High ratios of kidney function to kidney size are related to mortality and kidney function decline in high-risk patients
Background The ratio of estimated glomerular filtration rate (eGFR) to kidney size reflects the kidney’s capacity for filtration per kidney volume or kidney length. High ratios of eGFR to kidney size, which might indicate glomerular hyperfiltration, could be related to kidney function decline, cardi...
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| Veröffentlicht in: | European journal of preventive cardiology 2017-06, Vol.24 (9), p.926-933 |
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| creator | van der Sande, Nicolette GC Blankestijn, Peter J Leiner, Tim van der Graaf, Yolanda de Borst, Gert Jan Cramer, Maarten JM Visseren, Frank LJ |
| description | Background
The ratio of estimated glomerular filtration rate (eGFR) to kidney size reflects the kidney’s capacity for filtration per kidney volume or kidney length. High ratios of eGFR to kidney size, which might indicate glomerular hyperfiltration, could be related to kidney function decline, cardiovascular disease and mortality.
Methods
In 6926 patients with clinically manifest vascular disease, we evaluated the relationship between eGFR/kidney size and the risk of cardiovascular events and all-cause mortality using Cox regression. Quartiles were made for eGFR/kidney size, using the second quartile as the reference category. In 1516 patients with second measurements of eGFR, linear regression was used to evaluate the relationship between eGFR/kidney size and annual kidney function decline.
Results
The relationship between eGFR/kidney size and all-cause mortality followed a reversed J-shaped curve with increased risk for the lowest (hazard ratio (HR) 1.17; 95% confidence interval (CI) 1.01–1.36) and highest quartile (HR 1.04; 95% CI 0.87–1.25) of eGFR/volume, and for the lowest (HR 1.37;95%CI 1.19–1.59) and highest quartile (HR 1.28; 95% CI 1.06–1.54) of eGFR/length. The risk for cardiovascular events was increased for the lowest quartile of eGFR/length (HR 1.55; 95% CI 1.33–1.82). An increase in eGFR/volume and eGFR/length, was related to a greater kidney function decline, β −0.34 (95% CI −0.42 to −0.26) and β −0.55 (95% CI −0.63 to −0.48) ml/min/1.73 m2 per year respectively.
Conclusions
High eGFR/volume and eGFR/length, which might indicate glomerular hyperfiltration, are related to kidney function decline. High eGFR/length confers an increased risk for all-cause mortality in patients with clinically manifest vascular disease. |
| doi_str_mv | 10.1177/2047487317690950 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1861867563</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_2047487317690950</sage_id><sourcerecordid>1861867563</sourcerecordid><originalsourceid>FETCH-LOGICAL-c379t-419d76c49d69606760f16e97c0cbfab57250b75a4fcf1100c8793c4a54f2c5703</originalsourceid><addsrcrecordid>eNp1UE1LAzEUDKJYqb17khy9rCa72XwcpagVCl70vGSzSZt2N1uTLFh_vSn9OCiGB3nMm5nHGwBuMLrHmLGHHBFGOCswowKJEp2Bqx2UEc7x-alnxQhMQlih9CjKc84vwSjnOMeYoyvwNbOLJfQy2j7A3sC1bZzeQjM4lSAHY3-Egv3WUHoNvW5l1M1u1PU-ytbGLZSu-aNttGqt09A6uExbMm_DGm7SKu1iuAYXRrZBTw7_GHw8P71PZ9n87eV1-jjPVMFEzAgWDaOKiIYKiiijyGCqBVNI1UbWJctLVLNSEqMMxggpzkShiCyJyVXJUDEGd3vfje8_Bx1i1dmgdNtKp_shVJjTVKykRaKiPVX5PgSvTbXxtpN-W2FU7SKvfkeeJLcH96HudHMSHANOhGxPCHKhq1U_eJeu_d_wB_MKiRs</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1861867563</pqid></control><display><type>article</type><title>High ratios of kidney function to kidney size are related to mortality and kidney function decline in high-risk patients</title><source>SAGE Complete A-Z List</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>van der Sande, Nicolette GC ; Blankestijn, Peter J ; Leiner, Tim ; van der Graaf, Yolanda ; de Borst, Gert Jan ; Cramer, Maarten JM ; Visseren, Frank LJ</creator><creatorcontrib>van der Sande, Nicolette GC ; Blankestijn, Peter J ; Leiner, Tim ; van der Graaf, Yolanda ; de Borst, Gert Jan ; Cramer, Maarten JM ; Visseren, Frank LJ ; SMART study group</creatorcontrib><description>Background
The ratio of estimated glomerular filtration rate (eGFR) to kidney size reflects the kidney’s capacity for filtration per kidney volume or kidney length. High ratios of eGFR to kidney size, which might indicate glomerular hyperfiltration, could be related to kidney function decline, cardiovascular disease and mortality.
Methods
In 6926 patients with clinically manifest vascular disease, we evaluated the relationship between eGFR/kidney size and the risk of cardiovascular events and all-cause mortality using Cox regression. Quartiles were made for eGFR/kidney size, using the second quartile as the reference category. In 1516 patients with second measurements of eGFR, linear regression was used to evaluate the relationship between eGFR/kidney size and annual kidney function decline.
Results
The relationship between eGFR/kidney size and all-cause mortality followed a reversed J-shaped curve with increased risk for the lowest (hazard ratio (HR) 1.17; 95% confidence interval (CI) 1.01–1.36) and highest quartile (HR 1.04; 95% CI 0.87–1.25) of eGFR/volume, and for the lowest (HR 1.37;95%CI 1.19–1.59) and highest quartile (HR 1.28; 95% CI 1.06–1.54) of eGFR/length. The risk for cardiovascular events was increased for the lowest quartile of eGFR/length (HR 1.55; 95% CI 1.33–1.82). An increase in eGFR/volume and eGFR/length, was related to a greater kidney function decline, β −0.34 (95% CI −0.42 to −0.26) and β −0.55 (95% CI −0.63 to −0.48) ml/min/1.73 m2 per year respectively.
Conclusions
High eGFR/volume and eGFR/length, which might indicate glomerular hyperfiltration, are related to kidney function decline. High eGFR/length confers an increased risk for all-cause mortality in patients with clinically manifest vascular disease.</description><identifier>ISSN: 2047-4873</identifier><identifier>EISSN: 2047-4881</identifier><identifier>DOI: 10.1177/2047487317690950</identifier><identifier>PMID: 28121180</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Aged ; Cardiovascular Diseases - mortality ; Cardiovascular Diseases - pathology ; Cardiovascular Diseases - physiopathology ; Cause of Death ; Chi-Square Distribution ; Female ; Glomerular Filtration Rate ; Humans ; Kidney - diagnostic imaging ; Kidney - pathology ; Kidney - physiopathology ; Kidney Diseases - diagnostic imaging ; Kidney Diseases - mortality ; Kidney Diseases - pathology ; Kidney Diseases - physiopathology ; Linear Models ; Male ; Middle Aged ; Organ Size ; Prognosis ; Proportional Hazards Models ; Prospective Studies ; Risk Assessment ; Risk Factors ; Time Factors ; Ultrasonography</subject><ispartof>European journal of preventive cardiology, 2017-06, Vol.24 (9), p.926-933</ispartof><rights>The European Society of Cardiology 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c379t-419d76c49d69606760f16e97c0cbfab57250b75a4fcf1100c8793c4a54f2c5703</citedby><cites>FETCH-LOGICAL-c379t-419d76c49d69606760f16e97c0cbfab57250b75a4fcf1100c8793c4a54f2c5703</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/2047487317690950$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/2047487317690950$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21799,27903,27904,43600,43601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28121180$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>van der Sande, Nicolette GC</creatorcontrib><creatorcontrib>Blankestijn, Peter J</creatorcontrib><creatorcontrib>Leiner, Tim</creatorcontrib><creatorcontrib>van der Graaf, Yolanda</creatorcontrib><creatorcontrib>de Borst, Gert Jan</creatorcontrib><creatorcontrib>Cramer, Maarten JM</creatorcontrib><creatorcontrib>Visseren, Frank LJ</creatorcontrib><creatorcontrib>SMART study group</creatorcontrib><title>High ratios of kidney function to kidney size are related to mortality and kidney function decline in high-risk patients</title><title>European journal of preventive cardiology</title><addtitle>Eur J Cardiovasc Prev Rehabil</addtitle><description>Background
The ratio of estimated glomerular filtration rate (eGFR) to kidney size reflects the kidney’s capacity for filtration per kidney volume or kidney length. High ratios of eGFR to kidney size, which might indicate glomerular hyperfiltration, could be related to kidney function decline, cardiovascular disease and mortality.
Methods
In 6926 patients with clinically manifest vascular disease, we evaluated the relationship between eGFR/kidney size and the risk of cardiovascular events and all-cause mortality using Cox regression. Quartiles were made for eGFR/kidney size, using the second quartile as the reference category. In 1516 patients with second measurements of eGFR, linear regression was used to evaluate the relationship between eGFR/kidney size and annual kidney function decline.
Results
The relationship between eGFR/kidney size and all-cause mortality followed a reversed J-shaped curve with increased risk for the lowest (hazard ratio (HR) 1.17; 95% confidence interval (CI) 1.01–1.36) and highest quartile (HR 1.04; 95% CI 0.87–1.25) of eGFR/volume, and for the lowest (HR 1.37;95%CI 1.19–1.59) and highest quartile (HR 1.28; 95% CI 1.06–1.54) of eGFR/length. The risk for cardiovascular events was increased for the lowest quartile of eGFR/length (HR 1.55; 95% CI 1.33–1.82). An increase in eGFR/volume and eGFR/length, was related to a greater kidney function decline, β −0.34 (95% CI −0.42 to −0.26) and β −0.55 (95% CI −0.63 to −0.48) ml/min/1.73 m2 per year respectively.
Conclusions
High eGFR/volume and eGFR/length, which might indicate glomerular hyperfiltration, are related to kidney function decline. High eGFR/length confers an increased risk for all-cause mortality in patients with clinically manifest vascular disease.</description><subject>Aged</subject><subject>Cardiovascular Diseases - mortality</subject><subject>Cardiovascular Diseases - pathology</subject><subject>Cardiovascular Diseases - physiopathology</subject><subject>Cause of Death</subject><subject>Chi-Square Distribution</subject><subject>Female</subject><subject>Glomerular Filtration Rate</subject><subject>Humans</subject><subject>Kidney - diagnostic imaging</subject><subject>Kidney - pathology</subject><subject>Kidney - physiopathology</subject><subject>Kidney Diseases - diagnostic imaging</subject><subject>Kidney Diseases - mortality</subject><subject>Kidney Diseases - pathology</subject><subject>Kidney Diseases - physiopathology</subject><subject>Linear Models</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Organ Size</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Ultrasonography</subject><issn>2047-4873</issn><issn>2047-4881</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1UE1LAzEUDKJYqb17khy9rCa72XwcpagVCl70vGSzSZt2N1uTLFh_vSn9OCiGB3nMm5nHGwBuMLrHmLGHHBFGOCswowKJEp2Bqx2UEc7x-alnxQhMQlih9CjKc84vwSjnOMeYoyvwNbOLJfQy2j7A3sC1bZzeQjM4lSAHY3-Egv3WUHoNvW5l1M1u1PU-ytbGLZSu-aNttGqt09A6uExbMm_DGm7SKu1iuAYXRrZBTw7_GHw8P71PZ9n87eV1-jjPVMFEzAgWDaOKiIYKiiijyGCqBVNI1UbWJctLVLNSEqMMxggpzkShiCyJyVXJUDEGd3vfje8_Bx1i1dmgdNtKp_shVJjTVKykRaKiPVX5PgSvTbXxtpN-W2FU7SKvfkeeJLcH96HudHMSHANOhGxPCHKhq1U_eJeu_d_wB_MKiRs</recordid><startdate>201706</startdate><enddate>201706</enddate><creator>van der Sande, Nicolette GC</creator><creator>Blankestijn, Peter J</creator><creator>Leiner, Tim</creator><creator>van der Graaf, Yolanda</creator><creator>de Borst, Gert Jan</creator><creator>Cramer, Maarten JM</creator><creator>Visseren, Frank LJ</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201706</creationdate><title>High ratios of kidney function to kidney size are related to mortality and kidney function decline in high-risk patients</title><author>van der Sande, Nicolette GC ; Blankestijn, Peter J ; Leiner, Tim ; van der Graaf, Yolanda ; de Borst, Gert Jan ; Cramer, Maarten JM ; Visseren, Frank LJ</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c379t-419d76c49d69606760f16e97c0cbfab57250b75a4fcf1100c8793c4a54f2c5703</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Cardiovascular Diseases - mortality</topic><topic>Cardiovascular Diseases - pathology</topic><topic>Cardiovascular Diseases - physiopathology</topic><topic>Cause of Death</topic><topic>Chi-Square Distribution</topic><topic>Female</topic><topic>Glomerular Filtration Rate</topic><topic>Humans</topic><topic>Kidney - diagnostic imaging</topic><topic>Kidney - pathology</topic><topic>Kidney - physiopathology</topic><topic>Kidney Diseases - diagnostic imaging</topic><topic>Kidney Diseases - mortality</topic><topic>Kidney Diseases - pathology</topic><topic>Kidney Diseases - physiopathology</topic><topic>Linear Models</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Organ Size</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Ultrasonography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>van der Sande, Nicolette GC</creatorcontrib><creatorcontrib>Blankestijn, Peter J</creatorcontrib><creatorcontrib>Leiner, Tim</creatorcontrib><creatorcontrib>van der Graaf, Yolanda</creatorcontrib><creatorcontrib>de Borst, Gert Jan</creatorcontrib><creatorcontrib>Cramer, Maarten JM</creatorcontrib><creatorcontrib>Visseren, Frank LJ</creatorcontrib><creatorcontrib>SMART study group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of preventive cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>van der Sande, Nicolette GC</au><au>Blankestijn, Peter J</au><au>Leiner, Tim</au><au>van der Graaf, Yolanda</au><au>de Borst, Gert Jan</au><au>Cramer, Maarten JM</au><au>Visseren, Frank LJ</au><aucorp>SMART study group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>High ratios of kidney function to kidney size are related to mortality and kidney function decline in high-risk patients</atitle><jtitle>European journal of preventive cardiology</jtitle><addtitle>Eur J Cardiovasc Prev Rehabil</addtitle><date>2017-06</date><risdate>2017</risdate><volume>24</volume><issue>9</issue><spage>926</spage><epage>933</epage><pages>926-933</pages><issn>2047-4873</issn><eissn>2047-4881</eissn><abstract>Background
The ratio of estimated glomerular filtration rate (eGFR) to kidney size reflects the kidney’s capacity for filtration per kidney volume or kidney length. High ratios of eGFR to kidney size, which might indicate glomerular hyperfiltration, could be related to kidney function decline, cardiovascular disease and mortality.
Methods
In 6926 patients with clinically manifest vascular disease, we evaluated the relationship between eGFR/kidney size and the risk of cardiovascular events and all-cause mortality using Cox regression. Quartiles were made for eGFR/kidney size, using the second quartile as the reference category. In 1516 patients with second measurements of eGFR, linear regression was used to evaluate the relationship between eGFR/kidney size and annual kidney function decline.
Results
The relationship between eGFR/kidney size and all-cause mortality followed a reversed J-shaped curve with increased risk for the lowest (hazard ratio (HR) 1.17; 95% confidence interval (CI) 1.01–1.36) and highest quartile (HR 1.04; 95% CI 0.87–1.25) of eGFR/volume, and for the lowest (HR 1.37;95%CI 1.19–1.59) and highest quartile (HR 1.28; 95% CI 1.06–1.54) of eGFR/length. The risk for cardiovascular events was increased for the lowest quartile of eGFR/length (HR 1.55; 95% CI 1.33–1.82). An increase in eGFR/volume and eGFR/length, was related to a greater kidney function decline, β −0.34 (95% CI −0.42 to −0.26) and β −0.55 (95% CI −0.63 to −0.48) ml/min/1.73 m2 per year respectively.
Conclusions
High eGFR/volume and eGFR/length, which might indicate glomerular hyperfiltration, are related to kidney function decline. High eGFR/length confers an increased risk for all-cause mortality in patients with clinically manifest vascular disease.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>28121180</pmid><doi>10.1177/2047487317690950</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| source | SAGE Complete A-Z List; Oxford University Press Journals All Titles (1996-Current); MEDLINE; Alma/SFX Local Collection |
| subjects | Aged Cardiovascular Diseases - mortality Cardiovascular Diseases - pathology Cardiovascular Diseases - physiopathology Cause of Death Chi-Square Distribution Female Glomerular Filtration Rate Humans Kidney - diagnostic imaging Kidney - pathology Kidney - physiopathology Kidney Diseases - diagnostic imaging Kidney Diseases - mortality Kidney Diseases - pathology Kidney Diseases - physiopathology Linear Models Male Middle Aged Organ Size Prognosis Proportional Hazards Models Prospective Studies Risk Assessment Risk Factors Time Factors Ultrasonography |
| title | High ratios of kidney function to kidney size are related to mortality and kidney function decline in high-risk patients |
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