IR@PKUHSC  > 北京大学第一临床医学院  > 肾脏内科
学科主题临床医学
Associations of kidney disease measures with mortality and end-stage renal disease in individuals with and without hypertension: a meta-analysis
Mahmoodi, Bakhtawar K.1,2; Matsushita, Kunihiro1; Woodward, Mark1,3; Blankestijn, Peter J.4; Cirillo, Massimo5; Ohkubo, Takayoshi6,7; Rossing, Peter8,9; Sarnak, Mark J.10; Stengel, Benedicte11,12; Yamagishi, Kazumasa13,14,15; Yamashita, Kentaro16; Zhang, Luxia17; Coresh, Josef1; de Jong, Paul E.2; Astor, Brad C.18,19; Chronic Kidney Dis Prognosis Conso
刊名LANCET
2012-11-10
DOI10.1016/S0140-6736(12)61272-0
380期:9854页:1649-1661
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Medicine, General & Internal
研究领域[WOS]General & Internal Medicine
关键词[WOS]GLOMERULAR-FILTRATION-RATE ; RISK POPULATION COHORTS ; ALL-CAUSE MORTALITY ; BLOOD-PRESSURE ; COLLABORATIVE METAANALYSIS ; HIGHER ALBUMINURIA ; DIABETIC-NEPHROPATHY ; REVERSE EPIDEMIOLOGY ; PREVALENCE ; EQUATION
英文摘要

Background Hypertension is the most prevalent comorbidity in individuals with chronic kidney disease. However, whether the association of the kidney disease measures, estimated glomerular filtration rate (eGFR) and albuminuria, with mortality or end-stage renal disease (ESRD) differs by hypertensive status is unknown.

Methods We did a meta-analysis of studies selected according to Chronic Kidney Disease Prognosis Consortium criteria. Data transfer and analyses were done between March, 2011, and June, 2012. We used Cox proportional hazards models to estimate the hazard ratios (HR) of mortality and ESRD associated with eGFR and albuminuria in individuals with and without hypertension.

Findings We analysed data for 45 cohorts (25 general population, seven high-risk, and 13 chronic kidney disease) with 1 127 656 participants, 364 344 of whom had hypertension. Low eGFR and high albuminuria were associated with mortality irrespective of hypertensive status in the general population and high-risk cohorts. All-cause mortality risk was 1.1-1.2 times higher in individuals with hypertension than in those without hypertension at preserved eGFR. A steeper relative risk gradient in individuals without hypertension than in those with hypertension at eGFR range 45-75 mL/min per 1.73 m(2) led to much the same mortality risk at lower eGFR. With a reference eGFR of 95 mL/min per 1.73 m(2) in each group to explicitly assess interaction, adjusted HR for all-cause mortality at eGFR 45 mL/min per 1.73 m(2) was 1.77 (95% CI 1.57-1.99) in individuals without hypertension versus 1.24 (1.11-1.39) in those with hypertension (p for overall interaction=0.0003). Similarly, for albumin-creatinine ratio of 300 mg/g (vs 5 mg/g), HR was 2.30 (1.98-2.68) in individuals without hypertension versus 2.08 (1.84-2.35) in those with hypertension (p for overall interaction=0.019). We recorded much the same results for cardiovascular mortality. The associations of eGFR and albuminuria with ESRD, however, did not differ by hypertensive status. Results for chronic kidney disease cohorts were similar to those for general and high-risk population cohorts.

Interpretation Chronic kidney disease should be regarded as at least an equally relevant risk factor for mortality and ESRD in individuals without hypertension as it is in those with hypertension.

语种英语
WOS记录号WOS:000310951400027
资助机构Netherlands Organization for Scientific Research ; Dutch Kidney Foundation ; NFK ; Amgen ; NIH ; Servier ; Roche ; Sanofi ; Netherlands Heart Foundation ; Sanofi-Aventis ; Pfizer ; Merck Sharp Dohme Japan ; Dainippon Sumitomo Pharma ; Tanabe Mitsubishi Pharma ; Daiichi Sankyo Pharma ; Asterasu Pharma ; Kyowa Hakkou Kirin Pharma ; Takeda Pharma ; Bayer Health Care ; Abbott ; AstraZeneca ; Bristol-Myers Squibb ; Boehringer Ingelheim ; Lilly ; Novo Nordisk ; Novartis ; Baxter ; Fresenius ; GlaxoSmithKline ; Merck Sharp Dohme ; Merck ; Dutch Kidney Foundation (Nierstichting Nederland) ; US National Kidney Foundation
引用统计
被引频次:184[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/54604
专题北京大学第一临床医学院_肾脏内科
作者单位1.Ibaraki Hlth Serv Assoc, Mito, Ibaraki, Japan
2.Osaka Med Ctr Hlth Sci & Promot, Osaka, Japan
3.Peking Univ, Div Renal, Hosp 1, Beijing 100871, Peoples R China
4.Univ Salerno, Dept Med, I-84100 Salerno, Italy
5.Steno Diabet Ctr, DK-2820 Gentofte, Denmark
6.Univ Aarhus, HEALTH, Aarhus, Denmark
7.Tufts Med Ctr, Div Nephrol, Boston, MA USA
8.Univ Paris Sud, UMRS 1018, Villejuif, France
9.Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA
10.Univ Groningen, Dept Nephrol, Univ Med Ctr Groningen, Groningen, Netherlands
11.Univ Sydney, George Inst Global Hlth, Sydney, NSW 2006, Australia
12.Univ Med Ctr, Dept Nephrol, Utrecht, Netherlands
13.Tohoku Univ, Grad Sch Pharmaceut Sci, Dept Planning Drug Dev & Clin Evaluat, Sendai, Miyagi 980, Japan
14.Shiga Univ Med Sci, Dept Hlth Sci, Otsu, Shiga 52021, Japan
15.CESP Ctr Res Epidemiol & Populat Hlth, INSERM, U1018, Villejuif, France
16.Univ Tsukuba, Fac Med, Dept Publ Hlth Med, Tsukuba, Ibaraki, Japan
17.Nagoya Univ, Dept Publ Hlth & Hlth Syst, Nagoya, Aichi 4648601, Japan
18.Univ Wisconsin, Dept Med, Sch Med & Publ Hlth, Madison, WI USA
19.Univ Wisconsin, Sch Med & Publ Hlth, Dept Populat Hlth Sci, Madison, WI USA
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GB/T 7714
Mahmoodi, Bakhtawar K.,Matsushita, Kunihiro,Woodward, Mark,et al. Associations of kidney disease measures with mortality and end-stage renal disease in individuals with and without hypertension: a meta-analysis[J]. LANCET,2012,380(9854):1649-1661.
APA Mahmoodi, Bakhtawar K..,Matsushita, Kunihiro.,Woodward, Mark.,Blankestijn, Peter J..,Cirillo, Massimo.,...&Chronic Kidney Dis Prognosis Conso.(2012).Associations of kidney disease measures with mortality and end-stage renal disease in individuals with and without hypertension: a meta-analysis.LANCET,380(9854),1649-1661.
MLA Mahmoodi, Bakhtawar K.,et al."Associations of kidney disease measures with mortality and end-stage renal disease in individuals with and without hypertension: a meta-analysis".LANCET 380.9854(2012):1649-1661.
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