Low eGFR and severe albuminuria may be linked with poor kidney outcomes
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Key takeaways:
- Patients with a mean eGFR of 60 mL/min/1.73 m² or less was linked to a higher risk for adverse outcomes.
- Patients were also evaluated using the urine albumin-to-creatinine ratio.
Lower eGFR and severe albuminuria may be linked with higher rates of adverse kidney and cardiovascular outcomes, including death, according to a recently published study.
The comprehensive meta-analysis, which included data from more than 27 million people from 114 global cohorts, examined the association between chronic kidney disease markers, such as eGFR, albuminuria and various health outcomes.
“CKD affects approximately 14% of adults in the U.S.,” Morgan E. Grams, MD, PhD, of the Writing Group for the CKD Prognosis Consortium, and colleagues wrote. “Lower eGFR values and more severe albuminuria were associated with multiple adverse outcomes.”
Researchers ran the retrospective individual-level data analysis from 1980 to 2021. Participants were evaluated based on eGFR calculated using creatinine alone or creatinine combined with cystatin C, as well as albuminuria estimated as urine albumin-to-creatinine ratio (UACR). Data included analysis of 27,503,140 adults from 114 global cohorts with creatinine-based eGFR; 720,736 from 20 creatinine-and-cystatin C cohorts; and 9,067,753 from 114 albuminuria-based cohorts.
Researchers considered outcomes as kidney failure risk requiring replacement therapy, all-cause mortality, cardiovascular mortality, AKI, hospitalization, coronary heart disease, stroke, heart failure, atrial fibrillation and peripheral artery disease.
According to the results, mean eGFR of 60 mL/min/1.73 m² was associated with adverse outcomes in the population using creatinine alone and with creatinine and cystatin C. Lower eGFR and more severe albuminuria were also linked to adverse cardiovascular outcomes, such as cardiovascular death, heart failure and atrial fibrillation, according to the study.
“The unadjusted incidence rate for each adverse outcome was higher with more severe categories of eGFR and UACR,” the researchers wrote. “Hospitalizations were the most common adverse outcome. In the reference group (eGFR 90-104 mL/min/1.73 m2 and UACR <10 mg/g), the rate of hospitalizations was 79 per 1000 person-years … Among people with a UACR less than 10 mg/g, an eGFR of 45 to 59 mL/min/1.73 m2 based on creatinine alone was associated with significantly higher hospitalization rates …,” the researchers wrote.
Editor’s’ note: This story was updated on Oct. 5, 2023, to clarify that a mean eGFR of 90 mL/min/1.73 m² was identified as the reference category for healthy patients in the study when tested with creatine alone and with cystatin C.
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