Hallan, Stein I. and Ritz, Eberhard and Lydersen, Stian and Romundstad, Solfrid and Kvenild, Kurt and Orth, Stephan R. (2009) Combining GFR and Albuminuria to Classify CKD Improves Prediction of ESRD. JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 20 (5). pp. 1069-1077. ISSN 1046-6673,
Full text not available from this repository. (Request a copy)Abstract
Despite the high prevalence of chronic kidney disease (CKD), relatively few individuals with CKD progress to ESRD. A better understanding of the risk factors for progression could improve the classification system of CKD and strategies for screening. We analyzed data from 65,589 adults who participated in the Nord-Trondelag Health (HUNT 2) Study (1995 to 1997) and found 124 patients who progressed to ESRD after 10.3 yr of follow-up. In multivariable survival analysis, estimated GFR (eGFR) and albuminuria were independently and strongly associated with progression to ESRD: Hazard ratios for eGFR 45 to 59, 30 to 44, and 15 to 29 ml/min per 1.73 m(2) were 6.7, 18.8, and 65.7, respectively (P < 0.001 for all), and for micro- and macroalbuminuria were 13.0 and 47.2 (P < 0.001 for both). Hypertension, diabetes, male gender, smoking, depression, obesity, cardiovascular disease, dyslipidemia, physical activity and education did not add predictive information. Time-dependent receiver operating characteristic analyses showed that considering both the urinary albumin/creatinine ratio and eGFR substantially improved diagnostic accuracy. Referral based on current stages 3 to 4 CKD (eGFR 15 to 59 ml/min per 1.73 m(2)) would include 4.7% of the general population and identify 69.4% of all individuals progressing to ESRD. Referral based on our classification system would include 1.4% of the general population without losing predictive power (i.e., it would detect 65.6% of all individuals progressing to ESRD). In conclusion, all levels of reduced eGFR should
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CHRONIC KIDNEY-DISEASE; GLOMERULAR-FILTRATION-RATE; STAGE RENAL-DISEASE; MISSING DATA; MULTIPLE IMPUTATION; URINARY ALBUMIN; RISK SCORES; HUNT-II; PROTEINURIA; VALUES; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 16 Sep 2020 12:34 |
| Last Modified: | 16 Sep 2020 12:34 |
| URI: | https://pred.uni-regensburg.de/id/eprint/29072 |
Actions (login required)
 |
View Item |
