Dataset Information

Changes in renal function over time in outpatients with eGFR ≥ 30 mL/min/1.73 m²: implication for timing of renal function testing before contrast-enhanced CT imaging.

ABSTRACT:

Purpose

To evaluate the associations between comorbidities and kidney function decline at 6-month and 1-year follow-up in outpatients with initial estimated glomerular filtration rate (eGFR) ≥ 30 mL/min/1.73 m².

Materials and methods

Outpatients aged 18 and older with confirmed diagnosis, who had eGFR ≥ 30 mL/min/1.73 m² measured between April 2017 and March 2019, were included in this retrospective observational study. Of them, 30,595 included outpatients had 6-month eGFR test and 27,698 included outpatients had 1-year eGFR test. The outpatients were further divided into two groups based on initial eGFR: between 30 and 59 and ≥ 60 mL/min/1.73 m². Impaired renal function was defined as eGFR declined to below 30 mL/min/1.73 m². The comorbidities with P values less than 0.1 identified in univariable logistic regression models were entered into the multivariable analysis with backward selection, thereby identifying comorbidities that increased the risk of eGFR decline at 6-month and 1-year follow-up.

Results

Outpatients with initial eGFR between 30 and 59 mL/min/1.73 m² were 175.94 times more likely to have eGFR decline at 6 months, and were 94.10 times more likely to have eGFR decline at 1 year, compared with their corresponding initial eGFR ≥ 60 counterparts. Multivariable logistic regression analyses disclosed that chronic kidney disease, hypertension, and heart failure were independent risk factors for eGFR decline in outpatients with initial eGFR between 30 and 59 mL/min/1.73 m².

Conclusions

Outpatients with initial eGFR ≥ 60 mL/min/1.73 m² might not need routine eGFR test prior to contrast-enhanced CT scan for 1 year. In addition, chronic kidney disease, hypertension, and heart failure increased the risk of declined renal function, particularly, in outpatients with initial eGFR between 30 and 59 mL/min/1.73 m².

SUBMITTER: Kuwatsuru Y

PROVIDER: S-EPMC10469099 | biostudies-literature | 2023 Sep

REPOSITORIES: biostudies-literature

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Publications

Changes in renal function over time in outpatients with eGFR ≥ 30 mL/min/1.73 m<sup>2</sup>: implication for timing of renal function testing before contrast-enhanced CT imaging.

Kuwatsuru Yoshiki Y Hirano Takahiro T Wakabayashi Ryozo R Ishisaki Juliana Yumi JY Sokooshi Hideaki H Kuwatsuru Ryohei R

Japanese journal of radiology 20230411 9

<h4>Purpose</h4>To evaluate the associations between comorbidities and kidney function decline at 6-month and 1-year follow-up in outpatients with initial estimated glomerular filtration rate (eGFR) ≥ 30 mL/min/1.73 m<sup>2</sup>.<h4>Materials and methods</h4>Outpatients aged 18 and older with confirmed diagnosis, who had eGFR ≥ 30 mL/min/1.73 m<sup>2</sup> measured between April 2017 and March 2019, were included in this retrospective observational study. Of them, 30,595 included outpatients ha ...[more]

PMID: 37040025

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Project description:Background and objectivesThe Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) trial demonstrated that the sodium glucose cotransporter 2 (SGLT2) inhibitor canagliflozin reduced the risk of kidney failure and cardiovascular events in participants with type 2 diabetes mellitus and CKD. Little is known about the use of SGLT2 inhibitors in patients with eGFR <30 ml/min per 1.73 m2. The participants in the CREDENCE study had type 2 diabetes mellitus, a urinary albumin-creatinine ratio >300-5000 mg/g, and an eGFR of 30 to <90 ml/min per 1.73 m2 at screening. This post hoc analysis evaluated participants with eGFR <30 ml/min per 1.73 m2 at randomization.Design, setting, participants, & measurementsEffects of eGFR slope through week 130 were analyzed using a piecewise, linear, mixed-effects model. Efficacy was analyzed in the intention-to-treat population, on the basis of Cox proportional hazard models, and safety was analyzed in the on-treatment population. At randomization (an average of 29 days after screening), 174 of 4401 (4%) participants had an eGFR <30 ml/min per 1.73 m2 (mean [SD] eGFR, 26 [3] ml/min per 1.73 m2).ResultsFrom weeks 3 to 130, there was a 66% difference in the mean rate of eGFR decline with canagliflozin versus placebo (mean slopes, -1.30 versus -3.83 ml/min per 1.73 m2 per year; difference, -2.54 ml/min per 1.73 m2 per year; 95% confidence interval [CI], 0.90 to 4.17). Effects of canagliflozin on kidney, cardiovascular, and mortality outcomes were consistent for those with eGFR <30 and ≥30 ml/min per 1.73 m2 (all P interaction >0.20). The estimate for kidney failure in participants with eGFR <30 ml/min per 1.73 m2 (hazard ratio, 0.67; 95% CI, 0.35 to 1.27) was similar to those with eGFR ≥30 ml/min per 1.73 m2 (hazard ratio, 0.70; 95% CI, 0.54 to 0.91; P interaction=0.80). There was no imbalance in the rate of kidney-related adverse events or AKI associated with canagliflozin between participants with eGFR <30 and ≥30 ml/min per 1.73 m2 (all P interaction >0.12).ConclusionsThis post hoc analysis suggests canagliflozin slowed progression of kidney disease, without increasing AKI, even in participants with eGFR <30 ml/min per 1.73 m2.

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Dataset Information

Changes in renal function over time in outpatients with eGFR ≥ 30 mL/min/1.73 m²: implication for timing of renal function testing before contrast-enhanced CT imaging.

Purpose

Materials and methods

Results

Conclusions

Publications

Changes in renal function over time in outpatients with eGFR ≥ 30 mL/min/1.73 m<sup>2</sup>: implication for timing of renal function testing before contrast-enhanced CT imaging.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Dataset Information

Changes in renal function over time in outpatients with eGFR ≥ 30 mL/min/1.73 m2: implication for timing of renal function testing before contrast-enhanced CT imaging.

Purpose

Materials and methods

Results

Conclusions

Publications

Changes in renal function over time in outpatients with eGFR ≥ 30 mL/min/1.73 m<sup>2</sup>: implication for timing of renal function testing before contrast-enhanced CT imaging.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Changes in renal function over time in outpatients with eGFR ≥ 30 mL/min/1.73 m²: implication for timing of renal function testing before contrast-enhanced CT imaging.