Glomerular filtration rate estimated by differing measures and risk of all‐cause mortality among Chinese individuals without or with diabetes: A nationwide prospective study

Author:

Liu Yu‐Jie1ORCID,Li Fu‐Rong2,Chen Cai‐Long3,Wan Zhong‐Xiao1,Chen Jin‐Si1,Yang Jing14,Liu Rong5,Xu Jia‐Ying6,Zheng Yan789,Qin Li‐Qiang15,Chen Guo‐Chong1

Affiliation:

1. Department of Nutrition and Food Hygiene, School of Public Health Suzhou Medical College of Soochow University Suzhou China

2. School of Public Health and Emergency Management Southern University of Science and Technology Shenzhen China

3. Children Health Management Center Children's Hospital of Soochow University Suzhou China

4. Department of Clinical Nutrition The First Affiliated Hospital of Soochow University Suzhou China

5. Department of Endocrine Changzhou Geriatric Hospital Affiliated to Soochow University Changzhou China

6. State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection Suzhou Medical College of Soochow University Suzhou China

7. State Key Laboratory of Genetic Engineering, Human Phenome Institute, and School of Life Sciences Fudan University Shanghai China

8. Ministry of Education Key Laboratory of Public Health Safety, School of Public Health Fudan University Shanghai China

9. National Clinical Research Center for Aging and Medicine, Huashan Hospital Fudan University Shanghai China

Abstract

AbstractBackgroundWhether estimated glomerular filtration rates (eGFRs) by differing biomarkers are differentially associated with mortality or whether the associations differ by diabetes status remains unclear, especially in Chinese population.MethodsWe included 6995 participants without diabetes (mean age: 60.4 years) and 1543 with diabetes (mean age: 61.8 years). Each eGFR measure was divided into normal (≥90 mL/min/1.73 m2), modestly declined (60 to <90 mL/min/1.73 m2), and chronic kidney disease (CKD) (<60 mL/min/1.73 m2) groups. Cox proportional hazards models were used to estimate hazard ratio (HR) of all‐cause mortality associated with each eGFR.ResultsOver a follow‐up of 7 years, 677 and 215 deaths occurred among individuals without or with diabetes, respectively. Among those without diabetes, all measures of modestly declined eGFR were not associated with mortality, whereas CKD defined by eGFR cystatin C (eGFRcys) and eGFR creatinine (eGFRcr)‐cys (HRs were 1.71 and 1.55, respectively) but not by eGFRcr were associated with higher risk of mortality. Among diabetes, all measures of modestly declined eGFR (HRs: 1.53, 1.56, and 2.09 for eGFRcr, eGFRcys, and eGFRcr‐cys, respectively) and CKD (HRs: 2.57, 2.99, and 3.92 for eGFRcr, eGFRcys, and eGFRcr‐cys, respectively) were associated with higher risk of mortality. Regardless of diabetes status, an addition of eGFRcys or eGFRcr‐cys to traditional risk factors lead to a larger improvement in the prediction of all‐cause mortality risk than adding eGFRcr.ConclusionsThe association of eGFR with mortality risk appeared to be varied by its measures and by diabetes status among middle‐aged and older Chinese, which needs to be considered in clinical practice.

Publisher

Wiley

Subject

Endocrinology, Diabetes and Metabolism

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