@article{6521bddd613541e1bf8d3d0dff5e97f4,
title = "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",
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 m² lower eGFR below a threshold of 45 ml/min per 1.73 m² 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.",
keywords = "adult, aged, albuminuria, biological markers, chi-square distribution, cohort studies, creatine, disease progression, female, glomerular filtration rate, humans, kidney, kidney diseases, kidney failure, chronic, male, middle aged, predictive value of tests , prognosis, proportional hazards models, regression analysis, risk assessment, risk factors",
author = "Astor, {Brad C} and Kunihiro Matsushita and Gansevoort, {Ron T} and {van der Velde}, Marije and Mark Woodward and Levey, {Andrew S} and Jong, {Paul E de} and Josef Coresh and Astor, {Brad C} and Kunihiro Matsushita and Gansevoort, {Ron T} and {van der Velde}, Marije and Mark Woodward and Levey, {Andrew S} and {de Jong}, {Paul E} and Josef Coresh and Meguid El-Nahas and Kai-Uwe Eckardt and Kasiske, {Bertram L} and Jackson Wright and Larry Appel and Tom Greene and Adeera Levin and Ognjenka Djurdjev and Wheeler, {David C} and Landray, {Martin J} and Townend, {John N} and Jonathan Emberson and Clark, {Laura E} and Alison Macleod and Angharad Marks and Tariq Ali and Nicholas Fluck and Prescott, {Gordon J} and Smith, {David H} and Weinstein, {Jessica R} and Johnson, {Eric S} and Thorp, {Micah L} and Wetzels, {Jack F} and Blankestijn, {P J} and {van Zuilen}, {A D} and Vandana Menon and Mark Sarnak and Gerald Beck and Florian Kronenberg and Barbara Kollerits and Marc Froissart and Benedicte Stengel and Marie Metzger and {Chronic Kidney Disease Prognosis Consortium} and Corri Black",
year = "2011",
month = jun,
doi = "10.1038/ki.2010.550",
language = "English",
volume = "79",
pages = "1331--1340",
journal = "Kidney International",
publisher = "Nature Publishing Group",
number = "12",
}