Time-dependent risk factors associated with the decline of estimated GFR in CKD patients
Background Targeting the modifiable risk factors may help halt the progression of CKD, thus risk factor analysis is better performed using the parameters in the follow-up. This study aimed to examine the time-dependent risk factors for CKD progression using time-averaged values and to investigate th...
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| Veröffentlicht in: | Clinical and experimental nephrology 2016-02, Vol.20 (1), p.58-70 |
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| creator | Chang, Wen-xiu Arai, Shigeyuki Tamura, Yoshifuru Kumagai, Takanori Ota, Tatsuru Shibata, Shigeru Fujigaki, Yoshihide Shen, Zhong-yang Uchida, Shunya |
| description | Background
Targeting the modifiable risk factors may help halt the progression of CKD, thus risk factor analysis is better performed using the parameters in the follow-up. This study aimed to examine the time-dependent risk factors for CKD progression using time-averaged values and to investigate the characteristics of rapid progression group.
Methods
This is a retrospective cohort study enrolling 770 patients of CKD stage 3–4. Time-dependent parameters were calculated as time-averaged values by a trapezoidal rule. % decline of estimated GFR (eGFR) per year from entry was divided to three groups: |
| doi_str_mv | 10.1007/s10157-015-1132-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4756044</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3953699291</sourcerecordid><originalsourceid>FETCH-LOGICAL-c619t-fd7701e335332ec425e1e4b3e5f5d91d2f55f6bf4918f0db884208fa1344c38e3</originalsourceid><addsrcrecordid>eNp1kV9LXDEQxYMo1dp-AF8k4IsvafP35ualUNZqSwWhWOhbyCYTN3r3ZpvctfTbN9u1YgVfJoH5zZk5HISOGH3HKNXvK6NMadIKYUxwQnfQAZNCE62N2W1_ITlhWrF99LrWW0ppb5R5hfZ51-aFMQfox3VaAgmwgjHAOOGS6h2Ozk-5VOxqzT65CQL-laYFnhaAA_ghjYBzxFCntPzbvTj_htOIZ1_P8MpNqQnVN2gvuqHC24f3EH0__3Q9-0wury6-zD5eEt8xM5EYtKYMhFBCcPCSK2Ag5wJUVMGwwKNSsZtHaVgfaZj3veS0j65Zk170IA7Rh63uaj1fQvBtd3GDXZV2Wvlts0v2_86YFvYm31upVUelbAKnDwIl_1w3T3aZqodhcCPkdbVMdx3v2n0b9OQZepvXZWz2NpQS3EjTNYptKV9yrQXi4zGM2k1udpubbcVucrO0zRw_dfE48S-oBvAtUFtrvIHyZPWLqn8AE9yiwg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1765329496</pqid></control><display><type>article</type><title>Time-dependent risk factors associated with the decline of estimated GFR in CKD patients</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Chang, Wen-xiu ; Arai, Shigeyuki ; Tamura, Yoshifuru ; Kumagai, Takanori ; Ota, Tatsuru ; Shibata, Shigeru ; Fujigaki, Yoshihide ; Shen, Zhong-yang ; Uchida, Shunya</creator><creatorcontrib>Chang, Wen-xiu ; Arai, Shigeyuki ; Tamura, Yoshifuru ; Kumagai, Takanori ; Ota, Tatsuru ; Shibata, Shigeru ; Fujigaki, Yoshihide ; Shen, Zhong-yang ; Uchida, Shunya</creatorcontrib><description>Background
Targeting the modifiable risk factors may help halt the progression of CKD, thus risk factor analysis is better performed using the parameters in the follow-up. This study aimed to examine the time-dependent risk factors for CKD progression using time-averaged values and to investigate the characteristics of rapid progression group.
Methods
This is a retrospective cohort study enrolling 770 patients of CKD stage 3–4. Time-dependent parameters were calculated as time-averaged values by a trapezoidal rule. % decline of estimated GFR (eGFR) per year from entry was divided to three groups: <10 % (stable), 10–25 % (moderate progression), and ≥25 % (rapid progression). Multivariate regression analyses were employed for the baseline and the time-averaged datasets.
Results
eGFR decline was 2.83 ± 4.04 mL/min/1.73 m
2
/year (8.8 ± 12.9 %) in male and 1.66 ± 3.23 mL/min/1.73 m
2
/year (5.4 ± 11.0 %) in female (
p
< 0.001). % decline of eGFR was associated with male, proteinuria, phosphorus, and systolic blood pressure as risk factors and with age, albumin, and hemoglobin as protective factors using either dataset. Baseline eGFR and diabetic nephropathy appeared in the baseline dataset, while uric acid appeared in the time-averaged dataset. The rapid progression group was associated with proteinuria, phosphorus, albumin, and hemoglobin in the follow-up.
Conclusion
These results suggest that time-averaged values provide insightful clinical guide in targeting the risk factors. Rapid decline of eGFR is strongly associated with hyperphosphatemia, proteinuria, and anemia indicating that these risk factors should be intervened in the follow-up of CKD.</description><identifier>ISSN: 1342-1751</identifier><identifier>EISSN: 1437-7799</identifier><identifier>DOI: 10.1007/s10157-015-1132-0</identifier><identifier>PMID: 26100399</identifier><identifier>CODEN: CENPFV</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Anemia - epidemiology ; Chi-Square Distribution ; Comorbidity ; Disease Progression ; Female ; Glomerular Filtration Rate ; Humans ; Hyperphosphatemia - epidemiology ; Japan - epidemiology ; Kidney - physiopathology ; Linear Models ; Logistic Models ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Multivariate Analysis ; Nephrology ; Original ; Original Article ; Prevalence ; Proteinuria - epidemiology ; Renal Insufficiency, Chronic - diagnosis ; Renal Insufficiency, Chronic - epidemiology ; Renal Insufficiency, Chronic - physiopathology ; Renal Insufficiency, Chronic - therapy ; Retrospective Studies ; Risk Factors ; Sex Factors ; Time Factors ; Urology ; Young Adult</subject><ispartof>Clinical and experimental nephrology, 2016-02, Vol.20 (1), p.58-70</ispartof><rights>The Author(s) 2015</rights><rights>Japanese Society of Nephrology 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c619t-fd7701e335332ec425e1e4b3e5f5d91d2f55f6bf4918f0db884208fa1344c38e3</citedby><cites>FETCH-LOGICAL-c619t-fd7701e335332ec425e1e4b3e5f5d91d2f55f6bf4918f0db884208fa1344c38e3</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/s10157-015-1132-0$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10157-015-1132-0$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26100399$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chang, Wen-xiu</creatorcontrib><creatorcontrib>Arai, Shigeyuki</creatorcontrib><creatorcontrib>Tamura, Yoshifuru</creatorcontrib><creatorcontrib>Kumagai, Takanori</creatorcontrib><creatorcontrib>Ota, Tatsuru</creatorcontrib><creatorcontrib>Shibata, Shigeru</creatorcontrib><creatorcontrib>Fujigaki, Yoshihide</creatorcontrib><creatorcontrib>Shen, Zhong-yang</creatorcontrib><creatorcontrib>Uchida, Shunya</creatorcontrib><title>Time-dependent risk factors associated with the decline of estimated GFR in CKD patients</title><title>Clinical and experimental nephrology</title><addtitle>Clin Exp Nephrol</addtitle><addtitle>Clin Exp Nephrol</addtitle><description>Background
Targeting the modifiable risk factors may help halt the progression of CKD, thus risk factor analysis is better performed using the parameters in the follow-up. This study aimed to examine the time-dependent risk factors for CKD progression using time-averaged values and to investigate the characteristics of rapid progression group.
Methods
This is a retrospective cohort study enrolling 770 patients of CKD stage 3–4. Time-dependent parameters were calculated as time-averaged values by a trapezoidal rule. % decline of estimated GFR (eGFR) per year from entry was divided to three groups: <10 % (stable), 10–25 % (moderate progression), and ≥25 % (rapid progression). Multivariate regression analyses were employed for the baseline and the time-averaged datasets.
Results
eGFR decline was 2.83 ± 4.04 mL/min/1.73 m
2
/year (8.8 ± 12.9 %) in male and 1.66 ± 3.23 mL/min/1.73 m
2
/year (5.4 ± 11.0 %) in female (
p
< 0.001). % decline of eGFR was associated with male, proteinuria, phosphorus, and systolic blood pressure as risk factors and with age, albumin, and hemoglobin as protective factors using either dataset. Baseline eGFR and diabetic nephropathy appeared in the baseline dataset, while uric acid appeared in the time-averaged dataset. The rapid progression group was associated with proteinuria, phosphorus, albumin, and hemoglobin in the follow-up.
Conclusion
These results suggest that time-averaged values provide insightful clinical guide in targeting the risk factors. Rapid decline of eGFR is strongly associated with hyperphosphatemia, proteinuria, and anemia indicating that these risk factors should be intervened in the follow-up of CKD.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anemia - epidemiology</subject><subject>Chi-Square Distribution</subject><subject>Comorbidity</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Glomerular Filtration Rate</subject><subject>Humans</subject><subject>Hyperphosphatemia - epidemiology</subject><subject>Japan - epidemiology</subject><subject>Kidney - physiopathology</subject><subject>Linear Models</subject><subject>Logistic Models</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</subject><subject>Original Article</subject><subject>Prevalence</subject><subject>Proteinuria - epidemiology</subject><subject>Renal Insufficiency, Chronic - diagnosis</subject><subject>Renal Insufficiency, Chronic - epidemiology</subject><subject>Renal Insufficiency, Chronic - physiopathology</subject><subject>Renal Insufficiency, Chronic - therapy</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Sex Factors</subject><subject>Time Factors</subject><subject>Urology</subject><subject>Young Adult</subject><issn>1342-1751</issn><issn>1437-7799</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kV9LXDEQxYMo1dp-AF8k4IsvafP35ualUNZqSwWhWOhbyCYTN3r3ZpvctfTbN9u1YgVfJoH5zZk5HISOGH3HKNXvK6NMadIKYUxwQnfQAZNCE62N2W1_ITlhWrF99LrWW0ppb5R5hfZ51-aFMQfox3VaAgmwgjHAOOGS6h2Ozk-5VOxqzT65CQL-laYFnhaAA_ghjYBzxFCntPzbvTj_htOIZ1_P8MpNqQnVN2gvuqHC24f3EH0__3Q9-0wury6-zD5eEt8xM5EYtKYMhFBCcPCSK2Ag5wJUVMGwwKNSsZtHaVgfaZj3veS0j65Zk170IA7Rh63uaj1fQvBtd3GDXZV2Wvlts0v2_86YFvYm31upVUelbAKnDwIl_1w3T3aZqodhcCPkdbVMdx3v2n0b9OQZepvXZWz2NpQS3EjTNYptKV9yrQXi4zGM2k1udpubbcVucrO0zRw_dfE48S-oBvAtUFtrvIHyZPWLqn8AE9yiwg</recordid><startdate>20160201</startdate><enddate>20160201</enddate><creator>Chang, Wen-xiu</creator><creator>Arai, Shigeyuki</creator><creator>Tamura, Yoshifuru</creator><creator>Kumagai, Takanori</creator><creator>Ota, Tatsuru</creator><creator>Shibata, Shigeru</creator><creator>Fujigaki, Yoshihide</creator><creator>Shen, Zhong-yang</creator><creator>Uchida, Shunya</creator><general>Springer Japan</general><general>Springer Nature B.V</general><scope>C6C</scope><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><scope>5PM</scope></search><sort><creationdate>20160201</creationdate><title>Time-dependent risk factors associated with the decline of estimated GFR in CKD patients</title><author>Chang, Wen-xiu ; Arai, Shigeyuki ; Tamura, Yoshifuru ; Kumagai, Takanori ; Ota, Tatsuru ; Shibata, Shigeru ; Fujigaki, Yoshihide ; Shen, Zhong-yang ; Uchida, Shunya</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c619t-fd7701e335332ec425e1e4b3e5f5d91d2f55f6bf4918f0db884208fa1344c38e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anemia - epidemiology</topic><topic>Chi-Square Distribution</topic><topic>Comorbidity</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Glomerular Filtration Rate</topic><topic>Humans</topic><topic>Hyperphosphatemia - epidemiology</topic><topic>Japan - epidemiology</topic><topic>Kidney - physiopathology</topic><topic>Linear Models</topic><topic>Logistic Models</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</topic><topic>Original Article</topic><topic>Prevalence</topic><topic>Proteinuria - epidemiology</topic><topic>Renal Insufficiency, Chronic - diagnosis</topic><topic>Renal Insufficiency, Chronic - epidemiology</topic><topic>Renal Insufficiency, Chronic - physiopathology</topic><topic>Renal Insufficiency, Chronic - therapy</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Sex Factors</topic><topic>Time Factors</topic><topic>Urology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chang, Wen-xiu</creatorcontrib><creatorcontrib>Arai, Shigeyuki</creatorcontrib><creatorcontrib>Tamura, Yoshifuru</creatorcontrib><creatorcontrib>Kumagai, Takanori</creatorcontrib><creatorcontrib>Ota, Tatsuru</creatorcontrib><creatorcontrib>Shibata, Shigeru</creatorcontrib><creatorcontrib>Fujigaki, Yoshihide</creatorcontrib><creatorcontrib>Shen, Zhong-yang</creatorcontrib><creatorcontrib>Uchida, Shunya</creatorcontrib><collection>Springer Nature OA Free Journals</collection><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><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical and experimental nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chang, Wen-xiu</au><au>Arai, Shigeyuki</au><au>Tamura, Yoshifuru</au><au>Kumagai, Takanori</au><au>Ota, Tatsuru</au><au>Shibata, Shigeru</au><au>Fujigaki, Yoshihide</au><au>Shen, Zhong-yang</au><au>Uchida, Shunya</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Time-dependent risk factors associated with the decline of estimated GFR in CKD patients</atitle><jtitle>Clinical and experimental nephrology</jtitle><stitle>Clin Exp Nephrol</stitle><addtitle>Clin Exp Nephrol</addtitle><date>2016-02-01</date><risdate>2016</risdate><volume>20</volume><issue>1</issue><spage>58</spage><epage>70</epage><pages>58-70</pages><issn>1342-1751</issn><eissn>1437-7799</eissn><coden>CENPFV</coden><abstract>Background
Targeting the modifiable risk factors may help halt the progression of CKD, thus risk factor analysis is better performed using the parameters in the follow-up. This study aimed to examine the time-dependent risk factors for CKD progression using time-averaged values and to investigate the characteristics of rapid progression group.
Methods
This is a retrospective cohort study enrolling 770 patients of CKD stage 3–4. Time-dependent parameters were calculated as time-averaged values by a trapezoidal rule. % decline of estimated GFR (eGFR) per year from entry was divided to three groups: <10 % (stable), 10–25 % (moderate progression), and ≥25 % (rapid progression). Multivariate regression analyses were employed for the baseline and the time-averaged datasets.
Results
eGFR decline was 2.83 ± 4.04 mL/min/1.73 m
2
/year (8.8 ± 12.9 %) in male and 1.66 ± 3.23 mL/min/1.73 m
2
/year (5.4 ± 11.0 %) in female (
p
< 0.001). % decline of eGFR was associated with male, proteinuria, phosphorus, and systolic blood pressure as risk factors and with age, albumin, and hemoglobin as protective factors using either dataset. Baseline eGFR and diabetic nephropathy appeared in the baseline dataset, while uric acid appeared in the time-averaged dataset. The rapid progression group was associated with proteinuria, phosphorus, albumin, and hemoglobin in the follow-up.
Conclusion
These results suggest that time-averaged values provide insightful clinical guide in targeting the risk factors. Rapid decline of eGFR is strongly associated with hyperphosphatemia, proteinuria, and anemia indicating that these risk factors should be intervened in the follow-up of CKD.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>26100399</pmid><doi>10.1007/s10157-015-1132-0</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Adult Aged Aged, 80 and over Anemia - epidemiology Chi-Square Distribution Comorbidity Disease Progression Female Glomerular Filtration Rate Humans Hyperphosphatemia - epidemiology Japan - epidemiology Kidney - physiopathology Linear Models Logistic Models Male Medicine Medicine & Public Health Middle Aged Multivariate Analysis Nephrology Original Original Article Prevalence Proteinuria - epidemiology Renal Insufficiency, Chronic - diagnosis Renal Insufficiency, Chronic - epidemiology Renal Insufficiency, Chronic - physiopathology Renal Insufficiency, Chronic - therapy Retrospective Studies Risk Factors Sex Factors Time Factors Urology Young Adult |
| title | Time-dependent risk factors associated with the decline of estimated GFR in CKD patients |
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