Age-Specific Association of Reduced Estimated Glomerular Filtration Rate and Albuminuria with All-Cause Mortality
It has been suggested that reduced estimated GFR (eGFR) among older adults does not necessarily reflect a pathologic phenomenon. We examined the association between eGFR and albumin-to-creatinine ratio (ACR) and all-cause mortality stratified by age (45 to 59.9, 60 to 69.9, 70 to 79.9, and ≥80 years...
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| Veröffentlicht in: | Clinical journal of the American Society of Nephrology 2011-09, Vol.6 (9), p.2200-2207 |
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| creator | Muntner, Paul Bowling, C Barrett Gao, Liyan Rizk, Dana Judd, Suzanne Tanner, Rikki M McClellan, William Warnock, David G |
| description | It has been suggested that reduced estimated GFR (eGFR) among older adults does not necessarily reflect a pathologic phenomenon.
We examined the association between eGFR and albumin-to-creatinine ratio (ACR) and all-cause mortality stratified by age (45 to 59.9, 60 to 69.9, 70 to 79.9, and ≥80 years) among 24,350 U.S. adults in the population-based REasons for Geographic and Racial Differences in Stroke (REGARDS) study. A spot urine sample was used to calculate ACR, and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation was used to calculate eGFR. All-cause mortality was assessed over a median follow-up of 4.5 years.
Among participants ≥80 years of age (n = 1669), the age, race, gender, and geographic region of residence adjusted hazard ratios (95% confidence intervals) for mortality associated with eGFR levels of 45 to 59.9 and |
| doi_str_mv | 10.2215/CJN.02030311 |
| format | Article |
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We examined the association between eGFR and albumin-to-creatinine ratio (ACR) and all-cause mortality stratified by age (45 to 59.9, 60 to 69.9, 70 to 79.9, and ≥80 years) among 24,350 U.S. adults in the population-based REasons for Geographic and Racial Differences in Stroke (REGARDS) study. A spot urine sample was used to calculate ACR, and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation was used to calculate eGFR. All-cause mortality was assessed over a median follow-up of 4.5 years.
Among participants ≥80 years of age (n = 1669), the age, race, gender, and geographic region of residence adjusted hazard ratios (95% confidence intervals) for mortality associated with eGFR levels of 45 to 59.9 and <45 ml/min per 1.73 m(2), versus ≥60 ml/min per 1.73 m(2), were 1.6 (1.3 - 2.1) and 2.2 (1.7 - 2.9), respectively. Also, among participants ≥80 years of age, the hazard ratios for mortality associated with ACR levels of 10 to 29.9, 30 to 299.9, and ≥300 mg/g, versus <10 mg/g, were 1.7 (1.3 - 2.1), 2.5 (1.9 - 3.3), and 5.1 (3.6 - 7.4), respectively. These associations were present after further multivariable adjustment and within the younger age groupings studied.
These data suggest that reduced eGFR and albuminuria confer an increased risk for mortality in all age groups, including adults ≥80 years of age.</description><identifier>ISSN: 1555-9041</identifier><identifier>EISSN: 1555-905X</identifier><identifier>DOI: 10.2215/CJN.02030311</identifier><identifier>PMID: 21737849</identifier><language>eng</language><publisher>United States: American Society of Nephrology</publisher><subject>Age Factors ; Aged ; Aged, 80 and over ; Albuminuria - mortality ; Albuminuria - physiopathology ; Cause of Death ; Creatinine - blood ; Female ; Glomerular Filtration Rate ; Humans ; Male ; Middle Aged ; Original ; Serum Albumin - analysis</subject><ispartof>Clinical journal of the American Society of Nephrology, 2011-09, Vol.6 (9), p.2200-2207</ispartof><rights>Copyright © 2011 by the American Society of Nephrology 2011</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c415t-f9ae8774405bd4553f5bb833f629557ddd58f7aa104e93a572173b22280f811c3</citedby><cites>FETCH-LOGICAL-c415t-f9ae8774405bd4553f5bb833f629557ddd58f7aa104e93a572173b22280f811c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3359010/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3359010/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27903,27904,53769,53771</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21737849$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Muntner, Paul</creatorcontrib><creatorcontrib>Bowling, C Barrett</creatorcontrib><creatorcontrib>Gao, Liyan</creatorcontrib><creatorcontrib>Rizk, Dana</creatorcontrib><creatorcontrib>Judd, Suzanne</creatorcontrib><creatorcontrib>Tanner, Rikki M</creatorcontrib><creatorcontrib>McClellan, William</creatorcontrib><creatorcontrib>Warnock, David G</creatorcontrib><title>Age-Specific Association of Reduced Estimated Glomerular Filtration Rate and Albuminuria with All-Cause Mortality</title><title>Clinical journal of the American Society of Nephrology</title><addtitle>Clin J Am Soc Nephrol</addtitle><description>It has been suggested that reduced estimated GFR (eGFR) among older adults does not necessarily reflect a pathologic phenomenon.
We examined the association between eGFR and albumin-to-creatinine ratio (ACR) and all-cause mortality stratified by age (45 to 59.9, 60 to 69.9, 70 to 79.9, and ≥80 years) among 24,350 U.S. adults in the population-based REasons for Geographic and Racial Differences in Stroke (REGARDS) study. A spot urine sample was used to calculate ACR, and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation was used to calculate eGFR. All-cause mortality was assessed over a median follow-up of 4.5 years.
Among participants ≥80 years of age (n = 1669), the age, race, gender, and geographic region of residence adjusted hazard ratios (95% confidence intervals) for mortality associated with eGFR levels of 45 to 59.9 and <45 ml/min per 1.73 m(2), versus ≥60 ml/min per 1.73 m(2), were 1.6 (1.3 - 2.1) and 2.2 (1.7 - 2.9), respectively. Also, among participants ≥80 years of age, the hazard ratios for mortality associated with ACR levels of 10 to 29.9, 30 to 299.9, and ≥300 mg/g, versus <10 mg/g, were 1.7 (1.3 - 2.1), 2.5 (1.9 - 3.3), and 5.1 (3.6 - 7.4), respectively. These associations were present after further multivariable adjustment and within the younger age groupings studied.
These data suggest that reduced eGFR and albuminuria confer an increased risk for mortality in all age groups, including adults ≥80 years of age.</description><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Albuminuria - mortality</subject><subject>Albuminuria - physiopathology</subject><subject>Cause of Death</subject><subject>Creatinine - blood</subject><subject>Female</subject><subject>Glomerular Filtration Rate</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Original</subject><subject>Serum Albumin - analysis</subject><issn>1555-9041</issn><issn>1555-905X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkUlrHDEQhUVI8Bbfcg665ZK2tbqlS2AYvCTYDngB34RaLc3IqFtjSR3jfx8NY4-TUxVVH69e8QD4gtERIZgfz39dHyGCKKIYfwB7mHPeSMQfPm57hnfBfs6PCDFGCd8BuwS3tBVM7oGn2cI2tytrvPMGznKOxuvi4wijgze2n4zt4WkuftClduchDjZNQSd45kNJG_Sm7qAeezgL3TT4cUpew2dflnUQmrmesoVXMRUdfHn5DD45HbI9fK0H4P7s9G5-0Vz-Pv85n102hmFeGie1FW3LGOJdzzinjnedoNSdEMl52_c9F67VGiNmJdW8Xf_UEUIEcgJjQw_Aj43uauoG2xs7VrtBrVJ9Jb2oqL36fzP6pVrEP4pSLhFGVeDbq0CKT5PNRQ0-GxuCHm2cshJCIEmwXJPfN6RJMedk3fYKRmodkqohqbeQKv71X2db-C2V98tLv1g--2RVHnQIFSfKPOo8nihZdRGifwHtgZvR</recordid><startdate>20110901</startdate><enddate>20110901</enddate><creator>Muntner, Paul</creator><creator>Bowling, C Barrett</creator><creator>Gao, Liyan</creator><creator>Rizk, Dana</creator><creator>Judd, Suzanne</creator><creator>Tanner, Rikki M</creator><creator>McClellan, William</creator><creator>Warnock, David G</creator><general>American Society of Nephrology</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><scope>5PM</scope></search><sort><creationdate>20110901</creationdate><title>Age-Specific Association of Reduced Estimated Glomerular Filtration Rate and Albuminuria with All-Cause Mortality</title><author>Muntner, Paul ; Bowling, C Barrett ; Gao, Liyan ; Rizk, Dana ; Judd, Suzanne ; Tanner, Rikki M ; McClellan, William ; Warnock, David G</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c415t-f9ae8774405bd4553f5bb833f629557ddd58f7aa104e93a572173b22280f811c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Albuminuria - mortality</topic><topic>Albuminuria - physiopathology</topic><topic>Cause of Death</topic><topic>Creatinine - blood</topic><topic>Female</topic><topic>Glomerular Filtration Rate</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Original</topic><topic>Serum Albumin - analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Muntner, Paul</creatorcontrib><creatorcontrib>Bowling, C Barrett</creatorcontrib><creatorcontrib>Gao, Liyan</creatorcontrib><creatorcontrib>Rizk, Dana</creatorcontrib><creatorcontrib>Judd, Suzanne</creatorcontrib><creatorcontrib>Tanner, Rikki M</creatorcontrib><creatorcontrib>McClellan, William</creatorcontrib><creatorcontrib>Warnock, David G</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><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical journal of the American Society of Nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Muntner, Paul</au><au>Bowling, C Barrett</au><au>Gao, Liyan</au><au>Rizk, Dana</au><au>Judd, Suzanne</au><au>Tanner, Rikki M</au><au>McClellan, William</au><au>Warnock, David G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Age-Specific Association of Reduced Estimated Glomerular Filtration Rate and Albuminuria with All-Cause Mortality</atitle><jtitle>Clinical journal of the American Society of Nephrology</jtitle><addtitle>Clin J Am Soc Nephrol</addtitle><date>2011-09-01</date><risdate>2011</risdate><volume>6</volume><issue>9</issue><spage>2200</spage><epage>2207</epage><pages>2200-2207</pages><issn>1555-9041</issn><eissn>1555-905X</eissn><abstract>It has been suggested that reduced estimated GFR (eGFR) among older adults does not necessarily reflect a pathologic phenomenon.
We examined the association between eGFR and albumin-to-creatinine ratio (ACR) and all-cause mortality stratified by age (45 to 59.9, 60 to 69.9, 70 to 79.9, and ≥80 years) among 24,350 U.S. adults in the population-based REasons for Geographic and Racial Differences in Stroke (REGARDS) study. A spot urine sample was used to calculate ACR, and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation was used to calculate eGFR. All-cause mortality was assessed over a median follow-up of 4.5 years.
Among participants ≥80 years of age (n = 1669), the age, race, gender, and geographic region of residence adjusted hazard ratios (95% confidence intervals) for mortality associated with eGFR levels of 45 to 59.9 and <45 ml/min per 1.73 m(2), versus ≥60 ml/min per 1.73 m(2), were 1.6 (1.3 - 2.1) and 2.2 (1.7 - 2.9), respectively. Also, among participants ≥80 years of age, the hazard ratios for mortality associated with ACR levels of 10 to 29.9, 30 to 299.9, and ≥300 mg/g, versus <10 mg/g, were 1.7 (1.3 - 2.1), 2.5 (1.9 - 3.3), and 5.1 (3.6 - 7.4), respectively. These associations were present after further multivariable adjustment and within the younger age groupings studied.
These data suggest that reduced eGFR and albuminuria confer an increased risk for mortality in all age groups, including adults ≥80 years of age.</abstract><cop>United States</cop><pub>American Society of Nephrology</pub><pmid>21737849</pmid><doi>10.2215/CJN.02030311</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Age Factors Aged Aged, 80 and over Albuminuria - mortality Albuminuria - physiopathology Cause of Death Creatinine - blood Female Glomerular Filtration Rate Humans Male Middle Aged Original Serum Albumin - analysis |
| title | Age-Specific Association of Reduced Estimated Glomerular Filtration Rate and Albuminuria with All-Cause Mortality |
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