Relationship between mortality and speed of eGFR decline in the 3 months prior to dialysis initiation
Background The timing for initiating dialysis in chronic kidney disease is often determined by the clinical symptoms and estimated glomerular filtration rate (eGFR). However, very few studies have examined how the speed of kidney function decline before initiating dialysis relates to mortality after...
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| Veröffentlicht in: | Clinical and experimental nephrology 2017-02, Vol.21 (1), p.159-168 |
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| creator | Inaguma, Daijo Murata, Minako Tanaka, Akihito Shinjo, Hibiki |
| description | Background
The timing for initiating dialysis in chronic kidney disease is often determined by the clinical symptoms and estimated glomerular filtration rate (eGFR). However, very few studies have examined how the speed of kidney function decline before initiating dialysis relates to mortality after dialysis initiation. Here, we report our examination of the relationship between the speed of eGFR decline in the 3 months prior to dialysis initiation and mortality.
Methods
The study included 1292 new dialysis patients who were registered in the Aichi Cohort Study of Prognosis in Patients Newly Initiated into Dialysis. The subjects were placed in 4 groups based on the speed of eGFR decline in the 3 months before initiating dialysis (eGFR at 3 months before initiation—eGFR at initiation) |
| doi_str_mv | 10.1007/s10157-016-1262-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1868315813</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4312373651</sourcerecordid><originalsourceid>FETCH-LOGICAL-c484t-f6701dd95e5e18a6ae9a894e6e1f2100d06f65ec375685079923008211188eba3</originalsourceid><addsrcrecordid>eNqNkd9qFDEUh4MotrY-gDcS8MabsTnJ5N-llLYKBaHY65CdOeOmzCRrkkW2T-Oz-GRm3SoiCL1KIN_5hd_5CHkF7B0wps8KMJC6Y6A64Ip390_IMfRCd1pb-7TdRc870BKOyItS7hhjxkr7nBxxzUwvQR2T6QZnX0OKZR02dIX1G2KkS8rVz6HuqI8jLRvEkaaJ4tXlDR1xmENEGiKta6Tix_clxboudJNDyrQmOgY_70ooDQk1_Eo_Jc8mPxd8-XCekNvLi8_nH7rrT1cfz99fd0Nv-tpNSjMYRytRIhivPFpvbI8KYeKt8sjUpCQOQktlJGstuWilOAAYgysvTsjbQ-4mp69bLNUtoQw4zz5i2hYHRhkB0oB4BMqVUtb2vKFv_kHv0jbHVmQfKLkUqmeNggM15FRKxsm1jSw-7xwwt_flDr5c8-X2vtx9m3n9kLxdLTj-mfgtqAH8AJT2FL9g_uvr_6b-BAoHoAI</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1865253640</pqid></control><display><type>article</type><title>Relationship between mortality and speed of eGFR decline in the 3 months prior to dialysis initiation</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Inaguma, Daijo ; Murata, Minako ; Tanaka, Akihito ; Shinjo, Hibiki</creator><creatorcontrib>Inaguma, Daijo ; Murata, Minako ; Tanaka, Akihito ; Shinjo, Hibiki</creatorcontrib><description>Background
The timing for initiating dialysis in chronic kidney disease is often determined by the clinical symptoms and estimated glomerular filtration rate (eGFR). However, very few studies have examined how the speed of kidney function decline before initiating dialysis relates to mortality after dialysis initiation. Here, we report our examination of the relationship between the speed of eGFR decline in the 3 months prior to dialysis initiation and mortality.
Methods
The study included 1292 new dialysis patients who were registered in the Aichi Cohort Study of Prognosis in Patients Newly Initiated into Dialysis. The subjects were placed in 4 groups based on the speed of eGFR decline in the 3 months before initiating dialysis (eGFR at 3 months before initiation—eGFR at initiation) <2: ≥2, <4: ≥4, <6: ≥6 mL/min/1.73 m
2
. All-cause, cardiovascular, and infection-related mortality rates were compared using Kaplan–Meier curves. A multivariate analysis using the Cox proportional hazard model was used to extract the factors that contributed to all-cause mortality.
Results
The group with faster eGFR decline exhibited significantly more heart failure symptoms when dialysis was initiated. Rapid eGFR decline correlated with prognosis (log-rank test: all-cause mortality
p
< 0.001, cardiovascular mortality
p
< 0.001). The speed of eGFR decline was related to elevated all-cause mortality rates [eGFR decline 10 mL/min/1.73 m
2
, HR (95 % CI) = 1.53 (1.12–2.08)].
Conclusions
This study showed that patients with rapid eGFR decline in the 3 months before initiating dialysis more often presented with heart failure symptoms when dialysis was initiated and had poorer survival prognoses.</description><identifier>ISSN: 1342-1751</identifier><identifier>EISSN: 1437-7799</identifier><identifier>DOI: 10.1007/s10157-016-1262-z</identifier><identifier>PMID: 27084516</identifier><identifier>CODEN: CENPFV</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Aged ; Aged, 80 and over ; Disease Progression ; Female ; Glomerular Filtration Rate ; Health Status ; Heart Failure - diagnosis ; Heart Failure - mortality ; Heart Failure - physiopathology ; Humans ; Japan ; Kaplan-Meier Estimate ; Kidney - physiopathology ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Multivariate Analysis ; Nephrology ; Original Article ; Proportional Hazards Models ; Prospective Studies ; Renal Dialysis - adverse effects ; Renal Dialysis - mortality ; Renal Insufficiency, Chronic - diagnosis ; Renal Insufficiency, Chronic - mortality ; Renal Insufficiency, Chronic - physiopathology ; Renal Insufficiency, Chronic - therapy ; Risk Factors ; Time Factors ; Time-to-Treatment ; Treatment Outcome ; Urology</subject><ispartof>Clinical and experimental nephrology, 2017-02, Vol.21 (1), p.159-168</ispartof><rights>Japanese Society of Nephrology 2016</rights><rights>Clinical and Experimental Nephrology is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c484t-f6701dd95e5e18a6ae9a894e6e1f2100d06f65ec375685079923008211188eba3</citedby><cites>FETCH-LOGICAL-c484t-f6701dd95e5e18a6ae9a894e6e1f2100d06f65ec375685079923008211188eba3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10157-016-1262-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10157-016-1262-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27084516$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Inaguma, Daijo</creatorcontrib><creatorcontrib>Murata, Minako</creatorcontrib><creatorcontrib>Tanaka, Akihito</creatorcontrib><creatorcontrib>Shinjo, Hibiki</creatorcontrib><title>Relationship between mortality and speed of eGFR decline in the 3 months prior to dialysis initiation</title><title>Clinical and experimental nephrology</title><addtitle>Clin Exp Nephrol</addtitle><addtitle>Clin Exp Nephrol</addtitle><description>Background
The timing for initiating dialysis in chronic kidney disease is often determined by the clinical symptoms and estimated glomerular filtration rate (eGFR). However, very few studies have examined how the speed of kidney function decline before initiating dialysis relates to mortality after dialysis initiation. Here, we report our examination of the relationship between the speed of eGFR decline in the 3 months prior to dialysis initiation and mortality.
Methods
The study included 1292 new dialysis patients who were registered in the Aichi Cohort Study of Prognosis in Patients Newly Initiated into Dialysis. The subjects were placed in 4 groups based on the speed of eGFR decline in the 3 months before initiating dialysis (eGFR at 3 months before initiation—eGFR at initiation) <2: ≥2, <4: ≥4, <6: ≥6 mL/min/1.73 m
2
. All-cause, cardiovascular, and infection-related mortality rates were compared using Kaplan–Meier curves. A multivariate analysis using the Cox proportional hazard model was used to extract the factors that contributed to all-cause mortality.
Results
The group with faster eGFR decline exhibited significantly more heart failure symptoms when dialysis was initiated. Rapid eGFR decline correlated with prognosis (log-rank test: all-cause mortality
p
< 0.001, cardiovascular mortality
p
< 0.001). The speed of eGFR decline was related to elevated all-cause mortality rates [eGFR decline 10 mL/min/1.73 m
2
, HR (95 % CI) = 1.53 (1.12–2.08)].
Conclusions
This study showed that patients with rapid eGFR decline in the 3 months before initiating dialysis more often presented with heart failure symptoms when dialysis was initiated and had poorer survival prognoses.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Glomerular Filtration Rate</subject><subject>Health Status</subject><subject>Heart Failure - diagnosis</subject><subject>Heart Failure - mortality</subject><subject>Heart Failure - physiopathology</subject><subject>Humans</subject><subject>Japan</subject><subject>Kaplan-Meier Estimate</subject><subject>Kidney - physiopathology</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Nephrology</subject><subject>Original Article</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Renal Dialysis - adverse effects</subject><subject>Renal Dialysis - mortality</subject><subject>Renal Insufficiency, Chronic - diagnosis</subject><subject>Renal Insufficiency, Chronic - mortality</subject><subject>Renal Insufficiency, Chronic - physiopathology</subject><subject>Renal Insufficiency, Chronic - therapy</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Time-to-Treatment</subject><subject>Treatment Outcome</subject><subject>Urology</subject><issn>1342-1751</issn><issn>1437-7799</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkd9qFDEUh4MotrY-gDcS8MabsTnJ5N-llLYKBaHY65CdOeOmzCRrkkW2T-Oz-GRm3SoiCL1KIN_5hd_5CHkF7B0wps8KMJC6Y6A64Ip390_IMfRCd1pb-7TdRc870BKOyItS7hhjxkr7nBxxzUwvQR2T6QZnX0OKZR02dIX1G2KkS8rVz6HuqI8jLRvEkaaJ4tXlDR1xmENEGiKta6Tix_clxboudJNDyrQmOgY_70ooDQk1_Eo_Jc8mPxd8-XCekNvLi8_nH7rrT1cfz99fd0Nv-tpNSjMYRytRIhivPFpvbI8KYeKt8sjUpCQOQktlJGstuWilOAAYgysvTsjbQ-4mp69bLNUtoQw4zz5i2hYHRhkB0oB4BMqVUtb2vKFv_kHv0jbHVmQfKLkUqmeNggM15FRKxsm1jSw-7xwwt_flDr5c8-X2vtx9m3n9kLxdLTj-mfgtqAH8AJT2FL9g_uvr_6b-BAoHoAI</recordid><startdate>20170201</startdate><enddate>20170201</enddate><creator>Inaguma, Daijo</creator><creator>Murata, Minako</creator><creator>Tanaka, Akihito</creator><creator>Shinjo, Hibiki</creator><general>Springer Japan</general><general>Springer Nature B.V</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>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20170201</creationdate><title>Relationship between mortality and speed of eGFR decline in the 3 months prior to dialysis initiation</title><author>Inaguma, Daijo ; Murata, Minako ; Tanaka, Akihito ; Shinjo, Hibiki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c484t-f6701dd95e5e18a6ae9a894e6e1f2100d06f65ec375685079923008211188eba3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Glomerular Filtration Rate</topic><topic>Health Status</topic><topic>Heart Failure - diagnosis</topic><topic>Heart Failure - mortality</topic><topic>Heart Failure - physiopathology</topic><topic>Humans</topic><topic>Japan</topic><topic>Kaplan-Meier Estimate</topic><topic>Kidney - physiopathology</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Nephrology</topic><topic>Original Article</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Renal Dialysis - adverse effects</topic><topic>Renal Dialysis - mortality</topic><topic>Renal Insufficiency, Chronic - diagnosis</topic><topic>Renal Insufficiency, Chronic - mortality</topic><topic>Renal Insufficiency, Chronic - physiopathology</topic><topic>Renal Insufficiency, Chronic - therapy</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Time-to-Treatment</topic><topic>Treatment Outcome</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Inaguma, Daijo</creatorcontrib><creatorcontrib>Murata, Minako</creatorcontrib><creatorcontrib>Tanaka, Akihito</creatorcontrib><creatorcontrib>Shinjo, Hibiki</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical and experimental nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Inaguma, Daijo</au><au>Murata, Minako</au><au>Tanaka, Akihito</au><au>Shinjo, Hibiki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relationship between mortality and speed of eGFR decline in the 3 months prior to dialysis initiation</atitle><jtitle>Clinical and experimental nephrology</jtitle><stitle>Clin Exp Nephrol</stitle><addtitle>Clin Exp Nephrol</addtitle><date>2017-02-01</date><risdate>2017</risdate><volume>21</volume><issue>1</issue><spage>159</spage><epage>168</epage><pages>159-168</pages><issn>1342-1751</issn><eissn>1437-7799</eissn><coden>CENPFV</coden><abstract>Background
The timing for initiating dialysis in chronic kidney disease is often determined by the clinical symptoms and estimated glomerular filtration rate (eGFR). However, very few studies have examined how the speed of kidney function decline before initiating dialysis relates to mortality after dialysis initiation. Here, we report our examination of the relationship between the speed of eGFR decline in the 3 months prior to dialysis initiation and mortality.
Methods
The study included 1292 new dialysis patients who were registered in the Aichi Cohort Study of Prognosis in Patients Newly Initiated into Dialysis. The subjects were placed in 4 groups based on the speed of eGFR decline in the 3 months before initiating dialysis (eGFR at 3 months before initiation—eGFR at initiation) <2: ≥2, <4: ≥4, <6: ≥6 mL/min/1.73 m
2
. All-cause, cardiovascular, and infection-related mortality rates were compared using Kaplan–Meier curves. A multivariate analysis using the Cox proportional hazard model was used to extract the factors that contributed to all-cause mortality.
Results
The group with faster eGFR decline exhibited significantly more heart failure symptoms when dialysis was initiated. Rapid eGFR decline correlated with prognosis (log-rank test: all-cause mortality
p
< 0.001, cardiovascular mortality
p
< 0.001). The speed of eGFR decline was related to elevated all-cause mortality rates [eGFR decline 10 mL/min/1.73 m
2
, HR (95 % CI) = 1.53 (1.12–2.08)].
Conclusions
This study showed that patients with rapid eGFR decline in the 3 months before initiating dialysis more often presented with heart failure symptoms when dialysis was initiated and had poorer survival prognoses.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>27084516</pmid><doi>10.1007/s10157-016-1262-z</doi><tpages>10</tpages></addata></record> |
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| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Aged Aged, 80 and over Disease Progression Female Glomerular Filtration Rate Health Status Heart Failure - diagnosis Heart Failure - mortality Heart Failure - physiopathology Humans Japan Kaplan-Meier Estimate Kidney - physiopathology Male Medicine Medicine & Public Health Middle Aged Multivariate Analysis Nephrology Original Article Proportional Hazards Models Prospective Studies Renal Dialysis - adverse effects Renal Dialysis - mortality Renal Insufficiency, Chronic - diagnosis Renal Insufficiency, Chronic - mortality Renal Insufficiency, Chronic - physiopathology Renal Insufficiency, Chronic - therapy Risk Factors Time Factors Time-to-Treatment Treatment Outcome Urology |
| title | Relationship between mortality and speed of eGFR decline in the 3 months prior to dialysis initiation |
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