Abstract 8321: Reduced Estimated Glomerular Filtration Rate Levels to Predict Mortality Depend on Presence of Hypertension or Diabetes
BACKGROUND: The current staging system of chronic kidney disease based on estimated glomerular filtration rate (eGFR) led to a marked increase in number of subjects to target for intervention and better methods for identifying those at high risk of adverse outcomes is needed. Hypertension (HT) and diabetes (DM) are the leading causes of end-stage renal disease and effect of reduced eGFR on mortality may be different among subjects with HT or DM. We examined effect of reduced eGFR on all-cause mortality according to presence or absence of HT and DM.
METHODS: We studied 16,461 subjects (mean age 54±13 years, men 26%) who had the annual health examination offered to adult citizens of Moriguchi city, Osaka, Japan in 1997. The new equation for eGFR based on inulin renal clearance for Japanese was applied. The relative risks (RR) were calculated for mortality of each group according to eGFR levels of <30 mL/min/1.73m2 (group 1), 30-44 mL/min/1.73m2 (group 2) and 45-59 mL/min/1.73m2 (group 3), relative to the highest eGFR group (>60 mL/min/1.73m2; group 4), using proportional hazards regression analyses adjusted for age, sex, smoking, drinking, hypercholesterolemia, and history of cardiovascular disease, separately in DM subjects (with DM), HT only subjects (with HT without DM) and control subjects (no HT or DM).
RESULTS: Reduced eGFR <60 mL/min/1.73m2 was observed in 13.5%. During a mean follow-up of 11.0±3.0 years (median 12.2 years), there were 1,208 deaths. In DM subjects, the RRs were significantly higher in group 3 (HR=1.65, 95% CI=1.12 to 2.42), group 2 (HR=2.03, 95% CI=1.04 to 3.97), and group 1 (HR=8.86, 95% CI=4.28 to 18.31), compared to group 4. In HT only subjects, the RRs were significantly higher in group 2 (HR=1.91, 95% CI=1.32 to 2.78) and group 1 (HR=3.42, 95% CI=1.86 to 6.28). In control subjects, the RR was significantly higher only in group 1 (HR=2.98, 95% CI=1.39 to 6.39). (figure).
CONCLUSIONS: Reduced eGFR level to predict mortality depended on presence of HT or DM.
- © 2011 by American Heart Association, Inc.