Relationship of Estimated GFR and Albuminuria to Concurrent Laboratory Abnormalities: An Individual Participant Data Meta-analysis in a Global Consortium
Chronic kidney disease (CKD) is complicated by abnormalities that reflect disruption in filtration, tubular, and endocrine functions of the kidney. Our aim was to explore the relationship of specific laboratory result abnormalities and hypertension with the estimated glomerular filtration rate (eGFR...
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| Veröffentlicht in: | American journal of kidney diseases 2019-02, Vol.73 (2), p.206-217 |
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| creator | Coresh, Josef Cirillo, Massimo Gansevoort, Ron T. Heine, Gunnar H. Landray, Martin J. Miura, Katsuyuki Peralta, Carmen A. Shlipak, Michael G. Zhang, Luxia van Zuilen, Arjan D. Hallan, Stein I. Kovesdy, Csaba P. Woodward, Mark Levin, Adeera Appel, Larry Chen, Teresa Arima, Hisatomi Perkovic, Vlado Yatsuya, Hiroshi Li, Yuanying Hirakawa, Yoshihisa Matsushita, Kunihiro Grams, Morgan Sang, Yingying Chadban, Steven Levin, Adeera Liu, Lisheng Zhao, Minghui Wang, Fang Tang, Mila Seiler, Sarah Nally, Joseph Shlipak, Michael Katz, Ronit Hiramoto, Jade Iso, Hiroyasu Muraki, Isao Wheeler, David Emberson, John Brenner, Hermann Saum, Kai-Uwe Rothenbacher, Dietrich Kronenberg, Florian Eckardt, Kai-Uwe Kirchner, H Lester Ho, Kevin Miyazaki, Mariko Cirillo, Massimo Irie, Fujiko Kimm, Heejin Mok, Yejin Shalev, Varda Wetzels, Jack F.M. Nitsch, Dorothea Roderick, Paul Bottinger, Erwin Nadukuru, Rajiv Okayama, Akira Miura, Katsuyuki Okamura, Tomonori Elley, C Raina Collins, John F. Ohkubo, Takayoshi Metoki, Hirohito Kikuya, Masahiro Nelson, Robert G. Knowler, William C. Jassal, Simerjot K. Barrett-Connor, Elizabeth Kovesdy, Csaba Gutierrez, Orlando M. McClellan, William Hoorn, Ewout J. Dehghan, Abbas Carrero, Juan J. Gasparini, Alessandro Wettermark, Björn Sabanayagam, Charumathi Cheng, Ching-Yu Visseren, Frank L.J. Segelmark, Mårten Tangri, Navdeep Sud, Maneesh Naimark, David Konta, Tsuneo Hirayama, Atsushi Lannfelt, Lars Larsson, Anders Ärnlöv, Johan Bilo, Henk J.G. Kleefstra, Nanne Coresh (Chair, Josef Hallan, Stein Kovesdy, Csaba P. Ballew, Shoshana H. Coresh, Josef Grams, Morgan E. Sang, Yingying Surapaneni, Aditya Woodward, Mark |
| description | Chronic kidney disease (CKD) is complicated by abnormalities that reflect disruption in filtration, tubular, and endocrine functions of the kidney. Our aim was to explore the relationship of specific laboratory result abnormalities and hypertension with the estimated glomerular filtration rate (eGFR) and albuminuria CKD staging framework.
Cross-sectional individual participant-level analyses in a global consortium.
17 CKD and 38 general population and high-risk cohorts.
Cohorts in the CKD Prognosis Consortium with data for eGFR and albuminuria, as well as a measurement of hemoglobin, bicarbonate, phosphorus, parathyroid hormone, potassium, or calcium, or hypertension.
Data were obtained and analyzed between July 2015 and January 2018.
We modeled the association of eGFR and albuminuria with hemoglobin, bicarbonate, phosphorus, parathyroid hormone, potassium, and calcium values using linear regression and with hypertension and categorical definitions of each abnormality using logistic regression. Results were pooled using random-effects meta-analyses.
The CKD cohorts (n=254,666 participants) were 27% women and 10% black, with a mean age of 69 (SD, 12) years. The general population/high-risk cohorts (n=1,758,334) were 50% women and 2% black, with a mean age of 50 (16) years. There was a strong graded association between lower eGFR and all laboratory result abnormalities (ORs ranging from 3.27 [95% CI, 2.68-3.97] to 8.91 [95% CI, 7.22-10.99] comparing eGFRs of 15 to 29 with eGFRs of 45 to 59mL/min/1.73m2), whereas albuminuria had equivocal or weak associations with abnormalities (ORs ranging from 0.77 [95% CI, 0.60-0.99] to 1.92 [95% CI, 1.65-2.24] comparing urinary albumin-creatinine ratio > 300 vs < 30mg/g).
Variations in study era, health care delivery system, typical diet, and laboratory assays.
Lower eGFR was strongly associated with higher odds of multiple laboratory result abnormalities. Knowledge of risk associations might help guide management in the heterogeneous group of patients with CKD. |
| doi_str_mv | 10.1053/j.ajkd.2018.08.013 |
| format | Article |
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Cirillo, Massimo ; Gansevoort, Ron T. ; Heine, Gunnar H. ; Landray, Martin J. ; Miura, Katsuyuki ; Peralta, Carmen A. ; Shlipak, Michael G. ; Zhang, Luxia ; van Zuilen, Arjan D. ; Hallan, Stein I. ; Kovesdy, Csaba P. ; Woodward, Mark ; Levin, Adeera ; Appel, Larry ; Chen, Teresa ; Arima, Hisatomi ; Perkovic, Vlado ; Yatsuya, Hiroshi ; Li, Yuanying ; Hirakawa, Yoshihisa ; Matsushita, Kunihiro ; Grams, Morgan ; Sang, Yingying ; Chadban, Steven ; Levin, Adeera ; Liu, Lisheng ; Zhao, Minghui ; Wang, Fang ; Tang, Mila ; Seiler, Sarah ; Nally, Joseph ; Shlipak, Michael ; Katz, Ronit ; Hiramoto, Jade ; Iso, Hiroyasu ; Muraki, Isao ; Wheeler, David ; Emberson, John ; Brenner, Hermann ; Saum, Kai-Uwe ; Rothenbacher, Dietrich ; Kronenberg, Florian ; Eckardt, Kai-Uwe ; Kirchner, H Lester ; Ho, Kevin ; Miyazaki, Mariko ; Cirillo, Massimo ; Irie, Fujiko ; Kimm, Heejin ; Mok, Yejin ; Shalev, Varda ; Wetzels, Jack F.M. ; Nitsch, Dorothea ; Roderick, Paul ; Bottinger, Erwin ; Nadukuru, Rajiv ; Okayama, Akira ; Miura, Katsuyuki ; Okamura, Tomonori ; Elley, C Raina ; Collins, John F. ; Ohkubo, Takayoshi ; Metoki, Hirohito ; Kikuya, Masahiro ; Nelson, Robert G. ; Knowler, William C. ; Jassal, Simerjot K. ; Barrett-Connor, Elizabeth ; Kovesdy, Csaba ; Gutierrez, Orlando M. ; McClellan, William ; Hoorn, Ewout J. ; Dehghan, Abbas ; Carrero, Juan J. ; Gasparini, Alessandro ; Wettermark, Björn ; Sabanayagam, Charumathi ; Cheng, Ching-Yu ; Visseren, Frank L.J. ; Segelmark, Mårten ; Tangri, Navdeep ; Sud, Maneesh ; Naimark, David ; Konta, Tsuneo ; Hirayama, Atsushi ; Lannfelt, Lars ; Larsson, Anders ; Ärnlöv, Johan ; Bilo, Henk J.G. ; Kleefstra, Nanne ; Coresh (Chair, Josef ; Hallan, Stein ; Kovesdy, Csaba P. ; Ballew, Shoshana H. ; Coresh, Josef ; Grams, Morgan E. ; Sang, Yingying ; Surapaneni, Aditya ; Woodward, Mark</creator><creatorcontrib>Coresh, Josef ; Cirillo, Massimo ; Gansevoort, Ron T. ; Heine, Gunnar H. ; Landray, Martin J. ; Miura, Katsuyuki ; Peralta, Carmen A. ; Shlipak, Michael G. ; Zhang, Luxia ; van Zuilen, Arjan D. ; Hallan, Stein I. ; Kovesdy, Csaba P. ; Woodward, Mark ; Levin, Adeera ; Appel, Larry ; Chen, Teresa ; Arima, Hisatomi ; Perkovic, Vlado ; Yatsuya, Hiroshi ; Li, Yuanying ; Hirakawa, Yoshihisa ; Matsushita, Kunihiro ; Grams, Morgan ; Sang, Yingying ; Chadban, Steven ; Levin, Adeera ; Liu, Lisheng ; Zhao, Minghui ; Wang, Fang ; Tang, Mila ; Seiler, Sarah ; Nally, Joseph ; Shlipak, Michael ; Katz, Ronit ; Hiramoto, Jade ; Iso, Hiroyasu ; Muraki, Isao ; Wheeler, David ; Emberson, John ; Brenner, Hermann ; Saum, Kai-Uwe ; Rothenbacher, Dietrich ; Kronenberg, Florian ; Eckardt, Kai-Uwe ; Kirchner, H Lester ; Ho, Kevin ; Miyazaki, Mariko ; Cirillo, Massimo ; Irie, Fujiko ; Kimm, Heejin ; Mok, Yejin ; Shalev, Varda ; Wetzels, Jack F.M. ; Nitsch, Dorothea ; Roderick, Paul ; Bottinger, Erwin ; Nadukuru, Rajiv ; Okayama, Akira ; Miura, Katsuyuki ; Okamura, Tomonori ; Elley, C Raina ; Collins, John F. ; Ohkubo, Takayoshi ; Metoki, Hirohito ; Kikuya, Masahiro ; Nelson, Robert G. ; Knowler, William C. ; Jassal, Simerjot K. ; Barrett-Connor, Elizabeth ; Kovesdy, Csaba ; Gutierrez, Orlando M. ; McClellan, William ; Hoorn, Ewout J. ; Dehghan, Abbas ; Carrero, Juan J. ; Gasparini, Alessandro ; Wettermark, Björn ; Sabanayagam, Charumathi ; Cheng, Ching-Yu ; Visseren, Frank L.J. ; Segelmark, Mårten ; Tangri, Navdeep ; Sud, Maneesh ; Naimark, David ; Konta, Tsuneo ; Hirayama, Atsushi ; Lannfelt, Lars ; Larsson, Anders ; Ärnlöv, Johan ; Bilo, Henk J.G. ; Kleefstra, Nanne ; Coresh (Chair, Josef ; Hallan, Stein ; Kovesdy, Csaba P. ; Ballew, Shoshana H. ; Coresh, Josef ; Grams, Morgan E. ; Sang, Yingying ; Surapaneni, Aditya ; Woodward, Mark ; CKD Prognosis Consortium</creatorcontrib><description>Chronic kidney disease (CKD) is complicated by abnormalities that reflect disruption in filtration, tubular, and endocrine functions of the kidney. Our aim was to explore the relationship of specific laboratory result abnormalities and hypertension with the estimated glomerular filtration rate (eGFR) and albuminuria CKD staging framework.
Cross-sectional individual participant-level analyses in a global consortium.
17 CKD and 38 general population and high-risk cohorts.
Cohorts in the CKD Prognosis Consortium with data for eGFR and albuminuria, as well as a measurement of hemoglobin, bicarbonate, phosphorus, parathyroid hormone, potassium, or calcium, or hypertension.
Data were obtained and analyzed between July 2015 and January 2018.
We modeled the association of eGFR and albuminuria with hemoglobin, bicarbonate, phosphorus, parathyroid hormone, potassium, and calcium values using linear regression and with hypertension and categorical definitions of each abnormality using logistic regression. Results were pooled using random-effects meta-analyses.
The CKD cohorts (n=254,666 participants) were 27% women and 10% black, with a mean age of 69 (SD, 12) years. The general population/high-risk cohorts (n=1,758,334) were 50% women and 2% black, with a mean age of 50 (16) years. There was a strong graded association between lower eGFR and all laboratory result abnormalities (ORs ranging from 3.27 [95% CI, 2.68-3.97] to 8.91 [95% CI, 7.22-10.99] comparing eGFRs of 15 to 29 with eGFRs of 45 to 59mL/min/1.73m2), whereas albuminuria had equivocal or weak associations with abnormalities (ORs ranging from 0.77 [95% CI, 0.60-0.99] to 1.92 [95% CI, 1.65-2.24] comparing urinary albumin-creatinine ratio > 300 vs < 30mg/g).
Variations in study era, health care delivery system, typical diet, and laboratory assays.
Lower eGFR was strongly associated with higher odds of multiple laboratory result abnormalities. Knowledge of risk associations might help guide management in the heterogeneous group of patients with CKD.</description><identifier>ISSN: 0272-6386</identifier><identifier>ISSN: 1523-6838</identifier><identifier>EISSN: 1523-6838</identifier><identifier>DOI: 10.1053/j.ajkd.2018.08.013</identifier><identifier>PMID: 30348535</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; albuminuria ; Albuminuria - epidemiology ; Albuminuria - physiopathology ; anemia ; Blood Chemical Analysis ; Chronic kidney disease (CKD) ; CKD Prognosis Consortium ; CKD stage ; Clinical Medicine ; Creatinine - urine ; Cross-Sectional Studies ; diabetes ; Disease Progression ; Female ; Global Health ; glomerular filtration rate (GFR) ; Glomerular Filtration Rate - physiology ; hematocrit ; hemoglobin ; Humans ; hyperparathyroidism ; hypertension ; Hypertension, Renal - epidemiology ; Hypertension, Renal - physiopathology ; individual-level meta-analysis ; Internationality ; kidney function ; Kidney Function Tests ; Klinisk medicin ; laboratory abnormality ; laboratory tests ; Male ; Medical and Health Sciences ; Medicin och hälsovetenskap ; meta-analysis ; Middle Aged ; Predictive Value of Tests ; Renal Insufficiency, Chronic - epidemiology ; Renal Insufficiency, Chronic - physiopathology ; Retrospective Studies ; Sensitivity and Specificity ; serum bicarbonate ; serum calcium ; serum intact parathyroid hormone ; serum phosphorus ; serum potassium ; Severity of Illness Index ; staging system ; Urinalysis ; Urologi och njurmedicin ; Urology and Nephrology</subject><ispartof>American journal of kidney diseases, 2019-02, Vol.73 (2), p.206-217</ispartof><rights>2018 National Kidney Foundation, Inc.</rights><rights>Copyright © 2018 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c665t-8907a744b9e54b0aa300572235b0144633622960af18ca69a6158d905efb756b3</citedby><cites>FETCH-LOGICAL-c665t-8907a744b9e54b0aa300572235b0144633622960af18ca69a6158d905efb756b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0272638618309168$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,550,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30348535$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-364781$$DView record from Swedish Publication 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Mark</creatorcontrib><creatorcontrib>Levin, Adeera</creatorcontrib><creatorcontrib>Appel, Larry</creatorcontrib><creatorcontrib>Chen, Teresa</creatorcontrib><creatorcontrib>Arima, Hisatomi</creatorcontrib><creatorcontrib>Perkovic, Vlado</creatorcontrib><creatorcontrib>Yatsuya, Hiroshi</creatorcontrib><creatorcontrib>Li, Yuanying</creatorcontrib><creatorcontrib>Hirakawa, Yoshihisa</creatorcontrib><creatorcontrib>Matsushita, Kunihiro</creatorcontrib><creatorcontrib>Grams, Morgan</creatorcontrib><creatorcontrib>Sang, Yingying</creatorcontrib><creatorcontrib>Chadban, Steven</creatorcontrib><creatorcontrib>Levin, Adeera</creatorcontrib><creatorcontrib>Liu, Lisheng</creatorcontrib><creatorcontrib>Zhao, Minghui</creatorcontrib><creatorcontrib>Wang, Fang</creatorcontrib><creatorcontrib>Tang, Mila</creatorcontrib><creatorcontrib>Seiler, Sarah</creatorcontrib><creatorcontrib>Nally, Joseph</creatorcontrib><creatorcontrib>Shlipak, Michael</creatorcontrib><creatorcontrib>Katz, Ronit</creatorcontrib><creatorcontrib>Hiramoto, Jade</creatorcontrib><creatorcontrib>Iso, Hiroyasu</creatorcontrib><creatorcontrib>Muraki, Isao</creatorcontrib><creatorcontrib>Wheeler, David</creatorcontrib><creatorcontrib>Emberson, John</creatorcontrib><creatorcontrib>Brenner, Hermann</creatorcontrib><creatorcontrib>Saum, Kai-Uwe</creatorcontrib><creatorcontrib>Rothenbacher, Dietrich</creatorcontrib><creatorcontrib>Kronenberg, Florian</creatorcontrib><creatorcontrib>Eckardt, Kai-Uwe</creatorcontrib><creatorcontrib>Kirchner, H Lester</creatorcontrib><creatorcontrib>Ho, Kevin</creatorcontrib><creatorcontrib>Miyazaki, Mariko</creatorcontrib><creatorcontrib>Cirillo, Massimo</creatorcontrib><creatorcontrib>Irie, Fujiko</creatorcontrib><creatorcontrib>Kimm, Heejin</creatorcontrib><creatorcontrib>Mok, Yejin</creatorcontrib><creatorcontrib>Shalev, Varda</creatorcontrib><creatorcontrib>Wetzels, Jack F.M.</creatorcontrib><creatorcontrib>Nitsch, Dorothea</creatorcontrib><creatorcontrib>Roderick, Paul</creatorcontrib><creatorcontrib>Bottinger, Erwin</creatorcontrib><creatorcontrib>Nadukuru, Rajiv</creatorcontrib><creatorcontrib>Okayama, Akira</creatorcontrib><creatorcontrib>Miura, Katsuyuki</creatorcontrib><creatorcontrib>Okamura, Tomonori</creatorcontrib><creatorcontrib>Elley, C Raina</creatorcontrib><creatorcontrib>Collins, John F.</creatorcontrib><creatorcontrib>Ohkubo, Takayoshi</creatorcontrib><creatorcontrib>Metoki, Hirohito</creatorcontrib><creatorcontrib>Kikuya, Masahiro</creatorcontrib><creatorcontrib>Nelson, Robert G.</creatorcontrib><creatorcontrib>Knowler, William C.</creatorcontrib><creatorcontrib>Jassal, Simerjot K.</creatorcontrib><creatorcontrib>Barrett-Connor, Elizabeth</creatorcontrib><creatorcontrib>Kovesdy, Csaba</creatorcontrib><creatorcontrib>Gutierrez, Orlando M.</creatorcontrib><creatorcontrib>McClellan, William</creatorcontrib><creatorcontrib>Hoorn, Ewout J.</creatorcontrib><creatorcontrib>Dehghan, Abbas</creatorcontrib><creatorcontrib>Carrero, Juan J.</creatorcontrib><creatorcontrib>Gasparini, Alessandro</creatorcontrib><creatorcontrib>Wettermark, Björn</creatorcontrib><creatorcontrib>Sabanayagam, Charumathi</creatorcontrib><creatorcontrib>Cheng, Ching-Yu</creatorcontrib><creatorcontrib>Visseren, Frank L.J.</creatorcontrib><creatorcontrib>Segelmark, Mårten</creatorcontrib><creatorcontrib>Tangri, Navdeep</creatorcontrib><creatorcontrib>Sud, Maneesh</creatorcontrib><creatorcontrib>Naimark, David</creatorcontrib><creatorcontrib>Konta, Tsuneo</creatorcontrib><creatorcontrib>Hirayama, Atsushi</creatorcontrib><creatorcontrib>Lannfelt, Lars</creatorcontrib><creatorcontrib>Larsson, Anders</creatorcontrib><creatorcontrib>Ärnlöv, Johan</creatorcontrib><creatorcontrib>Bilo, Henk J.G.</creatorcontrib><creatorcontrib>Kleefstra, Nanne</creatorcontrib><creatorcontrib>Coresh (Chair, Josef</creatorcontrib><creatorcontrib>Hallan, Stein</creatorcontrib><creatorcontrib>Kovesdy, Csaba P.</creatorcontrib><creatorcontrib>Ballew, Shoshana H.</creatorcontrib><creatorcontrib>Coresh, Josef</creatorcontrib><creatorcontrib>Grams, Morgan E.</creatorcontrib><creatorcontrib>Sang, Yingying</creatorcontrib><creatorcontrib>Surapaneni, Aditya</creatorcontrib><creatorcontrib>Woodward, Mark</creatorcontrib><creatorcontrib>CKD Prognosis Consortium</creatorcontrib><title>Relationship of Estimated GFR and Albuminuria to Concurrent Laboratory Abnormalities: An Individual Participant Data Meta-analysis in a Global Consortium</title><title>American journal of kidney diseases</title><addtitle>Am J Kidney Dis</addtitle><description>Chronic kidney disease (CKD) is complicated by abnormalities that reflect disruption in filtration, tubular, and endocrine functions of the kidney. Our aim was to explore the relationship of specific laboratory result abnormalities and hypertension with the estimated glomerular filtration rate (eGFR) and albuminuria CKD staging framework.
Cross-sectional individual participant-level analyses in a global consortium.
17 CKD and 38 general population and high-risk cohorts.
Cohorts in the CKD Prognosis Consortium with data for eGFR and albuminuria, as well as a measurement of hemoglobin, bicarbonate, phosphorus, parathyroid hormone, potassium, or calcium, or hypertension.
Data were obtained and analyzed between July 2015 and January 2018.
We modeled the association of eGFR and albuminuria with hemoglobin, bicarbonate, phosphorus, parathyroid hormone, potassium, and calcium values using linear regression and with hypertension and categorical definitions of each abnormality using logistic regression. Results were pooled using random-effects meta-analyses.
The CKD cohorts (n=254,666 participants) were 27% women and 10% black, with a mean age of 69 (SD, 12) years. The general population/high-risk cohorts (n=1,758,334) were 50% women and 2% black, with a mean age of 50 (16) years. There was a strong graded association between lower eGFR and all laboratory result abnormalities (ORs ranging from 3.27 [95% CI, 2.68-3.97] to 8.91 [95% CI, 7.22-10.99] comparing eGFRs of 15 to 29 with eGFRs of 45 to 59mL/min/1.73m2), whereas albuminuria had equivocal or weak associations with abnormalities (ORs ranging from 0.77 [95% CI, 0.60-0.99] to 1.92 [95% CI, 1.65-2.24] comparing urinary albumin-creatinine ratio > 300 vs < 30mg/g).
Variations in study era, health care delivery system, typical diet, and laboratory assays.
Lower eGFR was strongly associated with higher odds of multiple laboratory result abnormalities. Knowledge of risk associations might help guide management in the heterogeneous group of patients with CKD.</description><subject>Aged</subject><subject>albuminuria</subject><subject>Albuminuria - epidemiology</subject><subject>Albuminuria - physiopathology</subject><subject>anemia</subject><subject>Blood Chemical Analysis</subject><subject>Chronic kidney disease (CKD)</subject><subject>CKD Prognosis Consortium</subject><subject>CKD stage</subject><subject>Clinical Medicine</subject><subject>Creatinine - urine</subject><subject>Cross-Sectional Studies</subject><subject>diabetes</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Global Health</subject><subject>glomerular filtration rate (GFR)</subject><subject>Glomerular Filtration Rate - physiology</subject><subject>hematocrit</subject><subject>hemoglobin</subject><subject>Humans</subject><subject>hyperparathyroidism</subject><subject>hypertension</subject><subject>Hypertension, Renal - epidemiology</subject><subject>Hypertension, Renal - physiopathology</subject><subject>individual-level meta-analysis</subject><subject>Internationality</subject><subject>kidney function</subject><subject>Kidney Function Tests</subject><subject>Klinisk medicin</subject><subject>laboratory abnormality</subject><subject>laboratory tests</subject><subject>Male</subject><subject>Medical and Health Sciences</subject><subject>Medicin och hälsovetenskap</subject><subject>meta-analysis</subject><subject>Middle Aged</subject><subject>Predictive Value of Tests</subject><subject>Renal Insufficiency, Chronic - epidemiology</subject><subject>Renal Insufficiency, Chronic - physiopathology</subject><subject>Retrospective Studies</subject><subject>Sensitivity and Specificity</subject><subject>serum bicarbonate</subject><subject>serum calcium</subject><subject>serum intact parathyroid hormone</subject><subject>serum phosphorus</subject><subject>serum potassium</subject><subject>Severity of Illness Index</subject><subject>staging system</subject><subject>Urinalysis</subject><subject>Urologi och njurmedicin</subject><subject>Urology and Nephrology</subject><issn>0272-6386</issn><issn>1523-6838</issn><issn>1523-6838</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>D8T</sourceid><recordid>eNp9ks9uEzEQxlcIREPhBTggHzmwYXb9Z3cRqhSlbagUBKqAqzW79rZON3awvUF5FN4WRwkVPRTJI1v27_tmrJkse13AtABO36-muLpT0xKKegppFfRJNil4SXNR0_ppNoGyKnNBa3GSvQhhBQANFeJ5dkKBsppTPsl-X-sBo3E23JoNcT25CNGsMWpFFpfXBK0is6Ed18aO3iCJjsyd7UbvtY1kia3zGJ3fkVlrnV_jYKLR4QOZWXJlldkaNeJAvqKPpjMbTJpzjEg-64g5Whx2wQRiLEGyGFyb0OQeXKLH9cvsWY9D0K-O-2n2_fLi2_xTvvyyuJrPlnknBI953UCFFWNtozlrAZEC8KosKW-hYExQKsqyEYB9UXcoGhQFr1UDXPdtxUVLT7P84Bt-6c3Yyo1P__c76dDI49VdOmnJaiYaSPzyUX4YNynaFHsBsLIQWCmZEjLJStZIFDWXHa9RK2hU36hk9-5Ru3PzYyadv5HjKKlgVV0k_OyAJ3atVZfa4HF4oHr4Ys2tvHFbKVLHge_Lf3s08O7nqEOUaxM6PQxotRuDTCVzqBoAkdDygHbeheB1f5-mALmfQLmS-wmU-wmUkFZBk-jNvwXeS_6OXAI-HgCdmro12svQGW07rYzXXZTKmf_5_wEFPe92</recordid><startdate>20190201</startdate><enddate>20190201</enddate><creator>Coresh, Josef</creator><creator>Cirillo, Massimo</creator><creator>Gansevoort, Ron T.</creator><creator>Heine, Gunnar H.</creator><creator>Landray, Martin J.</creator><creator>Miura, Katsuyuki</creator><creator>Peralta, Carmen A.</creator><creator>Shlipak, Michael G.</creator><creator>Zhang, Luxia</creator><creator>van Zuilen, Arjan D.</creator><creator>Hallan, Stein I.</creator><creator>Kovesdy, Csaba P.</creator><creator>Woodward, Mark</creator><creator>Levin, Adeera</creator><creator>Appel, Larry</creator><creator>Chen, Teresa</creator><creator>Arima, Hisatomi</creator><creator>Perkovic, Vlado</creator><creator>Yatsuya, Hiroshi</creator><creator>Li, Yuanying</creator><creator>Hirakawa, Yoshihisa</creator><creator>Matsushita, Kunihiro</creator><creator>Grams, Morgan</creator><creator>Sang, Yingying</creator><creator>Chadban, Steven</creator><creator>Levin, Adeera</creator><creator>Liu, Lisheng</creator><creator>Zhao, Minghui</creator><creator>Wang, Fang</creator><creator>Tang, Mila</creator><creator>Seiler, Sarah</creator><creator>Nally, Joseph</creator><creator>Shlipak, Michael</creator><creator>Katz, Ronit</creator><creator>Hiramoto, Jade</creator><creator>Iso, Hiroyasu</creator><creator>Muraki, Isao</creator><creator>Wheeler, David</creator><creator>Emberson, John</creator><creator>Brenner, Hermann</creator><creator>Saum, Kai-Uwe</creator><creator>Rothenbacher, Dietrich</creator><creator>Kronenberg, Florian</creator><creator>Eckardt, Kai-Uwe</creator><creator>Kirchner, H Lester</creator><creator>Ho, Kevin</creator><creator>Miyazaki, Mariko</creator><creator>Cirillo, Massimo</creator><creator>Irie, Fujiko</creator><creator>Kimm, Heejin</creator><creator>Mok, Yejin</creator><creator>Shalev, Varda</creator><creator>Wetzels, Jack F.M.</creator><creator>Nitsch, Dorothea</creator><creator>Roderick, Paul</creator><creator>Bottinger, Erwin</creator><creator>Nadukuru, Rajiv</creator><creator>Okayama, Akira</creator><creator>Miura, Katsuyuki</creator><creator>Okamura, Tomonori</creator><creator>Elley, C Raina</creator><creator>Collins, John F.</creator><creator>Ohkubo, Takayoshi</creator><creator>Metoki, Hirohito</creator><creator>Kikuya, Masahiro</creator><creator>Nelson, Robert G.</creator><creator>Knowler, William C.</creator><creator>Jassal, Simerjot K.</creator><creator>Barrett-Connor, Elizabeth</creator><creator>Kovesdy, Csaba</creator><creator>Gutierrez, Orlando M.</creator><creator>McClellan, William</creator><creator>Hoorn, Ewout J.</creator><creator>Dehghan, Abbas</creator><creator>Carrero, Juan J.</creator><creator>Gasparini, Alessandro</creator><creator>Wettermark, Björn</creator><creator>Sabanayagam, Charumathi</creator><creator>Cheng, Ching-Yu</creator><creator>Visseren, Frank L.J.</creator><creator>Segelmark, Mårten</creator><creator>Tangri, Navdeep</creator><creator>Sud, Maneesh</creator><creator>Naimark, David</creator><creator>Konta, Tsuneo</creator><creator>Hirayama, Atsushi</creator><creator>Lannfelt, Lars</creator><creator>Larsson, Anders</creator><creator>Ärnlöv, Johan</creator><creator>Bilo, Henk J.G.</creator><creator>Kleefstra, Nanne</creator><creator>Coresh (Chair, Josef</creator><creator>Hallan, Stein</creator><creator>Kovesdy, Csaba P.</creator><creator>Ballew, Shoshana H.</creator><creator>Coresh, Josef</creator><creator>Grams, Morgan E.</creator><creator>Sang, Yingying</creator><creator>Surapaneni, Aditya</creator><creator>Woodward, Mark</creator><general>Elsevier Inc</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><scope>ADTPV</scope><scope>AOWAS</scope><scope>DF2</scope><scope>D95</scope><scope>D8T</scope><scope>ZZAVC</scope></search><sort><creationdate>20190201</creationdate><title>Relationship of Estimated GFR and Albuminuria to Concurrent Laboratory Abnormalities: An Individual Participant Data Meta-analysis in a Global Consortium</title><author>Coresh, Josef ; Cirillo, Massimo ; Gansevoort, Ron T. ; Heine, Gunnar H. ; Landray, Martin J. ; Miura, Katsuyuki ; Peralta, Carmen A. ; Shlipak, Michael G. ; Zhang, Luxia ; van Zuilen, Arjan D. ; Hallan, Stein I. ; Kovesdy, Csaba P. ; Woodward, Mark ; Levin, Adeera ; Appel, Larry ; Chen, Teresa ; Arima, Hisatomi ; Perkovic, Vlado ; Yatsuya, Hiroshi ; Li, Yuanying ; Hirakawa, Yoshihisa ; Matsushita, Kunihiro ; Grams, Morgan ; Sang, Yingying ; Chadban, Steven ; Levin, Adeera ; Liu, Lisheng ; Zhao, Minghui ; Wang, Fang ; Tang, Mila ; Seiler, Sarah ; Nally, Joseph ; Shlipak, Michael ; Katz, Ronit ; Hiramoto, Jade ; Iso, Hiroyasu ; Muraki, Isao ; Wheeler, David ; Emberson, John ; Brenner, Hermann ; Saum, Kai-Uwe ; Rothenbacher, Dietrich ; Kronenberg, Florian ; Eckardt, Kai-Uwe ; Kirchner, H Lester ; Ho, Kevin ; Miyazaki, Mariko ; Cirillo, Massimo ; Irie, Fujiko ; Kimm, Heejin ; Mok, Yejin ; Shalev, Varda ; Wetzels, Jack F.M. ; Nitsch, Dorothea ; Roderick, Paul ; Bottinger, Erwin ; Nadukuru, Rajiv ; Okayama, Akira ; Miura, Katsuyuki ; Okamura, Tomonori ; Elley, C Raina ; Collins, John F. ; Ohkubo, Takayoshi ; Metoki, Hirohito ; Kikuya, Masahiro ; Nelson, Robert G. ; Knowler, William C. ; Jassal, Simerjot K. ; Barrett-Connor, Elizabeth ; Kovesdy, Csaba ; Gutierrez, Orlando M. ; McClellan, William ; Hoorn, Ewout J. ; Dehghan, Abbas ; Carrero, Juan J. ; Gasparini, Alessandro ; Wettermark, Björn ; Sabanayagam, Charumathi ; Cheng, Ching-Yu ; Visseren, Frank L.J. ; Segelmark, Mårten ; Tangri, Navdeep ; Sud, Maneesh ; Naimark, David ; Konta, Tsuneo ; Hirayama, Atsushi ; Lannfelt, Lars ; Larsson, Anders ; Ärnlöv, Johan ; Bilo, Henk J.G. ; Kleefstra, Nanne ; Coresh (Chair, Josef ; Hallan, Stein ; Kovesdy, Csaba P. ; Ballew, Shoshana H. ; Coresh, Josef ; Grams, Morgan E. ; Sang, Yingying ; Surapaneni, Aditya ; Woodward, Mark</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c665t-8907a744b9e54b0aa300572235b0144633622960af18ca69a6158d905efb756b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>albuminuria</topic><topic>Albuminuria - epidemiology</topic><topic>Albuminuria - physiopathology</topic><topic>anemia</topic><topic>Blood Chemical Analysis</topic><topic>Chronic kidney disease (CKD)</topic><topic>CKD Prognosis Consortium</topic><topic>CKD stage</topic><topic>Clinical Medicine</topic><topic>Creatinine - urine</topic><topic>Cross-Sectional Studies</topic><topic>diabetes</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Global Health</topic><topic>glomerular filtration rate (GFR)</topic><topic>Glomerular Filtration Rate - physiology</topic><topic>hematocrit</topic><topic>hemoglobin</topic><topic>Humans</topic><topic>hyperparathyroidism</topic><topic>hypertension</topic><topic>Hypertension, Renal - epidemiology</topic><topic>Hypertension, Renal - physiopathology</topic><topic>individual-level meta-analysis</topic><topic>Internationality</topic><topic>kidney function</topic><topic>Kidney Function Tests</topic><topic>Klinisk medicin</topic><topic>laboratory abnormality</topic><topic>laboratory tests</topic><topic>Male</topic><topic>Medical and Health Sciences</topic><topic>Medicin och hälsovetenskap</topic><topic>meta-analysis</topic><topic>Middle Aged</topic><topic>Predictive Value of Tests</topic><topic>Renal Insufficiency, Chronic - epidemiology</topic><topic>Renal Insufficiency, Chronic - physiopathology</topic><topic>Retrospective Studies</topic><topic>Sensitivity and Specificity</topic><topic>serum bicarbonate</topic><topic>serum calcium</topic><topic>serum intact parathyroid hormone</topic><topic>serum phosphorus</topic><topic>serum potassium</topic><topic>Severity of Illness Index</topic><topic>staging system</topic><topic>Urinalysis</topic><topic>Urologi och njurmedicin</topic><topic>Urology and Nephrology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Coresh, Josef</creatorcontrib><creatorcontrib>Cirillo, Massimo</creatorcontrib><creatorcontrib>Gansevoort, Ron T.</creatorcontrib><creatorcontrib>Heine, Gunnar H.</creatorcontrib><creatorcontrib>Landray, Martin J.</creatorcontrib><creatorcontrib>Miura, Katsuyuki</creatorcontrib><creatorcontrib>Peralta, Carmen A.</creatorcontrib><creatorcontrib>Shlipak, Michael G.</creatorcontrib><creatorcontrib>Zhang, Luxia</creatorcontrib><creatorcontrib>van Zuilen, Arjan D.</creatorcontrib><creatorcontrib>Hallan, Stein I.</creatorcontrib><creatorcontrib>Kovesdy, Csaba P.</creatorcontrib><creatorcontrib>Woodward, Mark</creatorcontrib><creatorcontrib>Levin, 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Josef</creatorcontrib><creatorcontrib>Grams, Morgan E.</creatorcontrib><creatorcontrib>Sang, Yingying</creatorcontrib><creatorcontrib>Surapaneni, Aditya</creatorcontrib><creatorcontrib>Woodward, Mark</creatorcontrib><creatorcontrib>CKD Prognosis Consortium</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><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Uppsala universitet</collection><collection>SWEPUB Lunds universitet</collection><collection>SWEPUB Freely available online</collection><collection>SwePub Articles full text</collection><jtitle>American journal of kidney diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Coresh, Josef</au><au>Cirillo, Massimo</au><au>Gansevoort, Ron T.</au><au>Heine, Gunnar H.</au><au>Landray, Martin J.</au><au>Miura, Katsuyuki</au><au>Peralta, Carmen A.</au><au>Shlipak, Michael G.</au><au>Zhang, Luxia</au><au>van Zuilen, Arjan D.</au><au>Hallan, Stein I.</au><au>Kovesdy, Csaba P.</au><au>Woodward, Mark</au><au>Levin, Adeera</au><au>Appel, Larry</au><au>Chen, Teresa</au><au>Arima, Hisatomi</au><au>Perkovic, Vlado</au><au>Yatsuya, Hiroshi</au><au>Li, Yuanying</au><au>Hirakawa, Yoshihisa</au><au>Matsushita, Kunihiro</au><au>Grams, Morgan</au><au>Sang, Yingying</au><au>Chadban, Steven</au><au>Levin, Adeera</au><au>Liu, Lisheng</au><au>Zhao, Minghui</au><au>Wang, Fang</au><au>Tang, Mila</au><au>Seiler, Sarah</au><au>Nally, Joseph</au><au>Shlipak, Michael</au><au>Katz, Ronit</au><au>Hiramoto, Jade</au><au>Iso, Hiroyasu</au><au>Muraki, Isao</au><au>Wheeler, David</au><au>Emberson, John</au><au>Brenner, Hermann</au><au>Saum, Kai-Uwe</au><au>Rothenbacher, Dietrich</au><au>Kronenberg, Florian</au><au>Eckardt, Kai-Uwe</au><au>Kirchner, H Lester</au><au>Ho, Kevin</au><au>Miyazaki, Mariko</au><au>Cirillo, Massimo</au><au>Irie, Fujiko</au><au>Kimm, Heejin</au><au>Mok, Yejin</au><au>Shalev, Varda</au><au>Wetzels, Jack F.M.</au><au>Nitsch, Dorothea</au><au>Roderick, Paul</au><au>Bottinger, Erwin</au><au>Nadukuru, Rajiv</au><au>Okayama, Akira</au><au>Miura, Katsuyuki</au><au>Okamura, Tomonori</au><au>Elley, C Raina</au><au>Collins, John F.</au><au>Ohkubo, Takayoshi</au><au>Metoki, Hirohito</au><au>Kikuya, Masahiro</au><au>Nelson, Robert G.</au><au>Knowler, William C.</au><au>Jassal, Simerjot K.</au><au>Barrett-Connor, Elizabeth</au><au>Kovesdy, Csaba</au><au>Gutierrez, Orlando M.</au><au>McClellan, William</au><au>Hoorn, Ewout J.</au><au>Dehghan, Abbas</au><au>Carrero, Juan J.</au><au>Gasparini, Alessandro</au><au>Wettermark, Björn</au><au>Sabanayagam, Charumathi</au><au>Cheng, Ching-Yu</au><au>Visseren, Frank L.J.</au><au>Segelmark, Mårten</au><au>Tangri, Navdeep</au><au>Sud, Maneesh</au><au>Naimark, David</au><au>Konta, Tsuneo</au><au>Hirayama, Atsushi</au><au>Lannfelt, Lars</au><au>Larsson, Anders</au><au>Ärnlöv, Johan</au><au>Bilo, Henk J.G.</au><au>Kleefstra, Nanne</au><au>Coresh (Chair, Josef</au><au>Hallan, Stein</au><au>Kovesdy, Csaba P.</au><au>Ballew, Shoshana H.</au><au>Coresh, Josef</au><au>Grams, Morgan E.</au><au>Sang, Yingying</au><au>Surapaneni, Aditya</au><au>Woodward, Mark</au><aucorp>CKD Prognosis Consortium</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relationship of Estimated GFR and Albuminuria to Concurrent Laboratory Abnormalities: An Individual Participant Data Meta-analysis in a Global Consortium</atitle><jtitle>American journal of kidney diseases</jtitle><addtitle>Am J Kidney Dis</addtitle><date>2019-02-01</date><risdate>2019</risdate><volume>73</volume><issue>2</issue><spage>206</spage><epage>217</epage><pages>206-217</pages><issn>0272-6386</issn><issn>1523-6838</issn><eissn>1523-6838</eissn><abstract>Chronic kidney disease (CKD) is complicated by abnormalities that reflect disruption in filtration, tubular, and endocrine functions of the kidney. Our aim was to explore the relationship of specific laboratory result abnormalities and hypertension with the estimated glomerular filtration rate (eGFR) and albuminuria CKD staging framework.
Cross-sectional individual participant-level analyses in a global consortium.
17 CKD and 38 general population and high-risk cohorts.
Cohorts in the CKD Prognosis Consortium with data for eGFR and albuminuria, as well as a measurement of hemoglobin, bicarbonate, phosphorus, parathyroid hormone, potassium, or calcium, or hypertension.
Data were obtained and analyzed between July 2015 and January 2018.
We modeled the association of eGFR and albuminuria with hemoglobin, bicarbonate, phosphorus, parathyroid hormone, potassium, and calcium values using linear regression and with hypertension and categorical definitions of each abnormality using logistic regression. Results were pooled using random-effects meta-analyses.
The CKD cohorts (n=254,666 participants) were 27% women and 10% black, with a mean age of 69 (SD, 12) years. The general population/high-risk cohorts (n=1,758,334) were 50% women and 2% black, with a mean age of 50 (16) years. There was a strong graded association between lower eGFR and all laboratory result abnormalities (ORs ranging from 3.27 [95% CI, 2.68-3.97] to 8.91 [95% CI, 7.22-10.99] comparing eGFRs of 15 to 29 with eGFRs of 45 to 59mL/min/1.73m2), whereas albuminuria had equivocal or weak associations with abnormalities (ORs ranging from 0.77 [95% CI, 0.60-0.99] to 1.92 [95% CI, 1.65-2.24] comparing urinary albumin-creatinine ratio > 300 vs < 30mg/g).
Variations in study era, health care delivery system, typical diet, and laboratory assays.
Lower eGFR was strongly associated with higher odds of multiple laboratory result abnormalities. Knowledge of risk associations might help guide management in the heterogeneous group of patients with CKD.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>30348535</pmid><doi>10.1053/j.ajkd.2018.08.013</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0272-6386 |
| ispartof | American journal of kidney diseases, 2019-02, Vol.73 (2), p.206-217 |
| issn | 0272-6386 1523-6838 1523-6838 |
| language | eng |
| recordid | cdi_swepub_primary_oai_swepub_ki_se_484690 |
| source | MEDLINE; Elsevier ScienceDirect Journals; SWEPUB Freely available online |
| subjects | Aged albuminuria Albuminuria - epidemiology Albuminuria - physiopathology anemia Blood Chemical Analysis Chronic kidney disease (CKD) CKD Prognosis Consortium CKD stage Clinical Medicine Creatinine - urine Cross-Sectional Studies diabetes Disease Progression Female Global Health glomerular filtration rate (GFR) Glomerular Filtration Rate - physiology hematocrit hemoglobin Humans hyperparathyroidism hypertension Hypertension, Renal - epidemiology Hypertension, Renal - physiopathology individual-level meta-analysis Internationality kidney function Kidney Function Tests Klinisk medicin laboratory abnormality laboratory tests Male Medical and Health Sciences Medicin och hälsovetenskap meta-analysis Middle Aged Predictive Value of Tests Renal Insufficiency, Chronic - epidemiology Renal Insufficiency, Chronic - physiopathology Retrospective Studies Sensitivity and Specificity serum bicarbonate serum calcium serum intact parathyroid hormone serum phosphorus serum potassium Severity of Illness Index staging system Urinalysis Urologi och njurmedicin Urology and Nephrology |
| title | Relationship of Estimated GFR and Albuminuria to Concurrent Laboratory Abnormalities: An Individual Participant Data Meta-analysis in a Global Consortium |
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