Faculty Opinions recommendation of Impact of proteinuria and glomerular filtration rate on risk of thromboembolism in atrial fibrillation: the anticoagulation and risk factors in atrial fibrillation (ATRIA) study.

2009 ◽  
Author(s):  
Andreas Goette
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate

Abstract 4580: Proteinuria and Reduced Glomerular Filtration Rate Independently Increase Risk of Thromboembolism in Atrial Fibrillation: The ATRIA Study

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Alan S Go ◽  
Margaret C Fang ◽  
Natalia Udaltsova ◽  
Yuchiao Chang ◽  
Leila H Borowsky ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Stroke Risk ◽  
Thromboembolic Events ◽  
Stroke Risk Factors

Atrial fibrillation (AF) substantially increases the risk of ischemic stroke but this risk varies among patients with AF. Existing stroke risk stratification schemes have limited predictive ability. Chronic kidney disease is a major cardiovascular risk factor, but whether it independently increases the risk for stroke in AF is unknown. In a large, diverse cohort of adults with nonvalvular atrial fibrillation, we examined how chronic kidney disease (i.e., reduced glomerular filtration rate or proteinuria) affects risk of thromboembolism off anticoagulation in patients with AF. We estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease equation and proteinuria from urine dipstick results found in laboratory databases. Data on patient characteristics, stroke risk factors, longitudinal use of warfarin therapy, and thromboembolic events between 1996 –2003 were ascertained from validated clinical databases. Thromboembolic events (ischemic stroke and other systemic embolism) were confirmed by chart review. We used multivariable Poisson regression to evaluate the independent association between reduced eGFR and documented proteinuria with risk of thromboembolic events off warfarin therapy. During 33,165 person-years off anticoagulation among 13,535 patients with AF and no prior dialysis or renal transplant, we observed 676 incident thromboembolic events. After adjustment for known risk factors for stroke and level of eGFR, proteinuria increased the risk of thromboembolism by 54% (adjusted relative risk [RR] 1.54, 1.28 to 1.84). Independent of proteinuria and other confounders, there was a graded, increased risk of stroke associated with progressively lower eGFR compared with eGFR ≥60 (in units of ml/min/1.73 m 2 ): adjusted RR 1.16 (95% CI: 0.95 to 1.40) for eGFR 45– 59, and RR 1.39 (1.12 to 1.71) for eGFR <45 (P=0.001 for trend). Chronic kidney disease increases the risk of thromboembolism in AF independent of other stroke risk factors. Knowing the level of kidney function and presence of proteinuria can potentially improve risk stratification for decision-making about the use of antithrombotic therapy for stroke prevention in AF.

scholarly journals Incidence and Risk Factors of Hyperuricemia among 2.5 Million Chinese Adults during the Years 2017–2018

2021 ◽  
Vol 18 (5) ◽  
pp. 2360
Author(s):  
Ruiqi Shan ◽  
Yi Ning ◽  
Yuan Ma ◽  
Xiang Gao ◽  
Zechen Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Population Size ◽  
Incidence Rate ◽  
Urban Population ◽  
Filtration Rate ◽  
Chinese Adults ◽  
Estimate Glomerular Filtration Rate ◽  
Fat Liver

Objective: To assess the incidence and risk factors of hyperuricemia among Chinese adults in 2017–2018. Methods: A total of 2,015,847 adults (mean age 41.2 ± 12.7, 53.1% men) with serum uric acid concentrations assayed on at least two separate days in routine health examinations during 2017–2018 were analyzed. Hyperuricemia was defined as fasting serum urate concentration >420 μmol/L in men and >360 μmol/L in women. The overall and sex-specific incidence rate were stratified according to age, urban population size, geographical region, annual average temperature and certain diseases. Logistic regression analyses were performed to explore risk factors associated with hyperuricemia. Results: 225,240 adults were newly diagnosed with hyperuricemia. The age- and sex-standardized incidence rate per 100 person-years was 11.1 (95%CI: 11.0–11.1) (15.2 for men and 6.80 for women). The risk of hyperuricemia was positively associated with younger age, being male, larger urban population size, higher annual temperature, higher body mass index, lower estimate glomerular filtration rate, hypertension, dyslipidemia and fat liver. Conclusions: The incidence of hyperuricemia was substantial and exhibited a rising trend among younger adults, especially among men. Socioeconomic and geographic variation in incidence were observed. The risk of hyperuricemia was associated with estimate glomerular filtration rate, fat liver and metabolic factors.

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.

Sign in / Sign up

Export Citation Format

Share Document