Yamagishi, K, Umesawa, M, Muraki, I, Fukagawa, M, Maruyama, S, Hamano, T, Fujii, N, Wheeler, D, Emberson, J, Townend, J, Landray, M, Green, J, Kirchner, HL, Chang, AR, Cirillo, Massimo, Jee, SH, Kimm, H, Mok, Y, Wetzels, JFM, Blankestijn, PJ, van Zuilen, Bots, M, Sarnak, M, Inker, L, Roderick, P, Fletcher, A, Bottinger, E, Nadkarni, GN, Ellis, SB, Nadukuru, R, Brunskill, N, Major, R, Shepherd, D, Medcalf, J, Gansevoort, RT, Bakker, SJL, Heerspink, HJL, Jassal, SK, Bergstrom, J, Ix, JH, Barrett-Connor, E, Kovesdy, C, Kalantar-Zadeh, K, de Zeeuw, D, Brenner, B, Gasparini, A, Elinder, CG, Barany, P, Evans, M, Segelmark, M, Stendahl, M, Schön, S, Tangri, N, Sud, M, Naimark, D, Wen, CP, Tsao, CK, Tsai, MK, Chen, CH, Konta, T, Ichikawa, K, Bilo, HJG, van Hateren, KJJ, Kleefstra, N, Hallan, S, Levey, AS, Ballew, SH, Chen, J, Kwak, L, Woodward, M., Kovesdy, Cp, Matsushita, K, Sang, Y, Brunskill, Nj, Carrero, Jj, Chodick, G, Hasegawa, T, Heerspink, Hl, Hirayama, A, Landman, Gwd, Levin, A, Nitsch, D, Wheeler, Dc, Coresh, J, Hallan, Si, Shalev, V, Grams, Me, Astor, B, Appel, L, Greene, T, Chen, T, Chalmers, J, Woodward, M, Arima, H, Perkovic, V, Djurdjev, O, Zhang, L, Liu, L, Zhao, M, Wang, F, Wang, J, Tang, M, Iso, H, Yamagishi, K, Umesawa, M, Muraki, I, Fukagawa, M, Maruyama, S, Hamano, T, Fujii, N, Wheeler, D, Emberson, J, Townend, J, Landray, M, Green, J, Kirchner, Hl, Chang, Ar, Cirillo, Massimo, Jee, Sh, Kimm, H, Mok, Y, Wetzels, Jfm, Blankestijn, Pj, Van, Zuilen, Ad, Bots, M, Sarnak, M, Inker, L, Roderick, P, Fletcher, A, Bottinger, E, Nadkarni, Gn, Ellis, Sb, Nadukuru, R, Brunskill, N, Major, R, Shepherd, D, Medcalf, J, Gansevoort, Rt, Bakker, Sjl, Heerspink, Hjl, Jassal, Sk, Bergstrom, J, Ix, Jh, Barrett-Connor, E, Kovesdy, C, Kalantar-Zadeh, K, De, Zeeuw, D, Brenner, B, Gasparini, A, Elinder, Cg, Barany, P, Evans, M, Segelmark, M, Stendahl, M, Schön, S, Tangri, N, Sud, M, Naimark, D, Wen, Cp, Tsao, Ck, Tsai, Mk, Chen, Ch, Konta, T, Ichikawa, K, Bilo, Hjg, Van, Hateren, Kjj, Kleefstra, N, Hallan, S, Levey, A, Ballew, Sh, Chen, J, Kwak, L, Woodward, M., Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Groningen Kidney Center (GKC), and Methods in Medicines evaluation & Outcomes research (M2O)

Subjects
Hyperkalemia, 030232 urology & nephrology, HEMODIALYSIS-PATIENTS, Comorbidity, 030204 cardiovascular system & hematology, GLOMERULAR-FILTRATION-RATE, HYPERKALEMIA, End-stage renal disease, CHRONIC RENAL-INSUFFICIENCY, 0302 clinical medicine, SODIUM ZIRCONIUM CYCLOSILICATE, Risk Factors, Cause of Death, Estimated glomerular filtration rate, ESTIMATED GFR, education.field_of_study, Hazard ratio, Middle Aged, Prognosis, CHRONIC HEART-FAILURE, EUROPEAN-SOCIETY, Cardiovascular Diseases, medicine.symptom, Cardiology and Cardiovascular Medicine, Glomerular Filtration Rate, Adult, medicine.medical_specialty, Population, Renal function, Hypokalemia, End stage renal disease, 03 medical and health sciences, Internal medicine, medicine, Humans, Albuminuria, Renal Insufficiency, Chronic, Mortality, education, CKD Prognosis Consortium, Aged, business.industry, Proportional hazards model, POLYMERIC POTASSIUM BINDER, medicine.disease, SERUM POTASSIUM, Potassium, Kidney Failure, Chronic, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11], business, Kidney disease
Abstract

Item does not contain fulltext 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

12. Chronic Kidney Disease and Coronary Artery Disease: JACC State-of-the-Art Review

Author

Sarnak, M. J., Amann, K., Bangalore, S., Cavalcante, J. L., Charytan, D. M., Craig, J. C., Gill, J. S., Hlatky, M. A., Jardine, A. G., Landmesser, U., Newby, L. K., Herzog, C. A., Cheung, M., Wheeler, D. C., Winkelmayer, W. C., Marwick, T. H., Banerjee, D., Briguori, C., Chang, T. I., Chen, C. -L., Defilippi, C. R., Ding, X., Ferro, C. J., Gill, J., Gossl, M., Isbel, N. M., Ishii, H., Jardine, M. J., Kalra, P. A., Laufer, G., Lentine, K. L., Lobdell, K., Lok, C. E., London, G. M., Malyszko, J., Mark, P. B., Marwan, M., Nie, Y., Parfrey, P. S., Pecoits-Filho, R., Pilmore, H., Qunibi, W. Y., Raggi, P., Rattazzi, M., Rossignol, P., Ruturi, J., Sabanayagam, C., Shanahan, C. M., Shroff, G. R., Shroff, R., Webster, A. C., Weiner, D. E., Winther, S., Wiseman, A. C., Yip, A., and Zarbock, A.

Subjects
calcification, acute coronary syndromes, chronic kidney disease, coronary artery disease, revascularization
Published
2019

13. Longitudinal TNFR1 and TNFR2 and Kidney Outcomes: Results from AASK and VA NEPHRON-D

Author

Chen, Teresa K., Coca, Steven G., Estrella, Michelle M., Appel, Lawrence J., Coresh, Josef, Thiessen Philbrook, Heather, Obeid, Wassim, Fried, Linda F., Heerspink, Hiddo J.L., Ix, Joachim H., Shlipak, Michael G., Kimmel, Paul L., Parikh, Chirag R., Grams, Morgan E., Ramachandran, Vasan S., Massaro, Joseph, Clish, Clary, Schelling, Jeffrey, Denburg, Michelle, Furth, Susan, Warady, Bradley, Bonventre, Joseph, Waikar, Sushrut, McMahon, Gearoid, Sabbisetti, Venkata, Coresh, Josef, Grams, Morgan, Rebholz, Casey, Abraham, Alison, Tin, Adrienne, Parikh, Chirag, Klein, Jon, Coca, Steven, Ferket, Bart S, Nadkarni, Girish N., Rhee, Eugene, Kimmel, Paul L., Gossett, Daniel, Rovin, Brad, Shlipak, Michael G., Sarnak, M, Levey, Andrew S., Inker, Lesley A., Foster, Meredith, Guti?rrez, Orlando M., Ix, Joachim, Dubin, Ruth, Seegmiller, Jesse, Hostetter, Tom, Deo, Rajat, Feldman, Harold I., Anderson, Amanda, Mifflin, Theodore, Xie, Dawei, Shou, Haochang, Ballard, Shawn, Whitehead, Krista, Collins, Heather, Greenberg, Jason, and Ganz, Peter

Abstract

Recent research suggests that biomarkers of the TNF pathway (TNFR1 and TNFR2) are associated with worse kidney outcomes. Most of these studies, however, evaluated baseline levels rather than longitudinal changes. In two cohorts (AASK, which enrolled Black people with CKD attributed to hypertension, and VA NEPHRON-D, which enrolled veterans with albuminuric CKD and type 2 diabetes), greater longitudinal increases in serum or plasma TNFR1 and TNFR2 were associated with higher risks of ESKD in AASK and subsequent kidney function decline in VA NEPHRON-D. These associations were independent of baseline biomarker level and kidney function. Longitudinal trajectories in TNFR1 and TNFR2 may ultimately allow improved risk assessment for kidney failure in persons with CKD.

Published
2022
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14. Relative risks of Chronic Kidney Disease for mortality and End Stage Renal Disease across races is similar

Author

Wright, Jt, Appel, L, Greene, T, Astor, Bc, Chalmers, J, Macmahon, S, Woodward, M, Arima, H, Yatsuya, H, Yamashita, K, Toyoshima, H, Tamakoshi, K, Coresh, J, Matsushita, K, Atkins, Rc, Polkinghorne, Kr, Chadban, S, Shankar, A, Klein, R, Klein, Be, Lee, Ke, Wang, H, Wang, F, Zhang, L, Zuo, L, Liu, L, Levin, A, Djurdjev, O, Tonelli, M, Sacks, F, Curhan, G, Shlipak, M, Peralta, C, Katz, R, Fried, L, Iso, H, Kitamura, A, Ohira, T, Yamagishi, K, Jafar, Th, Islam, M, Hatcher, J, Poulter, N, Chaturvedi, N, Landray, Mj, Emberson, J, Townend, J, Wheeler, Dc, Rothenbacher, D, Brenner, H, Müller, H, Schöttker, B, Fox, Cs, Hwang, Sj, Meigs, Jb, Perkins, Rm, Fluck, N, Clark, L, Prescott, Gj, Marks, A, Black, C, Cirillo, Massimo, Hallan, S, Aasard, K, Øien, Cm, Radtke, M, Irie, F, Sairenchi, T, Smith, Dh, Weiss, J, Johnson, Es, Thorp, Ml, Collins, Aj, Vassalotti, Ja, Li, S, Chen, Sc, Lee, Bj, Wetzels, Jf, Blankestijn, Pj, Van, Zuilen, Sarnak, M, Levey, As, Inker, L, Menon, V, Fried, Lf, Kramer, H, Boer, De, I, Kronenberg, F, Kollerits, B, Ritz, E, Roderick, P, Nitsch, D, Fletcher, A, Bulpitt, C, Ishani, A, Neaton, J, Froissart, M, Stengel, B, Metzger, M, Haymann, Jp, Houillier, P, Flamant, M, Ohkubo, T, Metoki, H, Nakayama, M, Kikuya, M, Imai, Y, Iseki, K, Nelson, Rg, Knowler, Wc, Gansevoort, Rt, Jong, De, Mahmoodi, Bk, Bakker, Sj, Bernardo, R, Kaur, Jassal, S, Barrett Connor, E, Bergstrom, J, Heerspink, Hj, Brenner, B, Zeeuw, De, D, Warnock, Dg, Muntner, P, Judd, S, Mcclellan, W, Jee, Sh, Kimm, H, Jo, J, Mok, Y, Choi, E, Rossing, P, Parving, Hh, Tangri, N, Naimark, D, Wen, Cp, Wen, Sf, Tsao, Ck, Tsai, Mk, Wu, Be, Ärnlöv, J, Lannfelt, L, Larsson, A, Bilo, Hj, Joosten, H, Kleefstra, N, Groenier, Kh, Drion, I, Hemmelgarn, Br, Ballew, Sh, Grams, M, Sang, Y, Camarata, L, Hui, X, Seltzer, J, Winegrad, H., Cardiovascular Centre (CVC), Groningen Kidney Center (GKC), Wright, Jt, Jr, Appel, L, Greene, T, Astor, Bc, Chalmers, J, Macmahon, S, Woodward, M, Arima, H, Yatsuya, H, Yamashita, K, Toyoshima, H, Tamakoshi, K, Coresh, J, Matsushita, K, Atkins, Rc, Polkinghorne, Kr, Chadban, S, Shankar, A, Klein, R, Klein, Be, Lee, Ke, Wang, H, Wang, F, Zhang, L, Zuo, L, Liu, L, Levin, A, Djurdjev, O, Tonelli, M, Sacks, F, Curhan, G, Shlipak, M, Peralta, C, Katz, R, Fried, L, Iso, H, Kitamura, A, Ohira, T, Yamagishi, K, Jafar, Th, Islam, M, Hatcher, J, Poulter, N, Chaturvedi, N, Landray, Mj, Emberson, J, Townend, J, Wheeler, Dc, Rothenbacher, D, Brenner, H, Müller, H, Schöttker, B, Fox, C, Hwang, Sj, Meigs, Jb, Perkins, Rm, Fluck, N, Clark, L, Prescott, Gj, Marks, A, Black, C, Cirillo, Massimo, Hallan, S, Aasard, K, Øien, Cm, Radtke, M, Irie, F, Sairenchi, T, Smith, Dh, Weiss, J, Johnson, E, Thorp, Ml, Collins, Aj, Vassalotti, Ja, Li, S, Chen, Sc, Lee, Bj, Wetzels, Jf, Blankestijn, Pj, Van, Zuilen, Ad, Sarnak, M, Levey, A, Inker, L, Menon, V, Fried, Lf, Kramer, H, De, Boer, I, Kronenberg, F, Kollerits, B, Ritz, E, Roderick, P, Nitsch, D, Fletcher, A, Bulpitt, C, Ishani, A, Neaton, J, Froissart, M, Stengel, B, Metzger, M, Haymann, Jp, Houillier, P, Flamant, M, Ohkubo, T, Metoki, H, Nakayama, M, Kikuya, M, Imai, Y, Iseki, K, Nelson, Rg, Knowler, Wc, Gansevoort, Rt, De, Jong, Pe, Mahmoodi, Bk, Bakker, Sj, Bernardo, R, Kaur, Jassal, S, Barrett Connor, E, Bergstrom, J, Heerspink, Hj, Brenner, B, De, Zeeuw, D, Warnock, Dg, Muntner, P, Judd, S, Mcclellan, W, Jee, Sh, Kimm, H, Jo, J, Mok, Y, Choi, E, Rossing, P, Parving, Hh, Tangri, N, Naimark, D, Wen, Cp, Wen, Sf, Tsao, Ck, Tsai, Mk, Be, Wu, Ärnlöv, J, Lannfelt, L, Larsson, A, Bilo, Hj, Joosten, H, Kleefstra, N, Groenier, Kh, Drion, I, Hemmelgarn, Br, Ballew, Sh, Grams, M, Sang, Y, Camarata, L, Hui, X, Seltzer, J, and Winegrad, H.

Subjects
Male, GLOMERULAR-FILTRATION-RATE, Cohort Studies, Risk Factors, eGFR, Odds Ratio, ASSOCIATIONS, African Continental Ancestry Group, Aged, 80 and over, education.field_of_study, end-stage renal disease, Hazard ratio, PROTEINURIA, Urology & Nephrology, Middle Aged, CKD-EPI EQUATION, 3. Good health, PREVALENCE, Nephrology, Cardiovascular Diseases, Creatinine, ethnicity, Female, medicine.symptom, epidemiology and outcomes, Glomerular Filtration Rate, Asian Continental Ancestry Group, Adult, medicine.medical_specialty, Population, European Continental Ancestry Group, Renal function, Black People, ALL-CAUSE, Article, White People, End stage renal disease, Asian People, Internal medicine, medicine, Chronic Kidney Disease Prognosis Consortium, Albuminuria, Humans, Renal Insufficiency, Chronic, education, Aged, business.industry, 1103 Clinical Sciences, Odds ratio, POPULATION COHORTS, medicine.disease, INDIVIDUALS, Endocrinology, Relative risk, COLLABORATIVE METAANALYSIS, mortality risk, Kidney Failure, Chronic, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11], business, HIGHER ALBUMINURIA, chronic kidney disease, Kidney disease
Abstract

Item does not contain fulltext Some suggest race-specific cutpoints for kidney measures to define and stage chronic kidney disease (CKD), but evidence for race-specific clinical impact is limited. To address this issue, we compared hazard ratios of estimated glomerular filtration rates (eGFR) and albuminuria across races using meta-regression in 1.1 million adults (75% Asians, 21% Whites, and 4% Blacks) from 45 cohorts. Results came mainly from 25 general population cohorts comprising 0.9 million individuals. The associations of lower eGFR and higher albuminuria with mortality and end-stage renal disease (ESRD) were largely similar across races. For example, in Asians, Whites, and Blacks, the adjusted hazard ratios (95% confidence interval) for eGFR 45-59 versus 90-104 ml/min per 1.73 m(2) were 1.3 (1.2-1.3), 1.1 (1.0-1.2), and 1.3 (1.1-1.7) for all-cause mortality, 1.6 (1.5-1.7), 1.4 (1.2-1.7), and 1.4 (0.7-2.9) for cardiovascular mortality, and 27.6 (11.1-68.7), 11.2 (6.0-20.9), and 4.1 (2.2-7.5) for ESRD, respectively. The corresponding hazard ratios for urine albumin-to-creatinine ratio 30-299 mg/g or dipstick 1+ versus an albumin-to-creatinine ratio under 10 or dipstick negative were 1.6 (1.4-1.8), 1.7 (1.5-1.9), and 1.8 (1.7-2.1) for all-cause mortality, 1.7 (1.4-2.0), 1.8 (1.5-2.1), and 2.8 (2.2-3.6) for cardiovascular mortality, and 7.4 (2.0-27.6), 4.0 (2.8-5.9), and 5.6 (3.4-9.2) for ESRD, respectively. Thus, the relative mortality or ESRD risks of lower eGFR and higher albuminuria were largely similar among three major races, supporting similar clinical approach to CKD definition and staging, across races.

Published
2014

15. Age and Association of Kidney Measures With Mortality and End-stage Renal Disease

Author

Wright, Jt, Appel, Lj, Greene, T, Astor, Bc, Chalmers, J, Macmahon, S, Woodward, M, Arima, H, Yatsuya, H, Yamashita, K, Toyoshima, H, Tamakoshi, K, Tonelli, M, Hemmelgarn, Br, Bello, A, James, Mt, Coresh, J, Matsushita, K, Sang, Y, Atkins, Rc, Polkinghorne, Kr, Chadban, S, Shankar, A, Klein, R, Klein, Be, Lee, Ke, Wang, H, Wang, F, Zhang, L, Zuo, L, Levin, A, Djurdjev, O, Sacks, Fm, Curhan, Gc, Shlipak, M, Peralta, C, Katz, R, Fried, Lf, Iso, H, Kitamura, A, Ohira, T, Yamagishi, K, Jafar, Th, Islam, M, Hatcher, J, Poulter, N, Chaturvedi, N, Landray, Mj, Emberson, J, Townend, Jn, Wheeler, Dc, Rothenbacher, D, Brenner, H, Müller, H, Schöttker, B, Fox, Cs, Hwang, Sj, Meigs, Jb, Perkins, Rm, Fluck, N, Clark, Le, Prescott, Gj, Marks, A, Black, C, Cirillo, Massimo, Hallan, S, Aasarød, K, Øien, Cm, Radtke, M, Irie, F, Sairenchi, T, Smith, Dh, Weiss, Jw, Johnson, Es, Thorp, Ml, Collins, Aj, Vassalotti, Ja, Li, S, Chen, Sc, Lee, Bj, Wetzels, Jf, Blankestijn, Pj, Van, Zuilen, Sarnak, M, Levey, As, Inker, La, Menon, V, Kramer, Hj, Kronenberg, F, Kollerits, B, Ritz, E, Roderick, P, Nitsch, D, Fletcher, A, Bulpitt, C, Ishani, A, Neaton, Jd, Froissart, M, Stengel, B, Metzger, M, Haymann, Jp, Houillier, P, Flamant, M, Ohkubo, T, Metoki, H, Nakayama, M, Kikuya, M, Imai, Y, Iseki, K, Nelson, Rg, Knowler, Wc, Gansevoort, Rt, Jong, De, Mahmoodi, Bk, Heerspink, Hj, Jassal, Sk, Barrett Connor, E, Bergstrom, J, Brenner, Be, Zeeuw, De, D, Warnock, Dg, Muntner, P, Judd, S, Mcclellan, W, Jee, Sh, Kimm, H, Jo, J, Mok, Y, Lim, Je, Rossing, P, Parving, Hh, Tangri, N, Naimark, D, Wen, Cp, Wen, Sf, Tsao, Ck, Tsai, Mk, Ärnlöv, J, Lannfelt, L, Larsson, A, Bilo, Hj, Joosten, H, Kleefstra, N, Groenier, Kh, Drion, I, Ballew, Sh, Grams, M, Camarata, L, Hui, X, Seltzer, J, Winegrad, H., Cardiovascular Centre (CVC), Groningen Kidney Center (GKC), Wright JT Jr, Appel, Lj, Greene, T, Astor, Bc, Chalmers, J, Macmahon, S, Woodward, M, Arima, H, Yatsuya, H, Yamashita, K, Toyoshima, H, Tamakoshi, K, Tonelli, M, Hemmelgarn, Br, Bello, A, James, Mt, Coresh, J, Matsushita, K, Sang, Y, Atkins, Rc, Polkinghorne, Kr, Chadban, S, Shankar, A, Klein, R, Klein, Be, Lee, Ke, Wang, H, Wang, F, Zhang, L, Zuo, L, Levin, A, Djurdjev, O, Sacks, Fm, Curhan, Gc, Shlipak, M, Peralta, C, Katz, R, Fried, Lf, Iso, H, Kitamura, A, Ohira, T, Yamagishi, K, Jafar, Th, Islam, M, Hatcher, J, Poulter, N, Chaturvedi, N, Landray, Mj, Emberson, J, Townend, Jn, Wheeler, Dc, Rothenbacher, D, Brenner, H, Müller, H, Schöttker, B, Fox, C, Hwang, Sj, Meigs, Jb, Perkins, Rm, Fluck, N, Clark, Le, Prescott, Gj, Marks, A, Black, C, Cirillo, Massimo, Hallan, S, Aasarød, K, Øien, Cm, Radtke, M, Irie, F, Sairenchi, T, Smith, Dh, Weiss, Jw, Johnson, E, Thorp, Ml, Collins, Aj, Vassalotti, Ja, Li, S, Chen, Sc, Lee, Bj, Wetzels, Jf, Blankestijn, Pj, van Zuilen AD, Sarnak, M, Levey, A, Inker, La, Menon, V, Kramer, Hj, Kronenberg, F, Kollerits, B, Ritz, E, Roderick, P, Nitsch, D, Fletcher, A, Bulpitt, C, Ishani, A, Neaton, Jd, Froissart, M, Stengel, B, Metzger, M, Haymann, Jp, Houillier, P, Flamant, M, Ohkubo, T, Metoki, H, Nakayama, M, Kikuya, M, Imai, Y, Iseki, K, Nelson, Rg, Knowler, Wc, Gansevoort, Rt, de Jong PE, Mahmoodi, Bk, Heerspink, Hj, Jassal, Sk, Barrett-Connor, E, Bergstrom, J, Brenner, Be, de Zeeuw, D, Warnock, Dg, Muntner, P, Judd, S, Mcclellan, W, Jee, Sh, Kimm, H, Jo, J, Mok, Y, Lim, Je, Rossing, P, Parving, Hh, Tangri, N, Naimark, D, Wen, Cp, Wen, Sf, Tsao, Ck, Tsai, Mk, Ärnlöv, J, Lannfelt, L, Larsson, A, Bilo, Hj, Joosten, H, Kleefstra, N, Groenier, Kh, Drion, I, Ballew, Sh, Grams, M, Camarata, L, Hui, X, Seltzer, J, and Winegrad, H.

Subjects
Male, BLOOD-PRESSURE, urologic and male genital diseases, Kidney, età, GLOMERULAR-FILTRATION-RATE, Cohort Studies, eGFR, Young adult, Renal disorder [IGMD 9], ALL-CAUSE MORTALITY, GENERAL-POPULATION, insufficienza renale, biology, CYSTATIN C, CARDIOVASCULAR RISK, Age Factors, General Medicine, Middle Aged, female genital diseases and pregnancy complications, RISK POPULATION COHORTS, medicine.anatomical_structure, Female, medicine.symptom, Glomerular Filtration Rate, albuminuria, rischio, mortalità, Adult, Risk, medicine.medical_specialty, Adolescent, Renal function, Context (language use), End stage renal disease, Young Adult, Internal medicine, medicine, Albuminuria, Humans, OLDER-ADULTS, Aged, urogenital system, business.industry, URINARY ALBUMIN EXCRETION, medicine.disease, Endocrinology, Cystatin C, COLLABORATIVE METAANALYSIS, biology.protein, Kidney Failure, Chronic, business, Kidney disease
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 m(2) vs 80 mL/min/1.73 m(2) 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 Conclusions Both low eGFR and high albuminuria were independently associated with mortality and ESRD regardless of age across a wide range of populations. Mortality showed lower relative risk but higher absolute risk differences at older age.

Published
2012

16. Predicting timing of clinical outcomes in patients with chronic kidney disease and severely decreased glomerular filtration rate

Author

Grams, ME, Sang, Y, Ballew, SH, Carrero, JJ, Djurdjev, O, Heerspink, HJL, Ho, K, Ito, S, Marks, A, Naimark, D, Nash, DM, Navaneethan, SD, Sarnak, M, Stengel, B, Visseren, FLJ, Wang, AYM, Köttgen, A, Levey, AS, Woodward, M, Eckardt, KU, Hemmelgarn, B, Coresh, J, Grams, ME, Sang, Y, Ballew, SH, Carrero, JJ, Djurdjev, O, Heerspink, HJL, Ho, K, Ito, S, Marks, A, Naimark, D, Nash, DM, Navaneethan, SD, Sarnak, M, Stengel, B, Visseren, FLJ, Wang, AYM, Köttgen, A, Levey, AS, Woodward, M, Eckardt, KU, Hemmelgarn, B, and Coresh, J

Abstract

Patients with chronic kidney disease and severely decreased glomerular filtration rate (GFR) are at high risk for kidney failure, cardiovascular disease (CVD) and death. Accurate estimates of risk and timing of these clinical outcomes could guide patient counseling and therapy. Therefore, we developed models using data of 264,296 individuals in 30 countries participating in the international Chronic Kidney Disease Prognosis Consortium with estimated GFR (eGFR)s under 30 ml/min/1.73m2. Median participant eGFR and urine albumin-to-creatinine ratio were 24 ml/min/1.73m2 and 168 mg/g, respectively. Using competing-risk regression, random-effect meta-analysis, and Markov processes with Monte Carlo simulations, we developed two- and four-year models of the probability and timing of kidney failure requiring kidney replacement therapy (KRT), a non-fatal CVD event, and death according to age, sex, race, eGFR, albumin-to-creatinine ratio, systolic blood pressure, smoking status, diabetes mellitus, and history of CVD. Hypothetically applied to a 60-year-old white male with a history of CVD, a systolic blood pressure of 140 mmHg, an eGFR of 25 ml/min/1.73m2 and a urine albumin-to-creatinine ratio of 1000 mg/g, the four-year model predicted a 17% chance of survival after KRT, a 17% chance of survival after a CVD event, a 4% chance of survival after both, and a 28% chance of death (9% as a first event, and 19% after another CVD event or KRT). Risk predictions for KRT showed good overall agreement with the published kidney failure risk equation, and both models were well calibrated with observed risk. Thus, commonly-measured clinical characteristics can predict the timing and occurrence of clinical outcomes in patients with severely decreased GFR.

Published
2018

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

Author

Fox, Cs, Matsushita, K, Woodward, M, Bilo, Hj, Chalmers, J, Heerspink, Hj, Lee, Bj, Perkins, Rm, Rossing, P, Sairenchi, T, Tonelli, M, Vassalotti, Ja, Yamagishi, K, Coresh, J, Jong, De, Wen, Cp, Nelson, Rg, Chronic, Kidney, Disease, Prognosis, Consortium, Investigators/collaborators:, Wright, J, Appel, L, Greene, T, Astor, Bc, Macmahon, S, Arima, H, Yatsuya, H, Yamashita, K, Toyoshima, H, Tamakoshi, K, Sang, Y, Atkins, Rc, Polkinghorne, Kr, Chadban, S, Shankar, A, Klein, R, Klein, Be, Lee, Ke, Wang, H, Wang, F, Zhang, L, Zuo, L, Levin, A, Djurdjev, O, Sacks, Fm, Curhan, Gc, Shlipak, M, Peralta, C, Katz, R, Fried, L, Iso, H, Kitamura, A, Ohira, T, Jafar, Th, Islam, M, Hatcher, J, Poulter, N, Chaturvedi, N, Landray, Mj, Emberson, Jr, Townend, Jn, Wheeler, Dc, Rothenbacher, D, Brenner, H, Müller, H, Schöttker, B, Hwang, Sj, Meigs, Jb, Fluck, N, Clark, Le, Prescott, Gj, Marks, A, Black, C, Cirillo, Massimo, Hallan, S, Aasarød, K, Øien, Cm, Radtke, M, Irie, F, Smith, Dh, Weiss, Jw, Johnson, Es, Thorp, Ml, Collins, Aj, Li, S, Chen, Sc, Wetzels, Jf, Blankestijn, Pj, Van, Zuilen, Sarnak, M, Levey, As, Menon, V, Kramer, Hj, Boer, De, Kronenberg, F, Kollerits, B, Ritz, E, Roderick, P, Nitsch, D, Fletcher, A, Bulpitt, C, Ishani, A, Neaton, Jd, Froissart, M, Stengel, B, Metzger, M, Haymann, Jp, Houillier, P, Flamant, M, Ohkubo, T, Metoki, H, Nakayama, M, Kikuya, M, Imai, Y, Knowler, Wc, Gansevoort, Rt, Mahmoodi, Bk, Bakker, Sj, Jassal, Sk, Barrett Connor, E, Bergstrom, J, Lambers, Heerspink, Brenner, Be, Zeeuw, D, Warnock, Dg, Muntner, P, Judd, S, Mcclellan, W, Jee, Sh, Kimm, H, Jo, J, Mok, Y, Lim, Je, Parving, Hh, Tangri, N, Naimark, D, Wen, Sf, Tsao, Ck, Tsai, Mk, Ärnlöv, J, Lannfelt, L, Larsson, A, Joosten, H, Kleefstra, N, Groenier, Kh, Drion, I, Hemmelgarn, B, Ballew, Sh, Grams, M, Camarata, L, Hui, X, Seltzer, J, Winegrad, H., Groningen Kidney Center (GKC), Methods in Medicines evaluation & Outcomes research (M2O), Lifestyle Medicine (LM), Fox, C, Matsushita, K, Woodward, M, Bilo, Hj, Chalmers, J, Heerspink, Hj, Lee, Bj, Perkins, Rm, Rossing, P, Sairenchi, T, Tonelli, M, Vassalotti, Ja, Yamagishi, K, Coresh, J, de Jong PE, Wen, Cp, Nelson, Rg, Investigators/Collaborators: Wright J, Chronic Kidney Disease Prognosis Consortium, Appel, L, Greene, T, Astor, Bc, Macmahon, S, Arima, H, Yatsuya, H, Yamashita, K, Toyoshima, H, Tamakoshi, K, Sang, Y, Atkins, Rc, Polkinghorne, Kr, Chadban, S, Shankar, A, Klein, R, Klein, Be, Lee, Ke, Wang, H, Wang, F, Zhang, L, Zuo, L, Levin, A, Djurdjev, O, Sacks, Fm, Curhan, Gc, Shlipak, M, Peralta, C, Katz, R, Fried, L, Iso, H, Kitamura, A, Ohira, T, Jafar, Th, Islam, M, Hatcher, J, Poulter, N, Chaturvedi, N, Landray, Mj, Emberson, Jr, Townend, Jn, Wheeler, Dc, Rothenbacher, D, Brenner, H, Müller, H, Schöttker, B, Hwang, Sj, Meigs, Jb, Fluck, N, Clark, Le, Prescott, Gj, Marks, A, Black, C, Cirillo, Massimo, Hallan, S, Aasarød, K, Øien, Cm, Radtke, M, Irie, F, Smith, Dh, Weiss, Jw, Johnson, E, Thorp, Ml, Collins, Aj, Li, S, Chen, Sc, Wetzels, Jf, Blankestijn, Pj, van Zuilen AD, Sarnak, M, Levey, A, Menon, V, Kramer, Hj, de Boer IH, Kronenberg, F, Kollerits, B, Ritz, E, Roderick, P, Nitsch, D, Fletcher, A, Bulpitt, C, Ishani, A, Neaton, Jd, Froissart, M, Stengel, B, Metzger, M, Haymann, Jp, Houillier, P, Flamant, M, Ohkubo, T, Metoki, H, Nakayama, M, Kikuya, M, Imai, Y, Knowler, Wc, Gansevoort, Rt, Mahmoodi, Bk, Bakker, Sj, Jassal, Sk, Barrett-Connor, E, Bergstrom, J, Lambers Heerspink HJ, Brenner, Be, Zeeuw, D, Warnock, Dg, Muntner, P, Judd, S, Mcclellan, W, Jee, Sh, Kimm, H, Jo, J, Mok, Y, Lim, Je, Parving, Hh, Tangri, N, Naimark, D, Wen, Sf, Tsao, Ck, Tsai, Mk, Ärnlöv, J, Lannfelt, L, Larsson, A, Joosten, H, Kleefstra, N, Groenier, Kh, Drion, I, Hemmelgarn, B, Ballew, Sh, Grams, M, Camarata, L, Hui, X, Seltzer, J, and Winegrad, H.

Subjects
medicine.medical_specialty, Population, UNITED-STATES, Renal function, ALL-CAUSE, GLOMERULAR-FILTRATION-RATE, albuminuria, End stage renal disease, Diabetic nephropathy, CKD-PC Consortium, Diabetes mellitus, Internal medicine, eGFR, Medicine, ESTIMATED GFR, education, Intensive care medicine, Renal disorder [IGMD 9], OUTCOMES, education.field_of_study, end-stage renal disease, diabetes, business.industry, Hazard ratio, PROTEINURIA, General Medicine, mortality, medicine.disease, RISK POPULATION COHORTS, PREVALENCE, diabete, COLLABORATIVE METAANALYSIS, Albuminuria, medicine.symptom, HIGHER ALBUMINURIA, business, Kidney disease
Abstract

Item does not contain fulltext 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 m(2) [vs 95 mL/min per 1.73 m(2)], 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.

Published
2012

18. Comparison of risk prediction using the CKD-EPI equation and the MDRD study equation for estimated glomerular filtration rate

Author

Matsushita, K, Mahmoodi, Bk, Woodward, M, Emberson, Jr, Jafar, Th, Jee, Sh, Polkinghorne, Kr, Shankar, A, Smith, Dh, Tonelli, M, Warnock, Dg, Wen, Cp, Coresh, J, Gansevoort, Rt, Hemmelgarn, Br, Levey, As, Chronic, Kidney, Disease, Prognosis, Consortium, Wright, J, Appel, Lj, Greene, T, Astor, Bc, Chalmers, J, Macmahon, S, Yatsuya, H, Yamashita, K, Toyoshima, H, Tamakoshi, K, Sang, Y, Atkins, Rc, Chadban, S, Klein, R, Klein, Be, Lee, Ke, Wang, H, Wang, F, Zhang, L, Zuo, L, Levin, A, Djurdjev, O, Sacks, Fm, Curhan, Gc, Shlipak, M, Peralta, C, Katz, R, Fried, Lf, Iso, H, Ohira, T, Kitamura, A, Yamagishi, K, Islam, M, Hatcher, J, Poulter, N, Chaturvedi, N, Landray, Mj, Townend, Jn, Wheeler, Dc, Rothenbacher, D, Brenner, H, Müller, H, Schöttker, B, Fox, Cs, Hwang, Sj, Meigs, Jb, Perkins, Rm, Fluck, N, Clark, Le, Prescott, Gj, Marks, A, Black, C, Cirillo, Massimo, Hallan, S, Aasarød, K, Øien, Cm, Radtke, M, Irie, F, Sairenchi, T, Johnson, Es, Thorp, Ml, Weiss, Jw, Collins, Aj, Li, S, Chen, Sc, Vassalotti, Ja, Lee, Bj, Wetzels, Jf, Blankestijn, Pj, Van, Zuilen, Sarnak, M, Menon, V, Boer, De, Kramer, Hj, Kronenberg, F, Kollerits, B, Ritz, E, Roderick, P, Nitsch, D, Fletcher, A, Bulpitt, C, Ishani, A, Neaton, Jd, Froissart, M, Stengel, B, Metzger, M, Haymann, Jp, Houillier, P, Flamant, M, Ohkubo, T, Nakayama, M, Metoki, H, Kikuya, M, Imai, Y, Iseki, K, Nelson, Rg, Knowler, Wc, Jong, De, Bakker, Sj, Jassal, Sk, Barrett-Connor, E, Bergstrom, J, Heerspink, Hj, Zeeuw, De, D, Brenner, Be, Muntner, P, Judd, S, Mcclellan, W, Kimm, H, Jo, J, Mok, Y, Choi, E, Rossing, P, Parving, Hh, Tangri, N, Naimark, D, Wen, Sf, Tsao, Ck, Tsai, Mk, Ärnlöv, J, Larsson, A, Lannfelt, L, Bilo, Hj, Kleefstra, N, Groenier, Kh, Drion, I, Joosten, H, Ballew, Sh, Grams, M, Camarata, L, Hui, X, Seltzer, J, Winegrad, H., Matsushita, K, Mahmoodi, Bk, Woodward, M, Emberson, Jr, Jafar, Th, Jee, Sh, Polkinghorne, Kr, Shankar, A, Smith, Dh, Tonelli, M, Warnock, Dg, Wen, Cp, Coresh, J, Gansevoort, Rt, Hemmelgarn, Br, Levey, A, Chronic, Kidney, Disease, Prognosi, Consortium, Wright, J, Appel, Lj, Greene, T, Astor, Bc, Chalmers, J, Macmahon, S, Yatsuya, H, Yamashita, K, Toyoshima, H, Tamakoshi, K, Sang, Y, Atkins, Rc, Chadban, S, Klein, R, Klein, Be, Lee, Ke, Wang, H, Wang, F, Zhang, L, Zuo, L, Levin, A, Djurdjev, O, Sacks, Fm, Curhan, Gc, Shlipak, M, Peralta, C, Katz, R, Fried, Lf, Iso, H, Ohira, T, Kitamura, A, Yamagishi, K, Islam, M, Hatcher, J, Poulter, N, Chaturvedi, N, Landray, Mj, Townend, Jn, Wheeler, Dc, Rothenbacher, D, Brenner, H, Müller, H, Schöttker, B, Fox, C, Hwang, Sj, Meigs, Jb, Perkins, Rm, Fluck, N, Clark, Le, Prescott, Gj, Marks, A, Black, C, Cirillo, Massimo, Hallan, S, Aasarød, K, Øien, Cm, Radtke, M, Irie, F, Sairenchi, T, Johnson, E, Thorp, Ml, Weiss, Jw, Collins, Aj, Li, S, Chen, Sc, Vassalotti, Ja, Lee, Bj, Wetzels, Jf, Blankestijn, Pj, Van, Zuilen, Ad, Sarnak, M, Menon, V, De, Boer, Ih, Kramer, Hj, Kronenberg, F, Kollerits, B, Ritz, E, Roderick, P, Nitsch, D, Fletcher, A, Bulpitt, C, Ishani, A, Neaton, Jd, Froissart, M, Stengel, B, Metzger, M, Haymann, Jp, Houillier, P, Flamant, M, Ohkubo, T, Nakayama, M, Metoki, H, Kikuya, M, Imai, Y, Iseki, K, Nelson, Rg, Knowler, Wc, De, Jong, Pe, Bakker, Sj, Jassal, Sk, Barrett-Connor, E, Bergstrom, J, Heerspink, Hj, De, Zeeuw, D, Brenner, Be, Muntner, P, Judd, S, Mcclellan, W, Kimm, H, Jo, J, Mok, Y, Choi, E, Rossing, P, Parving, Hh, Tangri, N, Naimark, D, Wen, Sf, Tsao, Ck, Tsai, Mk, Ärnlöv, J, Larsson, A, Lannfelt, L, Bilo, Hj, Kleefstra, N, Groenier, Kh, Drion, I, Joosten, H, Ballew, Sh, Grams, M, Camarata, L, Hui, X, Seltzer, J, Winegrad, H., Cardiovascular Centre (CVC), and Groningen Kidney Center (GKC)

Subjects
CHRONIC KIDNEY-DISEASE, Gerontology, Male, EVALUATION PROGRAM KEEP, Population, Renal function, Black People, Ckd epi equation, urologic and male genital diseases, Risk Assessment, White People, Article, Decision Support Techniques, Cohort Studies, Sex Factors, Asian People, EPIDEMIOLOGY COLLABORATION EQUATION, Diabetes mellitus, CYSTATIN-C, Medicine, Humans, education, ALL-CAUSE MORTALITY, Cardiovascular mortality, Aged, Renal disorder [IGMD 9], GENERAL-POPULATION, education.field_of_study, business.industry, CARDIOVASCULAR RISK, Hazard ratio, STAGE RENAL-DISEASE, General Medicine, POPULATION COHORTS, Middle Aged, Models, Theoretical, medicine.disease, female genital diseases and pregnancy complications, Net reclassification improvement, SERUM CREATININE VALUES, Cardiovascular Diseases, Kidney Failure, Chronic, Female, business, Algorithms, Demography, Glomerular Filtration Rate
Abstract

Contains fulltext : 110640.pdf (Publisher’s version ) (Closed access) CONTEXT: The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation more accurately estimates glomerular filtration rate (GFR) than the Modification of Diet in Renal Disease (MDRD) Study equation using the same variables, especially at higher GFR, but definitive evidence of its risk implications in diverse settings is lacking. OBJECTIVE: To evaluate risk implications of estimated GFR using the CKD-EPI equation compared with the MDRD Study equation in populations with a broad range of demographic and clinical characteristics. DESIGN, SETTING, AND PARTICIPANTS: A meta-analysis of data from 1.1 million adults (aged >/= 18 years) from 25 general population cohorts, 7 high-risk cohorts (of vascular disease), and 13 CKD cohorts. Data transfer and analyses were conducted between March 2011 and March 2012. MAIN OUTCOME MEASURES: All-cause mortality (84,482 deaths from 40 cohorts), cardiovascular mortality (22,176 events from 28 cohorts), and end-stage renal disease (ESRD) (7644 events from 21 cohorts) during 9.4 million person-years of follow-up; the median of mean follow-up time across cohorts was 7.4 years (interquartile range, 4.2-10.5 years). RESULTS: Estimated GFR was classified into 6 categories (>/=90, 60-89, 45-59, 30-44, 15-29, and /=65 years), sex, race/ethnicity (white, Asian, and black), and presence or absence of diabetes and hypertension. The results in the high-risk and CKD cohorts were largely consistent with the general population cohorts. CONCLUSION: The CKD-EPI equation classified fewer individuals as having CKD and more accurately categorized the risk for mortality and ESRD than did the MDRD Study equation across a broad range of populations.

Published
2012

19. Metabolite Biomarkers of CKD Progression in Children

Author

Denburg, Michelle R., Xu, Yunwen, Abraham, Alison G., Coresh, Josef, Chen, Jingsha, Grams, Morgan E., Feldman, Harold I., Kimmel, Paul L., Rebholz, Casey M., Rhee, Eugene P., Vasan, Ramachandran S., Warady, Bradley A., Furth, Susan L., Ramachandran, Vasan S., Massaro, Joseph, Clish, Clary, Schelling, Jeffrey, Denburg, Michelle, Furth, Susan, Warady, Bradley, Bonventre, Joseph, Waikar, Sushrut, McMahon, Gearoid, Sabbisetti, Venkata, Coresh, Josef, Grams, Morgan, Rebholz, Casey, Abraham, Alison, Tin, Adriene, Parikh, Chirag, Klein, Jon, Coca, Steven, Ferket, Bart S, Nadkarni, Girish N., Rhee, Eugene, Kimmel, Paul L., Gossett, Daniel, Rovin, Brad, Shlipak, Michael G., Sarnak, M, Levey, Andrew S., Inker, Lesley A., Foster, Meredith, Gutiérrez, Orlando M., Ix, Joachim, Dubin, Ruth, Seegmiller, Jesse, Hostetter, Tom, Deo, Rajat, Feldman, Harold I., Anderson, Amanda, Mifflin, Theodore, Xie, Dawei, Shou, Haochang, Ballard, Shawn, Whitehead, Krista, Collins, Heather, Greenberg, Jason, and Ganz, Peter

Published
2021
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20. Estimated glomerular filtration rate and albuminuria for prediction of cardiovascular outcomes: a collaborative meta-analysis of individual participant data

Author

Matsushita, K, Coresh, J, Sang, Y, Chalmers, J, Fox, C, Guallar, E, Jafar, T, Jassal, Sk, Landman, Gw, Muntner, P, Roderick, P, Sairenchi, T, Schöttker, B, Shankar, A, Shlipak, M, Tonelli, M, Townend, J, van Zuilen, A, Yamagishi, K, Yamashita, K, Gansevoort, R, Sarnak, M, Warnock, Dg, Woodward, M, Ärnlöv J, CKD Prognosis Consortium, Macmahon, S, Arima, H, Yatsuya, H, Toyoshima, H, Tamakoshi, K, Atkins, Rc, Polkinghorne, Kr, Chadban, S, Klein, R, Klein, Be, Lee, Ke, Sacks, Fm, Curhan, Gc, Sarnak, Mj, Katz, R, Iso, H, Kitamura, A, Imano, H, Jafar, Th, Islam, M, Hatcher, J, Poulter, N, Chaturvedi, N, Wheeler, Dc, Emberson, J, Townend, Jn, Landray, Mj, Brenner, H, Rothenbacher, D, Müller, H, Fox, Cs, Hwang, Sj, Meigs, Jb, Upadhyay, A, Perkins, R, Chang, Ar, Cirillo, Massimo, Hallan, S, Aasarød, K, Øien, Cm, Romundstad, S, Ryu, S, Chang, Y, Cho, J, Shin, H, Chodick, G, Shalev, V, Ash, N, Shainberg, B, Wetzels, Jf, Blankestijn, Pj, Van, Zuilen, Levey, As, Inker, La, Menon, V, Peralta, C, Nitsch, D, Fletcher, A, Bulpitt, C, Elley, Cr, Kenealy, T, Moyes, Sa, Collins, Jf, Drury, P, Ohkubo, T, Metoki, H, Nakayama, M, Kikuya, M, Imai, Y, Gansevoort, Rt, Bakker, Sj, Hillege, Hl, Heerspink, Hj, Bergstrom, J, Jh, Ix, Barrett Connor, E, Judd, S, Mcclellan, W, Jee, Sh, Kimm, H, Mok, Y, Tangri, N, Sud, M, Naimark, D, Wen, Cp, Wen, Sf, Tsao, Ck, Tsai, Mk, Ärnlöv, J, Lannfelt, L, Larsson, A, Bilo, Hj, Kleefstra, N, Groenier, Kh, Joosten, H, Drion, I, Jong, De, Iseki, K, Stengel, B, Warnock, D, Ballew, Sh, Woodward, M., Matsushita, K, Coresh, J, Sang, Y, Chalmers, J, Fox, C, Guallar, E, Jafar, T, Jassal, Sk, Landman, Gw, Muntner, P, Roderick, P, Sairenchi, T, Schöttker, B, Shankar, A, Shlipak, M, Tonelli, M, Townend, J, van Zuilen, A, Yamagishi, K, Yamashita, K, Gansevoort, R, Sarnak, M, Warnock, Dg, Woodward, M, Ärnlöv, J, CKD Prognosis, Consortium, Macmahon, S, Arima, H, Yatsuya, H, Toyoshima, H, Tamakoshi, K, Atkins, Rc, Polkinghorne, Kr, Chadban, S, Klein, R, Klein, Be, Lee, Ke, Sacks, Fm, Curhan, Gc, Sarnak, Mj, Katz, R, Iso, H, Kitamura, A, Imano, H, Jafar, Th, Islam, M, Hatcher, J, Poulter, N, Chaturvedi, N, Wheeler, Dc, Emberson, J, Townend, Jn, Landray, Mj, Brenner, H, Rothenbacher, D, Müller, H, Hwang, Sj, Meigs, Jb, Upadhyay, A, Perkins, R, Chang, Ar, Cirillo, Massimo, Hallan, S, Aasarød, K, Øien, Cm, Romundstad, S, Ryu, S, Chang, Y, Cho, J, Shin, H, Chodick, G, Shalev, V, Ash, N, Shainberg, B, Wetzels, Jf, Blankestijn, Pj, Van, Zuilen, Ad, Levey, A, Inker, La, Menon, V, Peralta, C, Nitsch, D, Fletcher, A, Bulpitt, C, Elley, Cr, Kenealy, T, Moyes, Sa, Collins, Jf, Drury, P, Ohkubo, T, Metoki, H, Nakayama, M, Kikuya, M, Imai, Y, Gansevoort, Rt, Bakker, Sj, Hillege, Hl, Heerspink, Hj, Bergstrom, J, Ix, Jh, Barrett Connor, E, Judd, S, Mcclellan, W, Jee, Sh, Kimm, H, Mok, Y, Tangri, N, Sud, M, Naimark, D, Wen, Cp, Wen, Sf, Tsao, Ck, Tsai, Mk, Lannfelt, L, Larsson, A, Bilo, Hj, Kleefstra, N, Groenier, Kh, Joosten, H, Drion, I, De, Jong, Pe, Iseki, K, Stengel, B, Warnock, D, Ballew, Sh, Woodward, M., Cardiovascular Centre (CVC), and Groningen Kidney Center (GKC)

Subjects
CHRONIC KIDNEY-DISEASE, Male, Endocrinology, Diabetes and Metabolism, Coronary Disease, 030204 cardiovascular system & hematology, chemistry.chemical_compound, 0302 clinical medicine, Endocrinology, cardiovascular disease, Risk Factors, eGFR, EQUATION, ARTERY-DISEASE, EPIDEMIOLOGY, 030212 general & internal medicine, RISK, education.field_of_study, CYSTATIN C, biology, ASSOCIATION, Middle Aged, 3. Good health, Stroke, 1101 Medical Biochemistry and Metabolomics, Cardiovascular Diseases, Creatinine, eGFR, albuminuria, cardiovascular disease, HEART, Female, medicine.symptom, Life Sciences & Biomedicine, Glomerular Filtration Rate, Adult, medicine.medical_specialty, Population, Renal function, 1117 Public Health and Health Services, Endocrinology & Metabolism, 03 medical and health sciences, Diabetes mellitus, Internal medicine, CKD, Internal Medicine, medicine, Albuminuria, Humans, education, CKD Prognosis Consortium, Heart Failure, Science & Technology, business.industry, MORTALITY, 1103 Clinical Sciences, medicine.disease, chemistry, Cystatin C, Heart failure, biology.protein, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11], business, Follow-Up Studies, Kidney disease
Abstract

Item does not contain fulltext BACKGROUND: The usefulness of estimated glomerular filtration rate (eGFR) and albuminuria for prediction of cardiovascular outcomes is controversial. We aimed to assess the addition of creatinine-based eGFR and albuminuria to traditional risk factors for prediction of cardiovascular risk with a meta-analytic approach. METHODS: We meta-analysed individual-level data for 637 315 individuals without a history of cardiovascular disease from 24 cohorts (median follow-up 4.2-19.0 years) included in the Chronic Kidney Disease Prognosis Consortium. We assessed C statistic difference and reclassification improvement for cardiovascular mortality and fatal and non-fatal cases of coronary heart disease, stroke, and heart failure in a 5 year timeframe, contrasting prediction models for traditional risk factors with and without creatinine-based eGFR, albuminuria (either albumin-to-creatinine ratio [ACR] or semi-quantitative dipstick proteinuria), or both. FINDINGS: The addition of eGFR and ACR significantly improved the discrimination of cardiovascular outcomes beyond traditional risk factors in general populations, but the improvement was greater with ACR than with eGFR, and more evident for cardiovascular mortality (C statistic difference 0.0139 [95% CI 0.0105-0.0174] for ACR and 0.0065 [0.0042-0.0088] for eGFR) and heart failure (0.0196 [0.0108-0.0284] and 0.0109 [0.0059-0.0159]) than for coronary disease (0.0048 [0.0029-0.0067] and 0.0036 [0.0019-0.0054]) and stroke (0.0105 [0.0058-0.0151] and 0.0036 [0.0004-0.0069]). Dipstick proteinuria showed smaller improvement than ACR. The discrimination improvement with eGFR or ACR was especially evident in individuals with diabetes or hypertension, but remained significant with ACR for cardiovascular mortality and heart failure in those without either of these disorders. In individuals with chronic kidney disease, the combination of eGFR and ACR for risk discrimination outperformed most single traditional predictors; the C statistic for cardiovascular mortality fell by 0.0227 (0.0158-0.0296) after omission of eGFR and ACR compared with less than 0.007 for any single modifiable traditional predictor. INTERPRETATION: Creatinine-based eGFR and albuminuria should be taken into account for cardiovascular prediction, especially when these measures are already assessed for clinical purpose or if cardiovascular mortality and heart failure are outcomes of interest. ACR could have particularly broad implications for cardiovascular prediction. In populations with chronic kidney disease, the simultaneous assessment of eGFR and ACR could facilitate improved classification of cardiovascular risk, supporting current guidelines for chronic kidney disease. Our results lend some support to also incorporating eGFR and ACR into assessments of cardiovascular risk in the general population. FUNDING: US National Kidney Foundation, National Institute of Diabetes and Digestive and Kidney Diseases.

Published
2015

21. Lower estimated glomerular filtration rate and higher albuminuria are associated with mortality and end-stage renal disease. A collaborative meta-analysis of kidney disease population cohorts

Author

Astor, BC, Matsushita, K, Gansevoort, RT, van der Velde, M, Woodward, M, Levey, AS, Jong, PE, Coresh, J, de Jong, PE, El-Nahas, M, Eckardt, KU, Kasiske, BL, Wright, J, Appel, L, Greene, T, Levin, A, Djurdjev, O, Wheeler, DC, Landray, MJ, Townend, JN, Emberson, J, Clark, LE, Macleod, A, Marks, A, Ali, T, Fluck, N, Prescott, G, Smith, DH, Weinstein, JR, Johnson, ES, Thorp, ML, Wetzels, JF, Blankestijn, PJ, van Zuilen, AD, Menon, V, Sarnak, M, Beck, G, Kronenberg, F, Kollerits, B, Froissart, M, Stengel, B, Metzger, M, Remuzzi, G, Ruggenenti, P, Perna, A, Heerspink, HJ, Brenner, B, de Zeeuw, D, Rossing, P, Parving, HH, Auguste, P, Veldhuis, K, Wang, Y, Camarata, L, Thomas, B, Manley, T, Cardiovascular Centre (CVC), and Groningen Kidney Center (GKC)

Subjects
Male, PROGRESSION, Kidney, urologic and male genital diseases, Cohort Studies, Risk Factors, Renal disorder [IGMD 9], education.field_of_study, OUTCOMES, CARDIOVASCULAR RISK, Hazard ratio, Confounding, Middle Aged, Prognosis, female genital diseases and pregnancy complications, Nephrology, Disease Progression, Regression Analysis, Female, Kidney Diseases, epidemiology, TRIAL, medicine.symptom, epidemiology and outcomes, Glomerular Filtration Rate, Adult, medicine.medical_specialty, Population, Renal function, Risk Assessment, Article, albuminuria, End stage renal disease, Predictive Value of Tests, Internal medicine, medicine, CKD, Humans, education, Aged, Proportional Hazards Models, Chi-Square Distribution, Proportional hazards model, business.industry, urogenital system, A300, medicine.disease, Creatine, Endocrinology, Albuminuria, Kidney Failure, Chronic, business, Biomarkers, chronic kidney disease, Kidney disease
Abstract

We studied here the independent associations of estimated glomerular filtration rate (eGFR) and albuminuria with mortality and end-stage renal disease (ESRD) in individuals with chronic kidney disease (CKD). We performed a collaborative meta-analysis of 13 studies totaling 21,688 patients selected for CKD of diverse etiology. After adjustment for potential confounders and albuminuria, we found that a 15 ml/min per 1.73 m(2) lower eGFR below a threshold of 45 ml/min per 1.73 m(2) was significantly associated with mortality and ESRD (pooled hazard ratios (HRs) of 1.47 and 6.24, respectively). There was significant heterogeneity between studies for both HR estimates. After adjustment for risk factors and eGFR, an eightfold higher albumin-or protein-to-creatinine ratio was significantly associated with mortality (pooled HR 1.40) without evidence of significant heterogeneity and with ESRD (pooled HR 3.04), with significant heterogeneity between HR estimates. Lower eGFR and more severe albuminuria independently predict mortality and ESRD among individuals selected for CKD, with the associations stronger for ESRD than for mortality. Thus, these relationships are consistent with CKD stage classifications based on eGFR and suggest that albuminuria provides additional prognostic information among individuals with CKD. Kidney International (2011) 79, 1331-1340; doi:10.1038/ki.2010.550; published online 2 February 2011

Published
2011

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

Author

Mahmoodi, Bk, Matsushita, K., Woodward, M., Blankestijn, Pj, Cirillo, Massimo, Ohkubo, T., Rossing, P., Sarnak, Mj, Stengel, B., Yamagishi, K., Yamashita, K., Zhang, L., Coresh, J., PE de Jong, Wright, BC Astor for the Chronic Kidney Disease Prognosis C. o. n. s. o. r. t. i. u. m. Investigators/Collaborators: J., Appel, L., Greene, T., Astor, Bc, Chalmers, J., Macmahon, S., Arima, H., Yatsuya, H., Toyoshima, H., Tamakoshi, K., Sang, Y., Atkins, R. C., Polkinghorne, Kr, Chadban, S., Shankar, A., Klein, R., Bek, Klein, Lee, Ke, Wang, H., Wang, F., Zuo, L., Levin, A., Djurdjev, O., Tonelli, M., Sacks, Fm, Curhan, Gc, Shlipak, M., Peralta, C., Katz, R., Fried, L., Iso, H., Kitamura, A., Ohira, T., Jafar, Th, Islam, M., Hatcher, J., Poulter, N., Chaturvedi, N., Landray, M. J., Emberson, Jr, Townend, Jn, Wheeler, Dc, Rothenbacher, D., Brenner, H., Muller, H., Schottker, B., Fox, Cs, Hwang, S. J., Meigs, Jb, Perkins, Rm, Fluck, N., Clark, Le, Prescott, Gj, Marks, A., Black, C., Hallan, S., Aasarod, K., Oien, Cm, Radtke, M., Irie, F., Sairenchi, T., Smith, Dh, Weiss, Jw, Johnson, Es, Thorp, Ml, Collins, Aj, Vassalotti, Ja, Li, S., Chen, S. C., Lee, Bj, Wetzels, Jf, AD van Zuilen, Sarnak, M., Levey, As, Menon, V., Kramer, Hj, IH de Boer, Kronenberg, F., Kollerits, B., Roderick, E. R. i. t. z. P., Nitsch, D., Fletcher, A., Bulpitt, C., Ishani, A., Neaton, Jd, Froissart, M., Metzger, M., Haymann, J. P., Houillier, P., Flamant, M., Metoki, H., Nakayama, M., Kikuya, M., Imai, Y., Iseki, K., Nelson, Rg, Knowler, Wc, Gansevoort, Rt, Hillege, H., Jassal, Sk, Barrett Connor, E., Bergstrom, J., HJ Lambers Heerspink, Brenner, Be, de Zeeuw, D., Warnock, Dg, Muntner, P., Judd, S., Mcclellan, W., Jee, Sh, Kimm, H., Jo, J., Mok, Y., Parving, H. H., Tangri, N., Naimark, D., Wen, C. P., Wen, S. F., Tsao, C. K., Tsai, M. K., Arnlov, J., Lannfelt, L., Larsson, A., Bilo, Hj, Joosten, H., Kleefstra, N., Groenier, Kh, Steering Committee: BC Astor, I. D. r. i. o. n., Hemmelgarn, Br, Data Coordinating Center: SH Ballew, M. W. o. o. d. w. a. r. d., Grams, M., Camarata, L., Hui, X., Seltzer, J., Winegrad, H., Mahmoodi, Bk, Matsushita, K, Woodward, M, Blankestijn, Pj, Cirillo, M, Ohkubo, T, Rossing, P, Sarnak, Mj, Stengel, B, Yamagishi, K, Yamashita, K, Zhang, L, Coresh, J, de Jong, Pe, Investigators/Collaborators: J Wright, BC Astor for the Chronic Kidney Disease Prognosis Consortium., Appel, L, Greene, T, Astor, Bc, Chalmers, J, Macmahon, S, Arima, H, Yatsuya, H, Toyoshima, H, Tamakoshi, K, Sang, Y, C Atkins, R, Polkinghorne, Kr, Chadban, S, Shankar, A, Klein, R, Klein, Bek, Lee, Ke, Wang, H, Wang, F, Zuo, L, Levin, A, Djurdjev, O, Tonelli, M, Sacks, Fm, Curhan, Gc, Shlipak, M, Peralta, C, Katz, R, Fried, L, Iso, H, Kitamura, A, Ohira, T, Jafar, Th, Islam, M, Hatcher, J, Poulter, N, Chaturvedi, N, J Landray, M, Emberson, Jr, Townend, Jn, Wheeler, Dc, Rothenbacher, D, Brenner, H, Muller, H, Schottker, B, Fox, C, Hwang, S-J, Meigs, Jb, Perkins, Rm, Fluck, N, Clark, Le, Prescott, Gj, Marks, A, Black, C, Hallan, S, Aasarod, K, Oien, Cm, Radtke, M, Irie, F, Sairenchi, T, Smith, Dh, Weiss, Jw, Johnson, E, Thorp, Ml, Collins, Aj, Vassalotti, Ja, Li, S, Chen, S-C, Lee, Bj, Wetzels, Jf, van Zuilen, Ad, Sarnak, M, Levey, A, Menon, V, Kramer, Hj, de Boer, Ih, Kronenberg, F, Kollerits, B, P Roderick, E Ritz., Nitsch, D, Fletcher, A, Bulpitt, C, Ishani, A, Neaton, Jd, Froissart, M, Metzger, M, Haymann, J-P, Houillier, P, Flamant, M, Metoki, H, Nakayama, M, Kikuya, M, Imai, Y, Iseki, K, Nelson, Rg, Knowler, Wc, Gansevoort, Rt, Hillege, H, Jassal, Sk, Barrett-Connor, E, Bergstrom, J, Lambers Heerspink, Hj, Brenner, Be, de Zeeuw, D, Warnock, Dg, Muntner, P, Judd, S, Mcclellan, W, Jee, Sh, Kimm, H, Jo, J, Mok, Y, Parving, H-H, Tangri, N, Naimark, D, Wen, C-P, Wen, S-F, Tsao, C-K, Tsai, M-K, Arnlov, J, Lannfelt, L, Larsson, A, Bilo, Hj, Joosten, H, Kleefstra, N, Groenier, Kh, Steering Committee: BC Astor, I Drion., Hemmelgarn, Br, Data Coordinating Center: SH Ballew, M Woodward., Grams, M, Camarata, L, Hui, X, Seltzer, J, and Winegrad., H

Subjects
Male, medicine.medical_specialty, hypertension, Blood Pressure, BLOOD-PRESSURE, GLOMERULAR-FILTRATION-RATE, Article, albuminuria, DIABETIC-NEPHROPATHY, End stage renal disease, CKD-PC Consortium, Risk Factors, Cause of Death, Internal medicine, REVERSE EPIDEMIOLOGY, eGFR, EQUATION, medicine, Humans, Intensive care medicine, Aged, Proportional Hazards Models, ALL-CAUSE MORTALITY, Renal disorder [IGMD 9], Aged, 80 and over, end-stage renal disease, business.industry, General Medicine, Middle Aged, medicine.disease, mortality, RISK POPULATION COHORTS, PREVALENCE, Chronic Disease, COLLABORATIVE METAANALYSIS, Kidney Failure, Chronic, Female, HIGHER ALBUMINURIA, business, Glomerular Filtration Rate, Kidney disease
Abstract

Item does not contain fulltext BACKGROUND: Hypertension is the most prevalent comorbidity in individuals with chronic kidney disease. However, whether the association of the kidney disease measures, estimated glomerular filtration rate (eGFR) and albuminuria, with mortality or end-stage renal disease (ESRD) differs by hypertensive status is unknown. METHODS: We did a meta-analysis of studies selected according to Chronic Kidney Disease Prognosis Consortium criteria. Data transfer and analyses were done between March, 2011, and June, 2012. We used Cox proportional hazards models to estimate the hazard ratios (HR) of mortality and ESRD associated with eGFR and albuminuria in individuals with and without hypertension. FINDINGS: We analysed data for 45 cohorts (25 general population, seven high-risk, and 13 chronic kidney disease) with 1,127,656 participants, 364,344 of whom had hypertension. Low eGFR and high albuminuria were associated with mortality irrespective of hypertensive status in the general population and high-risk cohorts. All-cause mortality risk was 1.1-1.2 times higher in individuals with hypertension than in those without hypertension at preserved eGFR. A steeper relative risk gradient in individuals without hypertension than in those with hypertension at eGFR range 45-75 mL/min per 1.73 m(2) led to much the same mortality risk at lower eGFR. With a reference eGFR of 95 mL/min per 1.73 m(2) in each group to explicitly assess interaction, adjusted HR for all-cause mortality at eGFR 45 mL/min per 1.73 m(2) was 1.77 (95% CI 1.57-1.99) in individuals without hypertension versus 1.24 (1.11-1.39) in those with hypertension (p for overall interaction=0.0003). Similarly, for albumin-creatinine ratio of 300 mg/g (vs 5 mg/g), HR was 2.30 (1.98-2.68) in individuals without hypertension versus 2.08 (1.84-2.35) in those with hypertension (p for overall interaction=0.019). We recorded much the same results for cardiovascular mortality. The associations of eGFR and albuminuria with ESRD, however, did not differ by hypertensive status. Results for chronic kidney disease cohorts were similar to those for general and high-risk population cohorts. INTERPRETATION: Chronic kidney disease should be regarded as at least an equally relevant risk factor for mortality and ESRD in individuals without hypertension as it is in those with hypertension. FUNDING: US National Kidney Foundation.

Published
2012

23. Estimated glomerular filtration rate and albuminuria for prediction of cardiovascular outcomes: a collaborative meta-analysis of individual participant data

Author

Matsushita, K., Coresh, J., Sang, Y., Chalmers, J., Fox, C., Guallar, E., Jafar, T., Jassal, S.K., Landman, G.W., Muntner, P., Roderick, P., Sairenchi, T., Schottker, B., Shankar, A., Shlipak, M., Tonelli, M., Townend, J., Zuilen, A. van, Yamagishi, K., Yamashita, K., Gansevoort, R., Sarnak, M., Warnock, D.G., Woodward, M., Arnlov, J., Wetzels, J.F.M., et al., Matsushita, K., Coresh, J., Sang, Y., Chalmers, J., Fox, C., Guallar, E., Jafar, T., Jassal, S.K., Landman, G.W., Muntner, P., Roderick, P., Sairenchi, T., Schottker, B., Shankar, A., Shlipak, M., Tonelli, M., Townend, J., Zuilen, A. van, Yamagishi, K., Yamashita, K., Gansevoort, R., Sarnak, M., Warnock, D.G., Woodward, M., Arnlov, J., Wetzels, J.F.M., and et al.

Abstract

Item does not contain fulltext, BACKGROUND: The usefulness of estimated glomerular filtration rate (eGFR) and albuminuria for prediction of cardiovascular outcomes is controversial. We aimed to assess the addition of creatinine-based eGFR and albuminuria to traditional risk factors for prediction of cardiovascular risk with a meta-analytic approach. METHODS: We meta-analysed individual-level data for 637 315 individuals without a history of cardiovascular disease from 24 cohorts (median follow-up 4.2-19.0 years) included in the Chronic Kidney Disease Prognosis Consortium. We assessed C statistic difference and reclassification improvement for cardiovascular mortality and fatal and non-fatal cases of coronary heart disease, stroke, and heart failure in a 5 year timeframe, contrasting prediction models for traditional risk factors with and without creatinine-based eGFR, albuminuria (either albumin-to-creatinine ratio [ACR] or semi-quantitative dipstick proteinuria), or both. FINDINGS: The addition of eGFR and ACR significantly improved the discrimination of cardiovascular outcomes beyond traditional risk factors in general populations, but the improvement was greater with ACR than with eGFR, and more evident for cardiovascular mortality (C statistic difference 0.0139 [95% CI 0.0105-0.0174] for ACR and 0.0065 [0.0042-0.0088] for eGFR) and heart failure (0.0196 [0.0108-0.0284] and 0.0109 [0.0059-0.0159]) than for coronary disease (0.0048 [0.0029-0.0067] and 0.0036 [0.0019-0.0054]) and stroke (0.0105 [0.0058-0.0151] and 0.0036 [0.0004-0.0069]). Dipstick proteinuria showed smaller improvement than ACR. The discrimination improvement with eGFR or ACR was especially evident in individuals with diabetes or hypertension, but remained significant with ACR for cardiovascular mortality and heart failure in those without either of these disorders. In individuals with chronic kidney disease, the combination of eGFR and ACR for risk discrimination outperformed most single traditional predictors; the C statistic f

Published
2015

26. Lower estimated glomerular filtration rate and higher albuminuria are associated with mortality and end-stage renal disease. A collaborative meta-analysis of kidney disease population cohorts

Author

Astor, B.C., Matsushita, K., Gansevoort, R.T., Velde, M. van de, Woodward, M., Levey, A.S., Jong, P.E. de, Coresh, J., El-Nahas, M., Eckardt, K.U., Kasiske, B.L., Wright, J., Appel, L., Greene, T., Levin, A., Djurdjev, O., Wheeler, D.C., Landray, M.J., Townend, J.N., Emberson, J., Clark, L.E., Macleod, A., Marks, A., Ali, T., Fluck, N., Prescott, G., Smith, D.H., Weinstein, J.R., Johnson, E.S., Thorp, M.L., Wetzels, J.F.M., Blankestijn, P.J., Zuilen, A.D. van, Menon, V., Sarnak, M., Beck, G., Kronenberg, F., Kollerits, B., Froissart, M., Stengel, B., Metzger, M., Remuzzi, G., Ruggenenti, P., Perna, A., Heerspink, H.J., Brenner, B., Zeeuw, D. de, Rossing, P., Parving, H.H., Auguste, P., Veldhuis, K., Wang, Y., Camarata, L., Thomas, B., Manley, T., Astor, B.C., Matsushita, K., Gansevoort, R.T., Velde, M. van de, Woodward, M., Levey, A.S., Jong, P.E. de, Coresh, J., El-Nahas, M., Eckardt, K.U., Kasiske, B.L., Wright, J., Appel, L., Greene, T., Levin, A., Djurdjev, O., Wheeler, D.C., Landray, M.J., Townend, J.N., Emberson, J., Clark, L.E., Macleod, A., Marks, A., Ali, T., Fluck, N., Prescott, G., Smith, D.H., Weinstein, J.R., Johnson, E.S., Thorp, M.L., Wetzels, J.F.M., Blankestijn, P.J., Zuilen, A.D. van, Menon, V., Sarnak, M., Beck, G., Kronenberg, F., Kollerits, B., Froissart, M., Stengel, B., Metzger, M., Remuzzi, G., Ruggenenti, P., Perna, A., Heerspink, H.J., Brenner, B., Zeeuw, D. de, Rossing, P., Parving, H.H., Auguste, P., Veldhuis, K., Wang, Y., Camarata, L., Thomas, B., and Manley, T.

Abstract

Item does not contain fulltext, We studied here the independent associations of estimated glomerular filtration rate (eGFR) and albuminuria with mortality and end-stage renal disease (ESRD) in individuals with chronic kidney disease (CKD). We performed a collaborative meta-analysis of 13 studies totaling 21,688 patients selected for CKD of diverse etiology. After adjustment for potential confounders and albuminuria, we found that a 15 ml/min per 1.73 m(2) lower eGFR below a threshold of 45 ml/min per 1.73 m(2) was significantly associated with mortality and ESRD (pooled hazard ratios (HRs) of 1.47 and 6.24, respectively). There was significant heterogeneity between studies for both HR estimates. After adjustment for risk factors and eGFR, an eightfold higher albumin- or protein-to-creatinine ratio was significantly associated with mortality (pooled HR 1.40) without evidence of significant heterogeneity and with ESRD (pooled HR 3.04), with significant heterogeneity between HR estimates. Lower eGFR and more severe albuminuria independently predict mortality and ESRD among individuals selected for CKD, with the associations stronger for ESRD than for mortality. Thus, these relationships are consistent with CKD stage classifications based on eGFR and suggest that albuminuria provides additional prognostic information among individuals with CKD.

Published
2011

27. Genome-wide association studies of serum magnesium, potassium, and sodium concentrations identify six loci influencing serum magnesium levels

Author

Meyer, T.E. (Tamra), Verwoert, G.C. (Germaine), Hwang, S.J., Glazer, N.L. (Nicole), Smith, A.V. (Albert Vernon), Rooij, F.J.A. (Frank) van, Ehret, G.B. (Georg), Boerwinkle, E.A. (Eric), Felix, J.F. (Janine), Leak, T.S. (Tennille), Harris, T.B. (Tamara), Yang, Q. (Qiong Fang), Dehghan, A. (Abbas), Aspelund, T. (Thor), Katz, R. (Ronit), Homuth, G. (Georg), Kocher, T. (Thomas), Rettig, R. (Rainer), Ried, J.S. (Janina), Gieger, C. (Christian), Prucha, H. (Hanna), Pfeufer, A. (Arne), Meitinger, T. (Thomas), Coresh, J. (Josef), Hofman, A. (Albert), Sarnak, M. (Mark), Chen, Y.D.I. (Yii-Der Ida), Uitterlinden, A.G. (André), Chakravarti, A. (Aravinda), Psaty, B.M. (Bruce), Tikka-Kleemola, P. (Päivi), Kao, W.-H.L. (Linda), Witteman, J.C.M. (Jacqueline), Gudnason, V. (Vilmundur), Siscovick, D.S. (David), Fox, C.S. (Caroline), Köttgen, A. (Anna), Meyer, T.E. (Tamra), Verwoert, G.C. (Germaine), Hwang, S.J., Glazer, N.L. (Nicole), Smith, A.V. (Albert Vernon), Rooij, F.J.A. (Frank) van, Ehret, G.B. (Georg), Boerwinkle, E.A. (Eric), Felix, J.F. (Janine), Leak, T.S. (Tennille), Harris, T.B. (Tamara), Yang, Q. (Qiong Fang), Dehghan, A. (Abbas), Aspelund, T. (Thor), Katz, R. (Ronit), Homuth, G. (Georg), Kocher, T. (Thomas), Rettig, R. (Rainer), Ried, J.S. (Janina), Gieger, C. (Christian), Prucha, H. (Hanna), Pfeufer, A. (Arne), Meitinger, T. (Thomas), Coresh, J. (Josef), Hofman, A. (Albert), Sarnak, M. (Mark), Chen, Y.D.I. (Yii-Der Ida), Uitterlinden, A.G. (André), Chakravarti, A. (Aravinda), Psaty, B.M. (Bruce), Tikka-Kleemola, P. (Päivi), Kao, W.-H.L. (Linda), Witteman, J.C.M. (Jacqueline), Gudnason, V. (Vilmundur), Siscovick, D.S. (David), Fox, C.S. (Caroline), and Köttgen, A. (Anna)

Abstract

Magnesium, potassium, and sodium, cations commonly measured in serum, are involved in many physiological processes including energy metabolism, nerve and muscle function, signal transduction, and fluid and blood pressure regulation. To evaluate the contribution of common genetic variation to normal physiologic variation in serum concentrations of these cations, we conducted genome-wide association studies of serum magnesium, potassium, and sodium concentrations using ~2.5 million genotyped and imputed common single nucleotide polymorphisms (SNPs) in 15,366 parti

Published
2010
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36. Age and cystatin C in healthy adults: a collaborative study

Author

Odden, M. C., primary, Tager, I. B., additional, Gansevoort, R. T., additional, Bakker, S. J. L., additional, Katz, R., additional, Fried, L. F., additional, Newman, A. B., additional, Canada, R. B., additional, Harris, T., additional, Sarnak, M. J., additional, Siscovick, D., additional, and Shlipak, M. G., additional

Published
2009
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45. Can A New Blood Test Help Predict Who Is At Risk for Developing Heart Failure?

Author

Sarnak, M. J., Katz, R., Stehman-Breen, C. O., Fried, L. F., Jenny, N. Swords, Psaty, B. M., Newman, A. B., Siscovick, D., and Shlipak, M. G.

Subjects
*HEART disease risk factors, *HEART failure, *CARDIAC arrest, *MYOCARDIAL infarction, *BLOOD pressure, *THERAPEUTICS
Abstract

The article reports on determining whether new bloods test help predict who is at risk for developing heart failure. In heart failure, the heart cannot pump enough blood to supply the body's needs. Risk factors include high blood pressure and a previous heart attack. Low kidney function may also increase risk. The easiest way to detect low kidney function is to measure creatinine, a protein in the blood that increases when kidney function decreases. However, creatinine levels are not always accurate.

Published
2005
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46. Long-term outcomes in nondiabetic chronic kidney disease.

Author

Menon, V., Wang, X., Sarnak, M. J., Hunsicker, L. H., Madero, M., Beck, G. J., Collins, A. J., Kusek, J. W., Levey, A. S., and Greene, T.

Subjects
*KIDNEY diseases, *BLOOD pressure, *CHRONIC kidney failure, *DIET in disease, *DISEASE risk factors
Abstract

The Modification of Diet in Renal Disease (MDRD) Study examined the effects of strict blood pressure control and dietary protein restriction on the progression of kidney disease. Here, we retrospectively evaluated outcomes of nondiabetic participants with stages 2–4 chronic kidney disease (CKD) from randomized and nonrandomized cohorts of the MDRD Study. Kidney failure and survival status through December of 2000, were obtained from the US Renal Data System and the National Death Index. Event rates were calculated for kidney failure, death, and a composite outcome of death and kidney failure. In the 1666 patients, rates for kidney failure were four times higher than that for death. Kidney failure was a more likely event than death in subgroups based on baseline glomerular filtration rate, proteinuria, kidney disease etiology, gender, and race. It was only among those older than 65 that the rate for death approximated that for kidney failure. In contrast to other populations with CKD, our study of relatively young subjects with nondiabetic disease has found that the majority of the participants advanced to kidney failure with a low competing risk of death. In such patients, the primary emphasis should be on delaying progression of kidney disease.Kidney International (2008) 73, 1310–1315; doi:10.1038/ki.2008.67; published online 12 March 2008 [ABSTRACT FROM AUTHOR]

Published
2008
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47. Fetuin-A is not associated with mortality in chronic kidney disease.

Author

Ix, J. H., Shlipak, M. G., Sarnak, M. J., Beck, G. J., Greene, T., Wang, X., Kusek, J. W., Collins, A. J., Levey, A. S., and Menon, V.

Subjects
*KIDNEY diseases, *CHRONIC kidney failure, *CHRONIC diseases, *DIET in disease, *LABORATORY rats
Abstract

Fetuin-A is a serum protein that inhibits vascular calcification such that lower levels are associated with a higher prevalence of vascular calcification and mortality risk among end-stage renal disease populations. We analyzed data of 822 persons in the Modification of Diet in Renal Disease study, a randomized, controlled trial of persons with predominantly non-diabetic stage 3–4 chronic kidney disease (CKD). Serum fetuin-A levels were measured in baseline serum. Survival status and cause of death were determined by the National Death Index. Cox proportional hazard models evaluated the association of fetuin-A levels with all-cause and cardiovascular mortality. Glomerular filtration ranged from 13 to 55 ml per min per 1.73 m2. During a median follow-up of 9.5 years, 25% of persons died from any cause and 12% died from a cardiovascular cause. Compared to the lowest tertile, no association was found between the highest fetuin-A tertile and all-cause or cardiovascular mortality. Similarly, no association was found between fetuin-A as a continuous variable and all-cause or cardiovascular mortality. Our study shows that serum fetuin-A levels are not related to all-cause or cardiovascular mortality among persons with predominantly non-diabetic stage 3 or 4 CKD.Kidney International (2007) 72, 1394–1399; doi:10.1038/sj.ki.5002549; published online 19 September 2007 [ABSTRACT FROM AUTHOR]

Published
2007
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48. Safety and Efficacy of Vadadustat for Anemia in Patients Undergoing Dialysis.

Author

Eckardt, K.-U., Agarwal, R., Aswad, A., Awad, A., Block, G. A., Bacci, M. R., Farag, Y. M. K., Fishbane, S., Hubert, H., Jardine, A., Khawaja, Z., Koury, M. J., Maroni, B. J., Matsushita, K., McCullough, P. A., Lewis, E. F., Luo, W., Parfrey, P. S., Pergola, P., and Sarnak, M. J.

Subjects
*DRUG efficacy, *HEMODIALYSIS patients, *HYPOXIA-inducible factors, *CHRONIC kidney failure, *ANEMIA
Abstract

BACKGROUND Vadadustat is an oral hypoxia-inducible factor prolyl hydroxylase inhibitor, a class of compounds that stimulate endogenous erythropoietin production. METHODS We conducted two randomized, open-label, noninferiority phase 3 trials to evaluate the safety and efficacy of vadadustat, as compared with darbepoetin alfa, patients with anemia and incident or prevalent dialysis-dependent chronic kidney disease (DD-CKD). The primary safety end point, assessed in a time-to-event analysis, was the first occurrence of a major adverse cardiovascular event (MACE, a composite of death from any cause, a nonfatal myocardial infarction, or a fatal stroke), pooled across the trials (noninferiority margin, 1.25). A key secondary safety end point was the first occurrence of a MACE plus hospitalization either heart failure or a thromboembolic event. The primary and key secondary efficacy end points were the mean change in hemoglobin from baseline to weeks 24 to 36 and from baseline to weeks 40 to 52, respectively, in each trial (noninferiority margin, -0.75 g per deciliter). RESULTS A total of 3923 patients were randomly assigned in a 1:1 ratio to receive vadadustat or darbepoetin alfa: 369 in the incident DD-CKD trial and 3554 in the prevalent DD-CKD trial. In the pooled analysis, a first MACE occurred in 355 patients (18.2%) in the vadadustat group and in 377 patients (19.3%) in the darbepoetin alfa group (hazard ratio, 0.96; 95% confidence interval [CI], 0.83 to 1.11). The mean differences between the groups in the change in hemoglobin concentration were -0.31 g per deciliter (95% CI, -0.53 to -0.10) at weeks 24 to 36 and -0.07 g per deciliter (95% CI, -0.34 to 0.19) at weeks 40 to 52 in the incident DD-CKD trial and -0.17 g per deciliter (95% CI, -0.23 to -0.10) and -0.18 g per deciliter (95% CI, -0.25 to -0.12), respectively, in the prevalent DD-CKD trial. The incidence of serious adverse events in the vadadustat group was 49.7% in the incident DD-CKD trial and 55.0% in the prevalent DD-CKD trial, and the incidences in the darbepoetin alfa group were 56.5% and 58.3%, respectively. CONCLUSIONS Among patients with anemia and CKD who were undergoing dialysis, vadadustat was noninferior to darbepoetin alfa with respect to cardiovascular safety and correction and maintenance of hemoglobin concentrations. [ABSTRACT FROM AUTHOR]

Published
2021
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49. Inflammation and cardiovascular events in individuals with and without chronic kidney disease.

Author

Weiner, D. E., Tighiouart, H., Elsayed, E. F., Griffith, J. L., Salem, D. N., Levey, A. S., and Sarnak, M. J.

Subjects
*INFLAMMATION, *KIDNEY diseases, *C-reactive protein, *FIBRINOGEN, *CARDIOVASCULAR diseases, *ALBUMINS
Abstract

Inflammation and chronic kidney disease predict cardiovascular events. Here we evaluated markers of inflammation including fibrinogen, albumin and white blood cell count in individuals with and without stages 3–4 chronic kidney disease to assess inflammation as a risk factor for adverse events, the synergy between inflammation and chronic kidney disease, and the prognostic ability of these inflammatory markers relative to that of C-reactive protein. Using Atherosclerosis Risk in Communities and Cardiovascular Health Study data, inflammation was defined by worst quartile of at least 2 of these 3 markers. In Cox regression models, inflammation was assessed as a risk factor for a composite of cardiac events, stroke and mortality as well as components of this composite. Among 20 413 patients, inflammation was identified in 3594 and chronic kidney disease in 1649. In multivariable analyses, both inflammation and chronic kidney disease predicted all outcomes, but their interaction was non-significant. In 5597 patients with C-reactive protein levels, inflammation and elevated C-reactive protein had similar hazard ratios. When focusing only on individuals with the worst quartile of white cell count and albumin, results remained consistent.Kidney International (2008) 73, 1406–1412; doi:10.1038/ki.2008.75; published online 9 April 2008 [ABSTRACT FROM AUTHOR]

Published
2008
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50. Blood pressure in chronic kidney disease: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

Author

Alfred K. Cheung, Tara I. Chang, William C. Cushman, Susan L. Furth, Joachim H. Ix, Roberto Pecoits-Filho, Vlado Perkovic, Mark J. Sarnak, Sheldon W. Tobe, Charles R.V. Tomson, Michael Cheung, David C. Wheeler, Wolfgang C. Winkelmayer, Johannes F.E. Mann, George L. Bakris, Albertino Damasceno, Jamie P. Dwyer, Linda F. Fried, Richard Haynes, Nobuhito Hirawa, Hallvard Holdaas, Hassan N. Ibrahim, Julie R. Ingelfinger, Kunitoshi Iseki, Arif Khwaja, Paul L. Kimmel, Csaba P. Kovesdy, Elaine Ku, Edgar V. Lerma, Friedrich C. Luft, Jicheng Lv, Christopher B. McFadden, Paul Muntner, Martin G. Myers, Sankar D. Navaneethan, Gianfranco Parati, Aldo J. Peixoto, Ramesh Prasad, Mahboob Rahman, Michael V. Rocco, Cibele Isaac Saad Rodrigues, Simon D. Roger, George S. Stergiou, Laurie A. Tomlinson, Marcello Tonelli, Robert D. Toto, Yusuke Tsukamoto, Robert Walker, Angela Yee-Moon Wang, Jiguang Wang, Bradley A. Warady, Paul K. Whelton, Jeff D. Williamson, Cheung, A, Chang, T, Cushman, W, Furth, S, Ix, J, Pecoits-Filho, R, Perkovic, V, Sarnak, M, Tobe, S, Tomson, C, Cheung, M, Wheeler, D, Winkelmayer, W, Mann, J, Bakris, G, Damasceno, A, Dwyer, J, Fried, L, Haynes, R, Hirawa, N, Holdaas, H, Ibrahim, H, Ingelfinger, J, Iseki, K, Khwaja, A, Kimmel, P, Kovesdy, C, Ku, E, Lerma, E, Luft, F, Lv, J, Mcfadden, C, Muntner, P, Myers, M, Navaneethan, S, Parati, G, Peixoto, A, Prasad, R, Rahman, M, Rocco, M, Rodrigues, C, Roger, S, Stergiou, G, Tomlinson, L, Tonelli, M, Toto, R, Tsukamoto, Y, Walker, R, Wang, A, Wang, J, Warady, B, Whelton, P, and Williamson, J

Subjects
Clinical Trials as Topic, blood pressure measurement, Blood Pressure, Blood Pressure Determination, blood pressure target, Congresses as Topic, cardiovascular event, Treatment Outcome, Nephrology, Practice Guidelines as Topic, blood pressure measurement, blood pressure targets, cardiovascular events, guideline, treatment threshold, Humans, Renal Insufficiency, Chronic, guideline, treatment threshold, Antihypertensive Agents
Abstract

In September 2017, KDIGO (Kidney Disease: Improving Global Outcomes) convened a Controversies Conference titled Blood Pressure in Chronic Kidney Disease (CKD). The purpose of the meeting was to consider which recommendations from the 2012 KDIGO Clinical Practice Guideline for the Management of Blood Pressure in CKD should be reevaluated based on new evidence from clinical trials. Participants included a multidisciplinary panel of clinical and scientific experts. Discussions focused on the optimal means for measuring blood pressure (BP) as well as managing BP in CKD patients. Consistent with the 2012 Guideline, the conference did not address BP management in patients on maintenance dialysis.

Published
2018

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