scholarly journals Rationale and population-based prospective cohort protocol for the disadvantaged populations at risk of decline in eGFR (CO-DEGREE)

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e031169 ◽  
Author(s):  
Marvin Gonzalez-Quiroz ◽  
Dorothea Nitsch ◽  
Sophie Hamilton ◽  
Cristina O'Callaghan Gordo ◽  
Rajiv Saran ◽  
...  
Keyword(s):  
Risk Factors ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Population Based ◽  
Local Health ◽  
Populations At Risk ◽  
High Prevalence ◽  
Egfr Decline

IntroductionA recently recognised form of chronic kidney disease (CKD) of unknown origin (CKDu) is afflicting communities, mostly in rural areas in several regions of the world. Prevalence studies are being conducted in a number of countries, using a standardised protocol, to estimate the distribution of estimated glomerular filtration rate (eGFR), and thus identify communities with a high prevalence of reduced glomerular filtration rate (GFR). In this paper, we propose a standardised minimum protocol for cohort studies in high-risk communities aimed at investigating the incidence of, and risk factors for, early kidney dysfunction.Methods and analysisThis generic cohort protocol provides the information to establish a prospective population-based cohort study in low-income settings with a high prevalence of CKDu. This involves a baseline survey that included key elements from the DEGREE survey (eg, using the previously published DEGREE methodology) of a population-representative sample, and subsequent follow-up visits in young adults (without a pre-existing diagnosis of CKD (eGFR<60 mL/min/1.73m2), proteinuria or risk factors for CKD at baseline) over several years. Each visit involves a core questionnaire, and collection and storage of biological samples. Local capacity to measure serum creatinine will be required so that immediate feedback on kidney function can be provided to participants. After completion of follow-up, repeat measures of creatinine should be conducted in a central laboratory, using reference standards traceable to isotope dilution mass spectrometry (IDMS) quality control material to quantify the main outcome of eGFR decline over time, alongside a description of the early evolution of disease and risk factors for eGFR decline.Ethics and disseminationEthical approval will be obtained by local researchers, and participants will provide informed consent before the study commences. Participants will typically receive feedback and advice on their laboratory results, and referral to a local health system where appropriate.

scholarly journals Severe Decline of Estimated Glomerular Filtration Rate Associates with Progressive Cognitive Deterioration in the Elderly: A Community-Based Cohort Study

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Yi-Chi Chen ◽  
Shuo-Chun Weng ◽  
Jia-Sin Liu ◽  
Han-Lin Chuang ◽  
Chih-Cheng Hsu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
The Elderly ◽  
Percentage Change ◽  
Cognitive Deterioration ◽  
Egfr Decline

Abstract Cognitive dysfunction is closely related to aging and chronic kidney disease (CKD). However, the association between renal function changes and the risk of developing cognitive impairment has not been elucidated. This longitudinal cohort study was to determine the influence of annual percentage change in estimated glomerular filtration rate (eGFR) on subsequent cognitive deterioration or death of the elderly within the community. A total of 33,654 elders with eGFR measurements were extracted from the Taipei City Elderly Health Examination Database. The Short Portable Mental Status Questionnaire was used to assess their cognitive progression at least twice during follow-up visits. Multivariable Cox regression models were used to estimate the hazard ratio (HR) for cognitive deterioration or all-cause mortality with the percentage change in eGFR. During a median follow-up of 5.4 years, the participants with severe decline in eGFR (>20% per year) had an increased risk of cognitive deterioration (HR, 1.33; 95% confidence interval [CI], 1.08–1.72) and the composite outcome (HR, 1.17; 95% CI, 1.03–1.35) when compared with those who had stable eGFR. Severe eGFR decline could be a possible predictor for cognitive deterioration or death among the elderly. Early detection of severe eGFR decline is a critical issue and needs clinical attentions.

scholarly journals ASSESSMENT OF CARDIOVASCULAR RISK AND COMORBIDITY IN PATIENTS WITH CHRONIC KIDNEY DISEASE

2018 ◽  
pp. 61
Author(s):  
Slobodan Davinić ◽  
Ivana Davinić ◽  
Ivan Tasić
Keyword(s):  
Risk Factors ◽  
Glomerular Filtration Rate ◽  
Cardiovascular Risk ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Kidney Diseases ◽  
Chronic Kidney Diseases ◽  
Mean Values ◽  
High Prevalence ◽  
Traditional Risk Factors

High rates of morbidity and mortality in patients with chronic diseases of the kidney are for the most part caused by the high prevalence of cardiovascular diseases and high rates of fatal cardiovascular events. The aim of the study was to establish the prevalence and distribution of cardiovascular risk factors in patients with chronic kidney diseases, in various stages of chronic renal failure. The examinees were classified into three groups based on the level of glomerular filtration rate: over 60 ml/min/1.73m2; 30-59 ml/min/1.73m2; and 15-29 ml/ min/1.73m2. Traditional risk factors of age, hypertension, systolic blood pressure, glycemia, diabetes, serum level of total cholesterol and triglycerides, triglyceridemia, and hypertrophy  of the left ventricle showed a significantly positive rising trend of their mean values or prevalence, inversely dependent upon the level of declining glomerular filtration rates. Mean values of serum HDL cholesterol level demonstrated a significant declining trend, concomitant with decreasing glomerular filtration rate. The prevalence of hypercholesterolemy, smoking and obesity, as well as the mean value of body mass index, showed significant intergroup variations, but without any continuing trend related to glomerular filtration rate. Non-traditional risk factors of anemia, proteinuria, and hypoalbuminemia showed a significant rising trend of prevalence inversely dependent upon the degree of reduction of glomerular filtration rate. The levels of hematocrit and serum albumins showed a positive correlation with the reduction of glomerular filtration rate. In pre-dialysis patients with chronic kidney diseases, a high prevalence of the studied cardiovascular risk factors was found. Cardiovascular risk progressively rises with decreasing glomerular filtration rate, being significantly elevated as early as the initial stages of renal failure.

scholarly journals Renal function of bladder cancer patients after urinary diversion by ileal conduit in Rajavithi Hospital

2021 ◽  
Vol 42 (1) ◽  
pp. 34-39
Author(s):  
Sittichon Suriyawongkul ◽  
◽  
Chawawat Gosrisirikul ◽  
Vorapot Choonhaklai ◽  
Tanet Thaidumrong ◽  
...  
Keyword(s):  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Urinary Tract ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Ileal Conduit ◽  
Upper Urinary Tract ◽  
Egfr Decline

Objectives: Our objectives were to evaluate the long-term renal function after radical cystectomy (RC) and ileal conduit diversion (ICD) and to analyze year-by-year the estimated glomerular filtration rate (eGFR) and morphologic upper urinary tract changes. Materials and Methods: We retrospectively identified 214 patients who had undergone RC and ICD from 2012 to 2018, with regular postoperative follow-up visits. The eGFR was calculated using the Modification of Diet in Renal Disease equation at baseline and during follow-up. A renal function decrease was defined as a greater than 10 mL/min/1.73 m2 reduction in the estimated glomerular filtration rate. Results: The median follow-up period after RC was 24 months (range, 6-60 months). The median eGFR decreased from 64 mL/min/1.73 m2 (range, 9-125 mL/min/1.73 m2) to 61.5 mL/min/1.73 m2 (range, 8-125 mL/min/1.73 m2). A decline in renal function occurred during the first postoperative years (2.74 mL/ min/1.73 m2 and 3.95 mL/min/1.73 m2 in the first and second year, respectively), with a slight decrease in the subsequent years. The strongest predictor of an eGFR decline was CKD stage 1 or 2 (> 60 mL/min/1.73 m2). Urinary obstruction was diagnosed in 6 patients (2.8%). Among the patients who underwent prompt interventional treatment, we did not find any association with the eGFR decline. Conclusion: Patients with urinary ICD have a lifelong risk of chronic kidney disease. Regular monitoring of renal function and the morphologic upper urinary tract will permit early diagnosis and treatment of modifiable factors, avoiding irreversible kidney damage.

scholarly journals Associations of blood biomarkers with glomerular filtration rate in patients with TIA and stroke: population-based study

2020 ◽  
pp. svn-2020-000422
Author(s):  
Dearbhla M. Kelly ◽  
Linxin Li ◽  
Annette I Burgess ◽  
Deborah L Poole ◽  
Julia M Duerden ◽  
...  
Keyword(s):  
Risk Factors ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Chronic Inflammation ◽  
Filtration Rate ◽  
Population Based ◽  
Tumour Necrosis Factor Receptor ◽  
Blood Biomarkers ◽  
Population Based Study ◽  
Fatty Acid Binding

Background and purposeNon-traditional risk factors such as chronic inflammation, oxidative stress and thrombogenic factors are believed to contribute to the excess stroke risk in chronic kidney disease (CKD) by triggering vascular injury and endothelial dysfunction. We aimed to determine how well a panel of biomarkers representative of these factors would correlate with estimated glomerular filtration rate (eGFR) in patients with recent transient ischaemic attack (TIA) or stroke. We also investigated whether eGFR would confound previously reported associations between biomarkers and mortality.MethodsWe studied a panel of 16 blood biomarkers related to inflammation, thrombosis, atherogenesis and cardiac or neuronal cell damage in TIA or ischaemic stroke in a population-based study (Oxford Vascular Study). Biomarker levels were log-transformed and correlated with eGFR, adjusted for age. Cox proportional hazard models were used for survival analysis.ResultsAmong 1297 patients with TIA or stroke, 52.7% (n=684) of patients had CKD (eGFR <60 mL/min/1.73 m2). There was a moderate correlation between log-eGFR and the log-transformed soluble tumour necrosis factor receptor-1 (R2=0.21), attenuating with adjustment for age (R2=0.12). There were moderate-to-strong correlations with markers of cardiac injury, N-terminal pro-brain natriuretic peptide and heart-type fatty acid binding protein (hFABP, R2=0.14 and 0.34, respectively). The strongest correlation after adjustment for age was between hFABP and eGFR (R2=0.20). Adjusting for eGFR did not impact any biomarker associations with mortality.ConclusionsCorrelations between biomarkers related to inflammation and thrombosis with renal dysfunction in the setting of cerebrovascular events were generally modest after adjustment for age, suggesting that putative risk factors such as chronic inflammation or coagulopathy are unlikely to be important stroke mechanisms in patients with CKD.

scholarly journals Inflammation and Renal Function after a Four-Year Follow-Up in Subjects with Unimpaired Glomerular Filtration Rate: Results from the Observational, Population-Based CARLA Cohort

PLoS ONE ◽  
2014 ◽  
Vol 9 (9) ◽  
pp. e108427 ◽  
Author(s):  
Daniel Medenwald ◽  
Matthias Girndt ◽  
Harald Loppnow ◽  
Alexander Kluttig ◽  
Sebastian Nuding ◽  
...  
Keyword(s):  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Population Based

scholarly journals Glomerular Filtration Rate and/or Ratio of Urine Albumin to Creatinine as Markers for Diabetic Retinopathy: A Ten-Year Follow-Up Study

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Pedro Romero-Aroca ◽  
Marc Baget-Bernaldiz ◽  
Raul Navarro-Gil ◽  
Antonio Moreno-Ribas ◽  
Aida Valls-Mateu ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Population Based ◽  
Annual Incidence ◽  
Disease Epidemiology ◽  
Urine Albumin ◽  
Study Results

Aims. To determine the relationship between diabetic nephropathy and diabetic retinopathy on a population of type 2 diabetes mellitus patients. Methods. A prospective ten-year follow-up population-based study. We determined differences between estimated glomerular filtration rate (eGFR) using the chronic kidney disease epidemiology collaboration equation and urine albumin to creatinine ratio. Results. Annual incidence of any-DR was 8.21 ± 0.60% (7.06%–8.92%), sight-threatening diabetic retinopathy (STDR) was 2.65 ± 0.14% (2.48%–2.88%), and diabetic macular edema (DME) was 2.21 ± 0.18% (2%–2.49%). Renal study results were as follows: UACR > 30 mg/g had an annual incidence of 7.02 ± 0.05% (6.97%–7.09%), eGFR < 60 ml/min/1.73 m2 incidence was 5.89 ± 0.12% (5.70%–6.13%). Cox’s proportional regression analysis of DR incidence shows that renal function studied by eGFR < 60 ml/min/1.73 m2 was less significant (p=0.04, HR 1.223, 1.098–1.201) than UACR ≥ 300 mg/g (p<0.001, HR 1.485, 1.103–1.548). The study of STDR shows that eGFR < 60 ml/min/1.73 m2 was significant (p=0.02, HR 1.890, 1.267–2.820), UACR ≥ 300 mg/g (p<0.001, HR 2.448, 1.595–3.757), and DME shows that eGFR < 60 ml/min/1.73 m2 was significant (p=0.02, HR 1.920, 1.287–2.864) and UACR ≥ 300 mg/g (p<0.001, HR 2.432, 1.584–3.732). Conclusions. The UACR has a better association with diabetic retinopathy than the eGFR, although both are important risk factors for diabetic retinopathy.

scholarly journals Body mass index change and estimated glomerular filtration rate decline in a middle-aged population: health check-based cohort in Japan

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e037247
Author(s):  
Shingo Fukuma ◽  
Tatsuyoshi Ikenoue ◽  
Jennifer Bragg-Gresham ◽  
Edward Norton ◽  
Yukari Yamada ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Body Mass ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Health Check ◽  
Middle Aged ◽  
Egfr Decline

BackgroundObesity is a growing public health problem worldwide. We evaluated the mediators and association between changes in obesity metrics and renal outcomes in the general population.MethodsUsing the Japanese nationwide health check-based cohort from April 2011 to March 2019, we selected individuals aged 40–74 years, with a baseline estimated glomerular filtration rate (eGFR) ≥45 mL/min/1.73 m2, whose body mass index (BMI) change was assessed. The primary outcome was combined 30% decline in eGFR, eGFR <15 mL/min/1.73 m2 and end-stage renal disease.ResultsDuring 245 147 person-years’ follow-up among 50 604 participants (mean eGFR, 83.7 mL/min/1.73 m2; mean BMI, 24.1 kg/m2), 645 demonstrated eGFR decline (incidence rate 2.6/1000 person-years, 95% CI: 2.4 to 2.8). We observed continued initial changes in BMI for over 6 years and a U-shaped association between BMI change and eGFR decline. Compared with 0% change in BMI, adjusted HRs for changes of −10%, −4%, 4% and 10% were 1.53 (95% CI: 1.15 to 2.04), 1.14 (95% CI: 1.01 to 1.30), 1.16 (95% CI: 1.02 to 1.32) and 1.87 (95% CI: 1.25 to 2.80), respectively. The percentage of excess risk of BMI increase (>4%) mediated by three risk factors (blood pressure, haemoglobin A1c and total cholesterol), was 13.3%.ConclusionIn the middle-aged Japanese population, both, increase and decrease in BMI were associated with subsequent eGFR decline. Changes in risk factors mediated a small proportion of the association between BMI increase and eGFR decline. Our findings support the clinical significance of monitoring BMI as a renal risk factor.

Sign in / Sign up

Export Citation Format

Share Document