scholarly journals Decreasing Estimated Glomerular Filtration Rate Is Associated With Increased Risk of Hospitalization After Kidney Transplantation

2016 ◽  
Vol 1 (4) ◽  
pp. 269-278 ◽  
Author(s):  
Farrah M. Keong ◽  
Yama A. Afshar ◽  
Stephen O. Pastan ◽  
Ritam Chowdhury ◽  
Jose N. Binongo ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Kidney Transplantation ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Increased Risk

scholarly journals Series: Cardiovascular outcome trials for diabetes drugs Saxagliptin and SAVOR-TIMI 53

2019 ◽  
Vol 19 (1) ◽  
pp. 34-36
Author(s):  
Miles Fisher
Keyword(s):  
Heart Failure ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Cardiovascular Outcome ◽  
Dipeptidyl Peptidase 4 ◽  
Cardiovascular Outcome Trials ◽  
Increased Risk ◽  
Cardiovascular Outcome Trial

SAVOR-TIMI 53 was the first FDA-mandated cardiovascular outcome trial to be presented and published. It compared saxagliptin and placebo in 16,492 patients with type 2 diabetes. SAVOR-TIMI 53 demonstrated non-inferiority for major cardiovascular events (cardiovascular death, myocardial infarction, stroke) but not superiority. An unexpected statistically significant increase in adjudicated hospitalisation for heart failure was seen in the saxagliptin group. Post hoc analysis demonstrated that subjects at greatest risk for hospitalisation for heart failure had previous heart failure, an estimated glomerular filtration rate <60 mL/min, or elevated baseline levels of N-terminal pro-B type natriuretic peptide. As other dipeptidyl peptidase 4 (DPP-4) inhibitors are available which have not been associated with an increased risk of hospitalisation for heart failure, saxagliptin should be avoided in patients with heart failure or a reduced estimated glomerular filtration rate.

scholarly journals Association of the Reproductive Period with Decreased Estimated Glomerular Filtration Rate in Menopausal Women: A Study from the Shanghai Suburban Adult Cohort and Biobank (2016–2020)

2021 ◽  
Vol 18 (19) ◽  
pp. 10451
Author(s):  
Yuting Yu ◽  
Qi Zhao ◽  
Yonggen Jiang ◽  
Na Wang ◽  
Xing Liu ◽  
...  
Keyword(s):  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Lower Risk ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Reproductive Period ◽  
Increased Risk ◽  
Menopausal Women ◽  
Metabolic Equivalent Of Task

In previous studies, it has been documented that a short reproductive period is associated with a higher risk of diabetes, cardiovascular disease, and chronic kidney disease. This study aims to investigate the association of the reproductive period length with decreased renal function. This study obtained data from “the Shanghai Suburban Adult Cohort and Biobank”. An estimated glomerular filtration rate (eGFR) below 60 mL/min/1.73 m2 indicated decreased renal function during follow-up. Participants were grouped into quintiles by reproductive period. Logistic regression analysis was performed to examine the association between the reproductive period and decreased renal function. A total of 5503 menopausal women with baseline eGFR > 60 mL/min/1.73 m2 were included. Age, eGFR, and metabolic equivalent of task (MET) at baseline were 61.0 (range, 36.0–74.0) years, 92.2 (range, 60.1–194.5) mL/min/1.73 m2, and 1386 (range, 160–6678), respectively. A reproductive period of 37–45 years was associated with a lower risk of decreased eGFR (OR: 0.59, 95% CI: 0.35–1.00, p = 0.049) after adjusting for confounding variables. METs decreased the risk of decreased eGFR in women with a reproductive period of 37–45 years (OR: 0.43, 95% CI: 0.23–0.81, p = 0.010). Women with a longer reproductive period have a lower risk of decreased renal function. METs had an opposite influence on renal function in women with longer (decreased risk) or shorter (increased risk) reproductive periods.

scholarly journals Prognostic value for long-term graft survival of estimated glomerular filtration rate and proteinuria quantified at 3 months after kidney transplantation

2020 ◽  
Vol 13 (5) ◽  
pp. 791-802 ◽  
Author(s):  
Clément Mottola ◽  
Nicolas Girerd ◽  
Kevin Duarte ◽  
Alice Aarnink ◽  
Magali Giral ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Kidney Transplantation ◽  
Glomerular Filtration ◽  
Graft Survival ◽  
Prognostic Value ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Validation Cohort ◽  
Predictive Accuracy

Abstract Background The estimated glomerular filtration rate (eGFR) measured at 1 year is the usual benchmark applied in kidney transplantation (KT). However, acting on earlier eGFR values could help in managing KT during the first post-operative year. We aimed to assess the prognostic value for long-term graft survival of the early (3 months) quantification of eGFR and proteinuria following KT. Methods The 3-, 6- and 12-month eGFR using the Modified Diet in Renal Disease equation (eGFRMDRD) was determined and proteinuria was measured in 754 patients who underwent their first KT between 2000 and 2010 (with a mean follow-up of 8.3 years) in our centre. Adjusted associations with graft survival were estimated using a multivariable Cox model. The predictive accuracy was estimated using the C-index and net reclassification index. These same analyses were measured in a multicentre validation cohort of 1936 patients. Results Both 3-month eGFRMDRD and proteinuria were independent predictors of return to dialysis (all P &lt; 0.05) and there was a strong correlation between eGFR at 3 and 12 months (Spearman’s ρ = 0.76). The predictive accuracy of the 3-month eGFR was within a similar range and did not differ significantly from the 12-month eGFR in either the derivation cohort [C-index 62.6 (range 57.2–68.1) versus 66.0 (range 60.1–71.9), P = 0.41] or the validation cohort [C-index 69.3 (range 66.4–72.1) versus 71.7 (range 68.7–74.6), P = 0.25]. Conclusion The 3-month eGFR was a valuable predictor of the long-term return to dialysis whose predictive accuracy was not significantly less than that of the 12-month eGFR in multicentre cohorts totalling &gt;2500 patients. Three-month outcomes may be useful in randomized controlled trials targeting early therapeutic interventions.

Prognostic Significance of Estimated Glomerular Filtration Rate and Cystatin C in Patients with Acute Intracerebral Hemorrhage

2016 ◽  
Vol 42 (5-6) ◽  
pp. 455-463 ◽  
Author(s):  
Shoujiang You ◽  
Luyao Shi ◽  
Chongke Zhong ◽  
Jiaping Xu ◽  
Qiao Han ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Intracerebral Hemorrhage ◽  
Functional Outcome ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Poor Functional Outcome ◽  
Increased Risk ◽  
All Cause Mortality

Background: The effects of the estimated glomerular filtration rate (eGFR) and cystatin C on clinical outcomes on intracerebral hemorrhage (ICH) remain unclear. We investigated the associations of eGFR and cystatin C with 3-month functional outcome and all-cause mortality in acute ICH patients. Methods: A total of 365 patients with acute ICH were enrolled. Serum creatinine and cystatin C levels were measured within 24 h of admission. Outcomes at 3-month were evaluated by interviews with patients or their family members. Poor functional outcome was defined as a modified Rankin Scale score ≥3. Results: During the 3-month follow-up, 154 patients experienced poor functional outcome, and 48 patients died from all causes. Low eGFR level was associated with poor outcome (adjusted OR 8.95; 95% CI 2.13-37.66; p-trend = 0.045) and all-cause mortality (adjusted hazards ratio (HR) 5.10; 95% CI 2.00-13.03; p-trend = 0.001). Additionally, a high cystatin C level was also found to be associated with all-cause mortality (adjusted HR 4.01; 95% CI 1.09-14.72; p-trend = 0.015). However, no significant association between cystatin C and poor functional outcome was observed (p-trend = 0.615). Conclusions: Low eGFR at baseline predicts poor functional outcome and all-cause mortality at 3-month in acute ICH patients. Also, high cystatin C was associated with increased risk of mortality but not with poor functional outcome.

scholarly journals Stabilization of estimated glomerular filtration rate in kidney transplantation from deceased donors with acute kidney injuries

2016 ◽  
Vol 6 (4) ◽  
pp. 712 ◽  
Author(s):  
Punlop Wiwattanathum ◽  
Atiporn Ingsathit ◽  
Surasak Kantachuvesiri ◽  
Nuttapon Arpornsujaritkun ◽  
Wiwat Tirapanich ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Kidney Transplantation ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Deceased Donors

scholarly journals Association of Lipoprotein(a)-Associated Mortality and the Estimated Glomerular Filtration Rate Level in Patients Undergoing Coronary Angiography: A 51,500 Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Zhidong Huang ◽  
Yanfang Yang ◽  
Jin Lu ◽  
Jingjing Liang ◽  
Yibo He ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Coronary Angiography ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Lipoprotein A ◽  
Adjusted Risk ◽  
Risk Of Death ◽  
Increased Risk ◽  
All Cause Mortality

Background: High lipoprotein(a) is associated with poor prognosis in patients at high risk for cardiovascular disease. Renal function based on the estimated glomerular filtration rate (eGFR) is a potential risk factor for the change of lipoprotein(a). However, the regulatory effect of eGFR stratification on lipoprotein(a)-associated mortality has not been adequately addressed.Methods: 51,500 patients who underwent coronary angiography (CAG) or percutaneous coronary intervention (PCI) were included from the Cardiorenal ImprovemeNt (CIN) study (ClinicalTrials.gov NCT04407936). These patients were grouped according to lipoprotein(a) quartiles (Q1–Q4) stratified by eGFR categories (&lt;60 and ≥60 mL/min/1.73m2). Cox regression models were used to estimate hazard ratios (HR) for mortality across combined eGFR and lipoprotein(a) categories.Results: The mean age of the study population was 62.3 ± 10.6 years, 31.3% were female (n = 16,112). During a median follow-up of 5.0 years (interquartile range: 3.0–7.6 years), 13.0% (n = 6,695) of patients died. Compared with lipoprotein(a) Q1, lipoprotein(a) Q2–Q4 was associated with 10% increased adjusted risk of death in all patients (HR: 1.10 [95% CI: 1.03–1.17]), and was strongly associated with about 23% increased adjusted risk of death in patients with eGFR &lt;60 mL/min/1.73m2 (HR: 1.23 [95% CI: 1.08–1.39]), while such association was not significant in patients with eGFR ≥60 mL/min/1.73m2 (HR: 1.05 [95% CI: 0.97–1.13]). P for interaction between lipoprotein(a) (Q1 vs. Q2–Q4) and eGFR (≥60 vs. eGFR &lt;60 mL/min/1.73m2) on all-cause mortality was 0.019.Conclusions: Elevated lipoprotein(a) was associated with increased risk of all-cause mortality and such an association was modified by the baseline eGFR in CAG patients. More attention should be paid to the patients with reduced eGFR and elevated lipoprotein(a), and the appropriate lipoprotein(a) intervention is required.

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