No difference in follow-up estimated glomerular filtration rate between hypertensive and matched nonhypertensive kidney donors

Background: Renal dysfunction negatively impacts survival in acute coronary syndrome patients. The Berlin Initiative Study creatinine-based (BIScrea) equation has recently been proposed for renal function assessment in older persons. However, up to now it is unknown if the superiority of the new BIScrea equation, with respect to the most recommended chronic kidney disease epidemiology collaboration creatinine-based (CKD-EPIcrea) formula, would translate into better risk prediction of adverse events in older patients with acute coronary syndrome. Objectives: To study the impact of using estimated glomerular filtration rate calculated according to the BIScrea and CKD-EPIcrea equations on mortality in acute coronary syndrome patients aged 70 years and over. Methods: Retrospectively, between 2011 and 2016, a total of 2008 patients with acute coronary syndrome (64% men; age 79±7 years) were studied. Follow-up was 18±10 months. Measures of performance were evaluated using continuous data and stratifying patients into three estimated glomerular filtration rate subgroups: ≥60, 59.9–30 and <30 mL/min/1.73 m2. Results: The two formulas afforded independent prognostic information over follow-up. However, risk prediction was most accurate using the BIScrea formula as evaluated by Cox proportional hazards models (hazard ratio (for each 10 mL/min/1.73 m2 decrease) 1.47 vs. 1.27 with the CKD-EPI equation; P<0.001 for comparison), c-statistic values (0.69 vs. 0.65, respectively; P=0.04 for comparison) and Bayesian information criterion. Net reclassification improvement based on the estimated glomerular filtration rate categories significantly favoured BIScrea +9 (95% confidence interval 2–16%; P=0.02). Conclusions: Our findings suggest that the BIScrea formula may improve death risk prediction more than the CKD-EPIcrea formula in older patients with acute coronary syndrome.

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Two-year follow-up of patients with septic shock presenting with low HDL: the effect upon acute kidney injury, death and estimated glomerular filtration rate

Journal of Internal Medicine ◽

10.1111/joim.12601 ◽

2017 ◽

Vol 281 (5) ◽

pp. 518-529 ◽

Cited By ~ 15

Author(s):

K. Roveran Genga ◽

C. Lo ◽

M. Cirstea ◽

G. Zhou ◽

K. R. Walley ◽

...

Keyword(s):

Septic Shock ◽

Acute Kidney Injury ◽

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Filtration Rate ◽

Estimated Glomerular Filtration Rate ◽

Kidney Injury ◽

Injury Death ◽

Low Hdl

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Estimated Glomerular Filtration Rate (eGFR) in Healthy Kidney Donors

Journal of Medical Science And clinical Research ◽

10.18535/jmscr/v4i1.39 ◽

2016 ◽

Author(s):

Sheetal LG ◽

Keyword(s):

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Filtration Rate ◽

Estimated Glomerular Filtration Rate ◽

Kidney Donors

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Abstract P526: Bariatric Surgery is Associated With Slower Decline in Kidney Function, Estimated by Multiple Filtration Markers

Circulation ◽

10.1161/circ.141.suppl_1.p526 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Alex R CHANG ◽

G. C Wood ◽

Adam Cook ◽

Xin Chu ◽

Morgan Grams

Keyword(s):

Bariatric Surgery ◽

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Kidney Function ◽

Cystatin C ◽

Filtration Rate ◽

Estimated Glomerular Filtration Rate ◽

Morbidly Obese ◽

Surgery Group

Background: Persons with morbid obesity are at increased risk for end-stage kidney disease, and prior studies have shown an association between bariatric surgery and improvements in creatinine-based estimated glomerular filtration rate (eGFR cr ). However, eGFR cr could be biased by loss of muscle mass after surgery, and creatinine-cystatin C estimated glomerular filtration rate (eGFR cr-cyc ) has been shown to be more accurate in this setting. Methods: We matched 144 patients who underwent bariatric surgery on pre-surgery age, sex, race, body mass index (BMI), and eGFR cr with 144 morbidly obese non-surgery patients at Geisinger with serial biobanked serum samples. We measured filtration markers (creatinine, cystatin C, beta-2 microglobulin [B2M] and beta-trace protein [BTP], and calculated eGFR cr-cyc using the CKD-EPI combined equation. Using mixed effects models with random intercepts, we compared changes in filtration markers and eGFR cr-cyc between surgery and non-surgery groups. Results: Mean (SD) values for age, BMI, and eGFR cr were 48.2 (10.4) years, 45.2 (6.3) kg/m 2 , and 91.7 (17.5) ml/min/1.73m 2 ; 87.5% were female, 0.7% were black, 50.3% had hypertension, and 41.0% had type 2 diabetes. Mean eGFR cr-cyc slope in the surgery group was -0.41 ml/min/1.73m 2 /yr (95% CI: -0.74, -0.08) over a mean follow-up of 9.2 (1.4) years, compared to -1.43 ml/min/1.73m 2 /yr in the non-surgery group over a mean follow-up of 8.2 (1.1) years. Bariatric surgery was associated with a 1.02 ml/min/1.73m 2 /yr slower decline in eGFR cr-cyc , and smaller increase in all 4 filtration markers (p< 0.02 for all comparisons). Conclusions: Bariatric surgery is associated with slower decline in kidney function, as assessed by eGFR cr-cyc , B2M and BTP.

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Variability in estimated glomerular filtration rate and the incidence of type 2 diabetes: a nationwide population-based study

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-001187 ◽

2020 ◽

Vol 8 (1) ◽

pp. e001187

Author(s):

You-Bin Lee ◽

Da Hye Kim ◽

Eun Roh ◽

So-Hyeon Hong ◽

Jung A Kim ◽

...

Keyword(s):

Type 2 Diabetes ◽

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Filtration Rate ◽

Estimated Glomerular Filtration Rate ◽

Diabetes Risk ◽

Incident Type ◽

Incident Type 2 Diabetes

ObjectiveVariability in estimated glomerular filtration rate (eGFR) has been associated with adverse outcomes in patients with diabetes or chronic kidney disease (CKD). However, no previous study has explored the relationship between eGFR variability and type 2 diabetes incidence.Research design and methodsIn this nationwide, longitudinal, cohort study, we investigated the association between eGFR variability and type 2 diabetes risk using the Korean National Health Insurance Service datasets from 2002 to 2017. eGFR variability was calculated using the variability independent of the mean (eGFR-VIM), coefficient of variation (eGFR-CV), standard deviation (eGFR-SD) and average real variability (eGFR-ARV).ResultsWithin 7 673 905.58 person-years of follow-up (mean follow-up: 3.19 years; n=2 402 668), 11 981 cases of incident type 2 diabetes were reported. The HRs and 95% CIs for incident type 2 diabetes increased according to advance in quartiles of eGFR-VIM (HR (95% CI): Q2, 1.068 (1.009 to 1.130); Q3, 1.077 (1.018 to 1.138); Q4, 1.203 (1.139 to 1.270)) even after adjusting for confounding factors including mean eGFR and mean fasting plasma glucose levels. The subgroup analyses according to risk factors as well as analyses using eGFR-CV, eGFR-SD and eGFR-ARV showed consistent results. The association between increased eGFR variability and type 2 diabetes risk was more prominent in men, individuals with dyslipidemia and those with CKD as shown in the subgroup analysis (p for interaction <0.001).ConclusionsIncreased eGFR variability may be an independent predictor of type 2 diabetes and might be useful for risk stratification of individuals without diabetes.

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