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Prediction of ESRD and death among people with CKD: the Chronic Renal Impairment in Birmingham (CRIB) prospective cohort study.

Landray MJ, Emberson JR, Blackwell L, Dasgupta T, Zakeri R, Morgan MD, Ferro CJ, Vickery S, Ayrton P, Nair D, Dalton RN, Lamb EJ, Baigent C, Townend JN, Wheeler DC - Am. J. Kidney Dis. (2010)

Bottom Line: For death, age, N-terminal pro-brain natriuretic peptide, troponin T level, and cigarette smoking remained strongly predictive of risk.Other important factors may have been missed because of limited study power.Larger cohort studies are required to further validate these results.

View Article: PubMed Central - PubMed

Affiliation: Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK. martin.landray@ctsu.ox.ac.uk

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Age- and sex-adjusted relative risk (RR) of end-stage renal disease (ESRD) and death in the CRIB (Chronic Renal Impairment in Birmingham) Study by baseline estimated glomerular filtration rate (eGFR; calculated using the 4-variable Modification of Diet in Renal Disease [MDRD] Study equation). Both the horizontal and vertical axes are shown on a logarithmic scale. The points in the right hand panel have been adjusted so that the absolute mortality rates they represent are comparable with the absolute ESRD rates represented in the left hand panel (thus, the point at which the 2 lines cross is the level of eGFR above which, in the CRIB cohort, the risk of death started to exceed the risk of ESRD). Abbreviation: CI, confidence interval.
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fig2: Age- and sex-adjusted relative risk (RR) of end-stage renal disease (ESRD) and death in the CRIB (Chronic Renal Impairment in Birmingham) Study by baseline estimated glomerular filtration rate (eGFR; calculated using the 4-variable Modification of Diet in Renal Disease [MDRD] Study equation). Both the horizontal and vertical axes are shown on a logarithmic scale. The points in the right hand panel have been adjusted so that the absolute mortality rates they represent are comparable with the absolute ESRD rates represented in the left hand panel (thus, the point at which the 2 lines cross is the level of eGFR above which, in the CRIB cohort, the risk of death started to exceed the risk of ESRD). Abbreviation: CI, confidence interval.

Mentions: There were strong inverse log-linear associations between proportional differences in eGFR and risks of ESRD and death (Fig 2). This was much more marked for ESRD than for death. Within the range of eGFRs studied, each 30% lower baseline eGFR (eg, 40 vs 28 mL/min/1.73 m2) was associated with an approximately 3-fold increase in risk of ESRD (RR, 3.02; 95% CI, 2.65-3.43; P < 0.001) and a 1.3-fold increase in risk of death (RR, 1.30; 95% CI, 1.17-1.45; P < 0.001). In this cohort, the risk of dying during follow-up exceeded that of developing ESRD for those with eGFR >25 mL/min/1.73 m2 (Fig 2).


Prediction of ESRD and death among people with CKD: the Chronic Renal Impairment in Birmingham (CRIB) prospective cohort study.

Landray MJ, Emberson JR, Blackwell L, Dasgupta T, Zakeri R, Morgan MD, Ferro CJ, Vickery S, Ayrton P, Nair D, Dalton RN, Lamb EJ, Baigent C, Townend JN, Wheeler DC - Am. J. Kidney Dis. (2010)

Age- and sex-adjusted relative risk (RR) of end-stage renal disease (ESRD) and death in the CRIB (Chronic Renal Impairment in Birmingham) Study by baseline estimated glomerular filtration rate (eGFR; calculated using the 4-variable Modification of Diet in Renal Disease [MDRD] Study equation). Both the horizontal and vertical axes are shown on a logarithmic scale. The points in the right hand panel have been adjusted so that the absolute mortality rates they represent are comparable with the absolute ESRD rates represented in the left hand panel (thus, the point at which the 2 lines cross is the level of eGFR above which, in the CRIB cohort, the risk of death started to exceed the risk of ESRD). Abbreviation: CI, confidence interval.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2991589&req=5

fig2: Age- and sex-adjusted relative risk (RR) of end-stage renal disease (ESRD) and death in the CRIB (Chronic Renal Impairment in Birmingham) Study by baseline estimated glomerular filtration rate (eGFR; calculated using the 4-variable Modification of Diet in Renal Disease [MDRD] Study equation). Both the horizontal and vertical axes are shown on a logarithmic scale. The points in the right hand panel have been adjusted so that the absolute mortality rates they represent are comparable with the absolute ESRD rates represented in the left hand panel (thus, the point at which the 2 lines cross is the level of eGFR above which, in the CRIB cohort, the risk of death started to exceed the risk of ESRD). Abbreviation: CI, confidence interval.
Mentions: There were strong inverse log-linear associations between proportional differences in eGFR and risks of ESRD and death (Fig 2). This was much more marked for ESRD than for death. Within the range of eGFRs studied, each 30% lower baseline eGFR (eg, 40 vs 28 mL/min/1.73 m2) was associated with an approximately 3-fold increase in risk of ESRD (RR, 3.02; 95% CI, 2.65-3.43; P < 0.001) and a 1.3-fold increase in risk of death (RR, 1.30; 95% CI, 1.17-1.45; P < 0.001). In this cohort, the risk of dying during follow-up exceeded that of developing ESRD for those with eGFR >25 mL/min/1.73 m2 (Fig 2).

Bottom Line: For death, age, N-terminal pro-brain natriuretic peptide, troponin T level, and cigarette smoking remained strongly predictive of risk.Other important factors may have been missed because of limited study power.Larger cohort studies are required to further validate these results.

View Article: PubMed Central - PubMed

Affiliation: Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK. martin.landray@ctsu.ox.ac.uk

Show MeSH
Related in: MedlinePlus