Kidney disease independent risk for all-cause and cardiovascular mortality

January 01, 0001

Kidney disease independent risk for all-cause and cardiovascular mortality

Substantial controversy surrounds the use of estimated glomerular filtration rate (eGFR) and albuminuria to define chronic kidney disease and assign its stages. The researchers undertook a meta-analysis to assess the independent and combined associations of eGFR and albuminuria with mortality. In this collaborative meta-analysis of general population cohorts, they pooled standardised data for all-cause and cardiovascular mortality from studies containing at least 1000 participants and baseline information about eGFR and urine albumin concentrations.

They found that eGFR and ACR were multiplicatively associated with risk of mortality without evidence of interaction. Similar findings were recorded for cardiovascular mortality and in studies with dipstick measurements.

The researchers concluded: "eGFR less than 60 mL/min/1·73 m2 and ACR 1·1 mg/mmol (10 mg/g) or more are independent predictors of mortality risk in the general population. This study provides quantitative data for use of both kidney measures for risk assessment and definition and staging of chronic kidney disease."

A reminder that kidney disease itself can be considered a cardiovascular risk factor.

For the full abstract, click here.

The Lancet published online 18 May 2010 © Elsevier Ltd 2010
Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis. Chronic Kidney Disease Prognosis Consortium.

Category: U. Urinary System. Keywords: eGFR, albuminuria, mortality, collaborative meta analysis, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 15 June 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.