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Chronic kidney disease and the risk of end-stage renal disease versus death.
Tuesday,2012-11-06 12:25 America/Los_Angeles — eenright
| Title | Chronic kidney disease and the risk of end-stage renal disease versus death. |
| Publication Type | Journal Article |
| Year of Publication | 2011 |
| Authors | Dalrymple, LS, Katz, R, Kestenbaum, B, Shlipak, MG, Sarnak, MJ, Stehman-Breen, C, Seliger, S, Siscovick, D, Newman, AB, Fried, L |
| Journal | J Gen Intern Med |
| Volume | 26 |
| Issue | 4 |
| Pagination | 379-85 |
| Date Published | 2011 Apr |
| ISSN | 1525-1497 |
| Keywords | Aged, Aged, 80 and over, Cause of Death, Cohort Studies, Female, Follow-Up Studies, Humans, Kidney Failure, Chronic, Longitudinal Studies, Male, Prospective Studies, Renal Insufficiency, Chronic, Risk Factors, Treatment Outcome |
| Abstract | <p><b>BACKGROUND: </b>Among older adults with chronic kidney disease (CKD), the comparative event rates of end-stage renal disease (ESRD) and cause-specific death are unknown.</p><p><b>OBJECTIVE: </b>To compare the rates of ESRD, cardiovascular and non-cardiovascular death and examine risk factors for ESRD and all-cause mortality in Cardiovascular Health Study (CHS) participants.</p><p><b>DESIGN: </b>The CHS is a longitudinal cohort study of community-dwelling adults aged 65 years and older.</p><p><b>PARTICIPANTS: </b>1,268 participants with an estimated glomerular filtration rate (eGFR) < 60 ml/min per 1.73 m(2) were followed until the time of first event (ESRD, cardiovascular or non-cardiovascular death) or until March 31, 2003.</p><p><b>MAIN MEASURES: </b>The outcomes were ESRD, cardiovascular- and non-cardiovascular death. Rates of each event were calculated, and a Cox Proportional Hazards Model with a competing risk framework was used to examine risk factors for ESRD as compared with death. Predictors included age, gender, race, BMI, hypertension, diabetes, cardiovascular disease, heart failure, tobacco use, eGFR, and total cholesterol.</p><p><b>KEY RESULTS: </b>During 9.7 years of follow-up, 5% of the cohort progressed to ESRD, and 61% of the cohort died. The rate (per 100 person-years) was 0.5 for ESRD and 6.8 for all-cause mortality (3.0 for cardiovascular and 3.8 for non-cardiovascular mortality). In the competing risk framework, lower eGFR, male gender, African-American race, and higher BMI were associated with an increased risk of ESRD.</p><p><b>CONCLUSIONS: </b>Older adults with CKD are 13-fold more likely to die from any cause than progress to ESRD and are 6-fold more likely to die from cardiovascular causes than develop ESRD.</p> |
| DOI | 10.1007/s11606-010-1511-x |
| Alternate Journal | J Gen Intern Med |
| PubMed ID | 20853156 |
| PubMed Central ID | PMC3055978 |
| Grant List | R01AG027002 / AG / NIA NIH HHS / United States UL1 TR000005 / TR / NCATS NIH HHS / United States N01-HC-85085 / HC / NHLBI NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States N01-HC-85081 / HC / NHLBI NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States N01-HC-85082 / HC / NHLBI NIH HHS / United States N01 HC-55222 / HC / NHLBI NIH HHS / United States N01-HC-85083 / HC / NHLBI NIH HHS / United States N01-HC-75150 / HC / NHLBI NIH HHS / United States N01-HC-85080 / HC / NHLBI NIH HHS / United States R01 AG027002 / AG / NIA NIH HHS / United States UL1 RR024146 / RR / NCRR NIH HHS / United States N01HC75150 / HL / NHLBI NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States N01 HC045133 / HC / NHLBI NIH HHS / United States N01 HC035129 / HC / NHLBI NIH HHS / United States N01-HC-85084 / HC / NHLBI NIH HHS / United States |