Abstract
Background The reason why coexistence of preserved estimated glomerular filtration rate (eGFR) and albuminuria contributes to a high risk of death and which cause of death increases all-cause mortality have not been elucidated. Methods A total of 16,759 participants aged 40 to 69 years with normal or mildly reduced eGFR (45-119 ml/min/1.73 m2) were enrolled and divided into six groups (group 1, eGFR: 90-119 without albuminuria; group 2, eGFR: 90-119 with albuminuria; group 3, eGFR: 60-89 without albuminuria (reference); group 4, eGFR: 60-89 with albuminuria; group 5, eGFR: 45-59 without albuminuria; group 6, eGFR: 45-59 with albuminuria) based on GFR estimated by using the CKD-EPI study equation modified by a Japanese coefficient and albuminuria (urine albumin-creatinine ratio ≥ 30 mg/g). Outcomes included all-cause death (ACD), cardiovascular death (CVD) and neoplasm-related death (NPD). Multivariable-adjusted mortality rate ratios (RR) and their 95% confidence intervals (CIs) in the groups were estimated by Poisson's regression analysis. Results The highest risk of ACD (RR (95% CIs): 3.95 (2.08-7.52)), CVD (7.15 (2.25-22.7)) and NPB (3.25 (1.26-8.38)) was observed in group 2. Subjects in group 2 were relatively young and had the highest levels of body mass index, blood pressure and HbA1c and the highest prevalence of diabetes and metabolic syndrome. Conclusion Coexistence of preserved eGFR and albuminuria increases risks for ACD, CVD and NPD. Relatively young metabolic persons having both preserved eGFR and albuminuria should be considered as a very high-risk population.
| Original language | English |
|---|---|
| Pages (from-to) | 167-172 |
| Number of pages | 6 |
| Journal | International Journal of Cardiology |
| Volume | 170 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 2013 Dec 10 |
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Keywords
- Albuminuria
- Chronic kidney disease
- Estimated glomerular filtration rate
- Mortality
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
High risks of all-cause and cardiovascular deaths in apparently healthy middle-aged people with preserved glomerular filtration rate and albuminuria : A prospective cohort study. / Ohsawa, Masaki; Fujioka, Tomoaki; Ogasawara, Kuniaki; Tanno, Kozo; Okamura, Tomonori; Turin, Tanvir Chowdhury; Itai, Kazuyoshi; Ogawa, Akira; Yoshida, Yuki; Omama, Shinichi; Onoda, Toshiyuki; Nakamura, Motoyuki; Makita, Shinji; Ishibashi, Yasuhiro; Tanaka, Fumitaka; Kuribayashi, Toru; Ohta, Mutsuko; Sakata, Kiyomi; Okayama, Akira.
In: International Journal of Cardiology, Vol. 170, No. 2, 10.12.2013, p. 167-172.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - High risks of all-cause and cardiovascular deaths in apparently healthy middle-aged people with preserved glomerular filtration rate and albuminuria
T2 - A prospective cohort study
AU - Ohsawa, Masaki
AU - Fujioka, Tomoaki
AU - Ogasawara, Kuniaki
AU - Tanno, Kozo
AU - Okamura, Tomonori
AU - Turin, Tanvir Chowdhury
AU - Itai, Kazuyoshi
AU - Ogawa, Akira
AU - Yoshida, Yuki
AU - Omama, Shinichi
AU - Onoda, Toshiyuki
AU - Nakamura, Motoyuki
AU - Makita, Shinji
AU - Ishibashi, Yasuhiro
AU - Tanaka, Fumitaka
AU - Kuribayashi, Toru
AU - Ohta, Mutsuko
AU - Sakata, Kiyomi
AU - Okayama, Akira
PY - 2013/12/10
Y1 - 2013/12/10
N2 - Background The reason why coexistence of preserved estimated glomerular filtration rate (eGFR) and albuminuria contributes to a high risk of death and which cause of death increases all-cause mortality have not been elucidated. Methods A total of 16,759 participants aged 40 to 69 years with normal or mildly reduced eGFR (45-119 ml/min/1.73 m2) were enrolled and divided into six groups (group 1, eGFR: 90-119 without albuminuria; group 2, eGFR: 90-119 with albuminuria; group 3, eGFR: 60-89 without albuminuria (reference); group 4, eGFR: 60-89 with albuminuria; group 5, eGFR: 45-59 without albuminuria; group 6, eGFR: 45-59 with albuminuria) based on GFR estimated by using the CKD-EPI study equation modified by a Japanese coefficient and albuminuria (urine albumin-creatinine ratio ≥ 30 mg/g). Outcomes included all-cause death (ACD), cardiovascular death (CVD) and neoplasm-related death (NPD). Multivariable-adjusted mortality rate ratios (RR) and their 95% confidence intervals (CIs) in the groups were estimated by Poisson's regression analysis. Results The highest risk of ACD (RR (95% CIs): 3.95 (2.08-7.52)), CVD (7.15 (2.25-22.7)) and NPB (3.25 (1.26-8.38)) was observed in group 2. Subjects in group 2 were relatively young and had the highest levels of body mass index, blood pressure and HbA1c and the highest prevalence of diabetes and metabolic syndrome. Conclusion Coexistence of preserved eGFR and albuminuria increases risks for ACD, CVD and NPD. Relatively young metabolic persons having both preserved eGFR and albuminuria should be considered as a very high-risk population.
AB - Background The reason why coexistence of preserved estimated glomerular filtration rate (eGFR) and albuminuria contributes to a high risk of death and which cause of death increases all-cause mortality have not been elucidated. Methods A total of 16,759 participants aged 40 to 69 years with normal or mildly reduced eGFR (45-119 ml/min/1.73 m2) were enrolled and divided into six groups (group 1, eGFR: 90-119 without albuminuria; group 2, eGFR: 90-119 with albuminuria; group 3, eGFR: 60-89 without albuminuria (reference); group 4, eGFR: 60-89 with albuminuria; group 5, eGFR: 45-59 without albuminuria; group 6, eGFR: 45-59 with albuminuria) based on GFR estimated by using the CKD-EPI study equation modified by a Japanese coefficient and albuminuria (urine albumin-creatinine ratio ≥ 30 mg/g). Outcomes included all-cause death (ACD), cardiovascular death (CVD) and neoplasm-related death (NPD). Multivariable-adjusted mortality rate ratios (RR) and their 95% confidence intervals (CIs) in the groups were estimated by Poisson's regression analysis. Results The highest risk of ACD (RR (95% CIs): 3.95 (2.08-7.52)), CVD (7.15 (2.25-22.7)) and NPB (3.25 (1.26-8.38)) was observed in group 2. Subjects in group 2 were relatively young and had the highest levels of body mass index, blood pressure and HbA1c and the highest prevalence of diabetes and metabolic syndrome. Conclusion Coexistence of preserved eGFR and albuminuria increases risks for ACD, CVD and NPD. Relatively young metabolic persons having both preserved eGFR and albuminuria should be considered as a very high-risk population.
KW - Albuminuria
KW - Chronic kidney disease
KW - Estimated glomerular filtration rate
KW - Mortality
UR - http://www.scopus.com/inward/record.url?scp=84889099513&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84889099513&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2013.10.076
DO - 10.1016/j.ijcard.2013.10.076
M3 - Article
C2 - 24211064
AN - SCOPUS:84889099513
VL - 170
SP - 167
EP - 172
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
IS - 2
ER -