Dataset Information

Time-Updated Changes in Estimated GFR and Proteinuria and Major Adverse Cardiac Events: Findings from the Chronic Renal Insufficiency Cohort (CRIC) Study.

ABSTRACT:

Rationale & objective

Evaluating repeated measures of estimated glomerular filtration rate (eGFR) and urinary protein-creatinine ratio (UPCR) over time may enhance our ability to understand the association between changes in kidney parameters and cardiovascular disease risk.

Study design

Prospective cohort study.

Setting & participants

Annual visit data from 2,438 participants in the Chronic Renal Insufficiency Cohort (CRIC).

Exposures

Average and slope of eGFR and UPCR in time-updated, 1-year exposure windows.

Outcomes

Incident heart failure, atherosclerotic cardiovascular disease events, death, and a composite of incident heart failure, atherosclerotic cardiovascular disease events, and death.

Analytical approach

A landmark analysis, a dynamic approach to survival modeling that leverages longitudinal, iterative profiles of laboratory and clinical information to assess the time-updated 3-year risk of adverse cardiovascular outcomes.

Results

Adjusting for baseline and time-updated covariates, every standard deviation lower mean eGFR (19mL/min/1.73m²) and declining slope of eGFR (8mL/min/1.73m² per year) were independently associated with higher risks of heart failure (hazard ratios [HRs] of 1.82 [95% CI, 1.39-2.44] and 1.28 [95% CI, 1.12-1.45], respectively) and the composite outcome (HRs of 1.32 [95% CI, 1.11-1.54] and 1.11 [95% CI, 1.03-1.20], respectively). Every standard deviation higher mean UPCR (136mg/g) and increasing UPCR (240mg/g per year) were also independently associated with higher risks of heart failure (HRs of 1.58 [95% CI, 1.28-1.97] and 1.20 [95% CI, 1.10-1.29], respectively) and the composite outcome (HRs of 1.33 [95% CI, 1.17-1.50] and 1.12 [95% CI, 1.06-1.18], respectively).

Limitations

Limited generalizability of annual eGFR and UPCR assessments; several biomarkers for cardiovascular disease risk were not available annually.

Conclusions

Using the landmark approach to account for time-updated patterns of kidney function, average and slope of eGFR and proteinuria were independently associated with 3-year cardiovascular risk. Short-term changes in kidney function provide information about cardiovascular risk incremental to level of kidney function, representing possible opportunities for more effective management of patients with chronic kidney disease.

SUBMITTER: Cohen JB

PROVIDER: S-EPMC8627522 | biostudies-literature | 2022 Jan

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Time-Updated Changes in Estimated GFR and Proteinuria and Major Adverse Cardiac Events: Findings from the Chronic Renal Insufficiency Cohort (CRIC) Study.

Cohen Jordana B JB Yang Wei W Li Liang L Zhang Xiaoming X Zheng Zihe Z Orlandi Paula P Bansal Nisha N Deo Rajat R Lash James P JP Rahman Mahboob M He Jiang J Shafi Tariq T Chen Jing J Cohen Debbie L DL Matsushita Kunihiro K Shlipak Michael G MG Wolf Myles M Go Alan S AS Feldman Harold I HI

American journal of kidney diseases : the official journal of the National Kidney Foundation 20210528 1

<h4>Rationale & objective</h4>Evaluating repeated measures of estimated glomerular filtration rate (eGFR) and urinary protein-creatinine ratio (UPCR) over time may enhance our ability to understand the association between changes in kidney parameters and cardiovascular disease risk.<h4>Study design</h4>Prospective cohort study.<h4>Setting & participants</h4>Annual visit data from 2,438 participants in the Chronic Renal Insufficiency Cohort (CRIC).<h4>Exposures</h4>Average and slope of eGFR and U ...[more]

PMID: 34052355

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Dataset Information

Time-Updated Changes in Estimated GFR and Proteinuria and Major Adverse Cardiac Events: Findings from the Chronic Renal Insufficiency Cohort (CRIC) Study.

Rationale & objective

Study design

Setting & participants

Exposures

Outcomes

Analytical approach

Results

Limitations

Conclusions

Publications

Time-Updated Changes in Estimated GFR and Proteinuria and Major Adverse Cardiac Events: Findings from the Chronic Renal Insufficiency Cohort (CRIC) Study.

Similar Datasets

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