{"id":24305,"date":"2023-07-29T04:14:00","date_gmt":"2023-07-28T20:14:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=24305"},"modified":"2023-07-29T06:54:08","modified_gmt":"2023-07-28T22:54:08","slug":"bmj%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e9%9d%92%e5%b9%b4%e4%ba%ba%e8%82%be%e5%8a%9f%e8%83%bd%e8%bd%bb%e5%ba%a6%e4%b8%8b%e9%99%8d%e4%b8%8e%e4%b8%8d%e8%89%af%e9%a2%84%e5%90%8e%e7%9a%84","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=24305","title":{"rendered":"[BMJ\u53d1\u8868\u8bba\u6587]\uff1a\u9752\u5e74\u4eba\u80be\u529f\u80fd\u8f7b\u5ea6\u4e0b\u964d\u4e0e\u4e0d\u826f\u9884\u540e\u7684\u76f8\u5173\u6027"},"content":{"rendered":"\n

Research<\/strong><\/p>\n\n\n\n

Associations between modest reductions in kidney function and adverse outcomes in young adults: retrospective, population based cohort study<\/h1>\n\n\n\n

Junayd Hussain, Nicholas Grubic, Ayub Akbari,\u00a0et al<\/h3>\n\n\n\n

BMJ<\/em>\u00a02023;\u00a0381\u00a0doi:\u00a0https:\/\/doi.org\/10.1136\/bmj-2023-075062<\/a>\u00a0(Published 23 June 2023)Cite this as:\u00a0BMJ<\/em>\u00a02023;381:e075062<\/h3>\n\n\n\n

Abstract<\/h2>\n\n\n\n

Abstract<\/strong><\/p>\n\n\n\n

Objective<\/strong> To study age specific associations of modest reductions in estimated glomerular filtration rate (eGFR) with adverse outcomes.<\/p>\n\n\n\n

Design<\/strong> Retrospective, population based cohort study.<\/p>\n\n\n\n

Setting<\/strong> Linked healthcare administrative datasets in Ontario, Canada.<\/p>\n\n\n\n

Participants<\/strong> Adult residents (18-65 years) with at least one outpatient eGFR value (categorized in 10 unit increments from 50 mL\/min\/1.73m2<\/sup> to >120 mL\/min\/1.73m2<\/sup>), with no history of kidney disease.<\/p>\n\n\n\n

Main outcome measures<\/strong> eGFRs and hazard ratios of composite adverse outcome (all cause mortality, any cardiovascular event, and kidney failure) stratified by age (18-39 years, 40-49 years, and 50-65 years), and relative to age specific eGFR referents (100-110 mL\/min\/1.73m2<\/sup>) for ages 18-39 years, 90-100 for 40-49 years, 80-90 for 50-65 years).<\/p>\n\n\n\n

Results<\/strong>\u00a0From 1 January 2008 to 31 March 2021, among 8\u2009703\u2009871 adults (mean age 41.3 (standard deviation 13.6) years; mean index eGFR 104.2 mL\/min\/1.73m2<\/sup>\u00a0(standard deviation 16.1); median follow-up 9.2 years (interquartile range 5.7-11.4)), modestly reduced eGFR measurements specific to age were recorded in 18.0% of those aged 18-39, 18.8% in those aged 40-49, and 17.0% in those aged 50-65. In comparison with age specific referents, adverse outcomes were consistently higher by hazard ratio and incidence for ages 18-39 compared with older groups across all eGFR categories. For modest reductions (eGFR 70-80 mL\/min\/1.73m2<\/sup>), the hazard ratio for ages 18-39 years was 1.42 (95% confidence interval 1.35 to 1.49), 4.39 per 1000 person years; for ages 40-49 years was 1.13 (1.10 to 1.16), 9.61 per 1000 person years; and for ages 50-65 years was 1.08 (1.07 to 1.09), 23.4 per 1000 person years. Results persisted for each individual outcome and in many sensitivity analyses.<\/p>\n\n\n\n

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Conclusions<\/strong> Modest eGFR reductions were consistently associated with higher rates of adverse outcomes. Higher relative hazards were most prominent and occurred as early as eGFR <80 mL\/min\/1.73m2<\/sup> in younger adults, compared with older groups. These findings suggest a role for more frequent monitoring of kidney function in younger adults to identify individuals at risk to prevent chronic kidney disease and its complications.<\/p>\n","protected":false},"excerpt":{"rendered":"

Research Associations between modest reductions in kidn […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24305"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=24305"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24305\/revisions"}],"predecessor-version":[{"id":24306,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24305\/revisions\/24306"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=24305"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=24305"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=24305"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}