Mild decrease in estimated glomerular filtration rate and proteinuria are associated with all-cause and cardiovascular mortality in the general population

Se Won Oh, Seon Ha Baek, Yong Chul Kim, Ho Suk Goo, Nam Ju Heo, Ki Young Na, Dong Wan Chae, Suhnggwon Kim, Ho Jun Chin

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background. A recent collaborative meta-analysis by Kidney Disease: Improving Global Outcomes reported that an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m 2 and an albumin-to-creatinine ratio of ≥10 mg/g were independent predictors for mortality in the general population. However, selection bias, heterogeneity of the cohorts and measurement issues could be limitations.Methods.We analyzed the relationship of eGFR and proteinuria with mortality in the Korean general population, represented by 112115 participants, aged ≥20 years, who had a voluntary health check-up with homogenous calibration of creatinine measurement from 2003 to 2009. Proteinuria (trace or more) was determined by urine dipstick.Results.eGFR and proteinuria were independently associated with all-cause mortality (ACM) and cardiovascular mortality (CVM), and progressive increases in risks for mortality were noted according to eGFR level and the presence of proteinuria. Compared with eGFR 90-105 mL/min/1.73m 2, hazard ratio (HRs) for ACM were 1.60 [95% confidence interval (CI) 1.12-2.30] for eGFR 60-74 mL/min/1.73m 2 and 3.54 (2.20-5.68) for eGFR <60 mL/min/1.73m 2 in participants with no proteinuria. In participants with proteinuria, HRs for ACM were 2.10 (1.41-3.12) for eGFR 75-89 mL/min/1.73m 2, 2.30 (1.50-3.53) for eGFR 60-74 mL/min/1.73m 2 and 3.77 (2.15-6.38) for eGFR <60 mL/min/1.73m 2. Similar findings were observed for CVM.Conclusions.eGFR <75 mL/min/1.73m 2 and urine dipstick trace or more were independent risk factors of ACM and CVM. The risks of adverse outcomes are greater in the general population with mild renal impairment or mild proteinuria.

Original languageEnglish
Pages (from-to)2284-2290
Number of pages7
JournalNephrology Dialysis Transplantation
Volume27
Issue number6
DOIs
Publication statusPublished - 2012 Jun 1
Externally publishedYes

Fingerprint

Glomerular Filtration Rate
Proteinuria
Mortality
Population
Creatinine
Urine
Selection Bias
Kidney Diseases
Calibration
Meta-Analysis
Albumins
Confidence Intervals
Kidney
Health

Keywords

  • All-cause mortality
  • Cardiovascular mortality
  • General population
  • Glomerular filtration rate
  • Proteinuria

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

Mild decrease in estimated glomerular filtration rate and proteinuria are associated with all-cause and cardiovascular mortality in the general population. / Oh, Se Won; Baek, Seon Ha; Kim, Yong Chul; Goo, Ho Suk; Heo, Nam Ju; Na, Ki Young; Chae, Dong Wan; Kim, Suhnggwon; Chin, Ho Jun.

In: Nephrology Dialysis Transplantation, Vol. 27, No. 6, 01.06.2012, p. 2284-2290.

Research output: Contribution to journalArticle

Oh, Se Won ; Baek, Seon Ha ; Kim, Yong Chul ; Goo, Ho Suk ; Heo, Nam Ju ; Na, Ki Young ; Chae, Dong Wan ; Kim, Suhnggwon ; Chin, Ho Jun. / Mild decrease in estimated glomerular filtration rate and proteinuria are associated with all-cause and cardiovascular mortality in the general population. In: Nephrology Dialysis Transplantation. 2012 ; Vol. 27, No. 6. pp. 2284-2290.
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T1 - Mild decrease in estimated glomerular filtration rate and proteinuria are associated with all-cause and cardiovascular mortality in the general population

AU - Oh, Se Won

AU - Baek, Seon Ha

AU - Kim, Yong Chul

AU - Goo, Ho Suk

AU - Heo, Nam Ju

AU - Na, Ki Young

AU - Chae, Dong Wan

AU - Kim, Suhnggwon

AU - Chin, Ho Jun

PY - 2012/6/1

Y1 - 2012/6/1

N2 - Background. A recent collaborative meta-analysis by Kidney Disease: Improving Global Outcomes reported that an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m 2 and an albumin-to-creatinine ratio of ≥10 mg/g were independent predictors for mortality in the general population. However, selection bias, heterogeneity of the cohorts and measurement issues could be limitations.Methods.We analyzed the relationship of eGFR and proteinuria with mortality in the Korean general population, represented by 112115 participants, aged ≥20 years, who had a voluntary health check-up with homogenous calibration of creatinine measurement from 2003 to 2009. Proteinuria (trace or more) was determined by urine dipstick.Results.eGFR and proteinuria were independently associated with all-cause mortality (ACM) and cardiovascular mortality (CVM), and progressive increases in risks for mortality were noted according to eGFR level and the presence of proteinuria. Compared with eGFR 90-105 mL/min/1.73m 2, hazard ratio (HRs) for ACM were 1.60 [95% confidence interval (CI) 1.12-2.30] for eGFR 60-74 mL/min/1.73m 2 and 3.54 (2.20-5.68) for eGFR <60 mL/min/1.73m 2 in participants with no proteinuria. In participants with proteinuria, HRs for ACM were 2.10 (1.41-3.12) for eGFR 75-89 mL/min/1.73m 2, 2.30 (1.50-3.53) for eGFR 60-74 mL/min/1.73m 2 and 3.77 (2.15-6.38) for eGFR <60 mL/min/1.73m 2. Similar findings were observed for CVM.Conclusions.eGFR <75 mL/min/1.73m 2 and urine dipstick trace or more were independent risk factors of ACM and CVM. The risks of adverse outcomes are greater in the general population with mild renal impairment or mild proteinuria.

AB - Background. A recent collaborative meta-analysis by Kidney Disease: Improving Global Outcomes reported that an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m 2 and an albumin-to-creatinine ratio of ≥10 mg/g were independent predictors for mortality in the general population. However, selection bias, heterogeneity of the cohorts and measurement issues could be limitations.Methods.We analyzed the relationship of eGFR and proteinuria with mortality in the Korean general population, represented by 112115 participants, aged ≥20 years, who had a voluntary health check-up with homogenous calibration of creatinine measurement from 2003 to 2009. Proteinuria (trace or more) was determined by urine dipstick.Results.eGFR and proteinuria were independently associated with all-cause mortality (ACM) and cardiovascular mortality (CVM), and progressive increases in risks for mortality were noted according to eGFR level and the presence of proteinuria. Compared with eGFR 90-105 mL/min/1.73m 2, hazard ratio (HRs) for ACM were 1.60 [95% confidence interval (CI) 1.12-2.30] for eGFR 60-74 mL/min/1.73m 2 and 3.54 (2.20-5.68) for eGFR <60 mL/min/1.73m 2 in participants with no proteinuria. In participants with proteinuria, HRs for ACM were 2.10 (1.41-3.12) for eGFR 75-89 mL/min/1.73m 2, 2.30 (1.50-3.53) for eGFR 60-74 mL/min/1.73m 2 and 3.77 (2.15-6.38) for eGFR <60 mL/min/1.73m 2. Similar findings were observed for CVM.Conclusions.eGFR <75 mL/min/1.73m 2 and urine dipstick trace or more were independent risk factors of ACM and CVM. The risks of adverse outcomes are greater in the general population with mild renal impairment or mild proteinuria.

KW - All-cause mortality

KW - Cardiovascular mortality

KW - General population

KW - Glomerular filtration rate

KW - Proteinuria

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DO - 10.1093/ndt/gfr622

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