Association between renal function and cardiovascular mortality: a retrospective cohort study of elderly from health check-up

Huang, Ying-Jhen; Hsu, Yu‐Lin; Chuang, Yung-Hsin; Lin, Hugo You-Hsien; Chen, Yen-Hsu; Chan, Ta‐Chien

doi:10.1136/bmjopen-2021-049307

Cited by 6 publications

(4 citation statements)

References 43 publications

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“…Preoperative RD was defined by the preoperative EGFR. CKD stage 3a (45 ≤ EGFR < 60 mL/min/1.73 m 2 ) or higher according to KDIGO CKD guideline is reportedly associated with an increase in the risk of various diseases and mortality[ 18 - 20 ], so the RD group comprised patients with an EGFR < 60 mL/min/1.73 m 2 , and the non-RD group comprised patients with an EGFR ≥ 60 mL/min/1.73 m 2 . Moreover, we also categorized patients into three groups according to the RD as defined by the EGFR (severe CKD, EGFR < 30 mL/min/1.73 m 2 ; mild CKD, 30 ≤ EGFR < 60 mL/min/1.73 m 2 ; control, EGFR ≥ 60 mL/min/1.73 m 2 ) because patients with ESRD who were undergoing dialysis were likely to be at high risk of developing HCC[ 21 ].…”

Section: Methodsmentioning

confidence: 99%

Impact of comorbid renal dysfunction in patients with hepatocellular carcinoma on long-term outcomes after curative resection

Sakamoto¹,

Shimada²,

Kamiyama³

et al. 2022

WJGS

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BACKGROUND Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. However, the number of patients with chronic kidney disease (CKD) is on the rise because of the increase in lifestyle-related diseases. AIM To establish a tailored management strategy for HCC patients, we evaluated the impact of comorbid renal dysfunction (RD), as stratified by using the estimated glomerular filtration rate (EGFR), and assessed the oncologic validity of hepatectomy for HCC patients with RD. METHODS We enrolled 800 HCC patients who underwent hepatectomy between 1997 and 2015 at our university hospital. We categorized patients into two (RD, EGFR < 60 mL/min/1.73 m 2 ; non-RD, EGFR ≥ 60 mL/min/1.73 m 2 ) and three groups (severe CKD, EGFR < 30 mL/min/1.73 m 2 ; mild CKD, 30 ≤ EGFR < 60 mL/min/1.73 m 2 ; control, EGFR ≥ 60 mL/min/1.73 m 2 ) according to renal function as defined by the EGFR. Overall survival (OS) and recurrence-free survival (RFS) were compared among these groups with the log-rank test, and we also analyzed survival by using a propensity score matching (PSM) model to exclude the influence of patient characteristics. The mean postoperative observation period was 64.7 ± 53.0 mo. RESULTS The RD patients were significantly older and had lower serum total bilirubin, aspartate aminotransferase, and aspartate aminotransferase levels than the non-RD patients ( P < 0.0001, P < 0.001, P < 0.05, and P < 0.01, respectively). No patient received maintenance hemodialysis after surgery. Although the overall postoperative complication rates were similar between the RD and non-RD patients, the proportions of postoperative bleeding and surgical site infection were significantly higher in the RD patients (5.5% vs 1.8%; P < 0.05, 3.9% vs 1.8%; P < 0.05, respectively), and postoperative bleeding was the highest in the severe CKD group ( P < 0.05). Regardless of the degree of comorbid RD, OS and RFS were comparable, even after PSM between the RD and non-RD groups to exclude the influence of patient characteristics, liver function, and other causes of death. CONCLUSION Comorbid mild RD had a negligible impact on the prognosis of HCC patients who underwent curative hepatectomy with appropriate perioperative management, and close attention to severe CKD is necessary to prevent postoperative bleeding and surgical site infection.

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Section: Methodsmentioning

confidence: 99%

Impact of comorbid renal dysfunction in patients with hepatocellular carcinoma on long-term outcomes after curative resection

Sakamoto¹,

Shimada²,

Kamiyama³

et al. 2022

WJGS

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“…However, some studies found that accelerated decline in kidney function was associated with high uric acid levels, high blood pressure, and metabolic syndrome [ 7 – 9 ]. Also, rapid deterioration in kidney function is strongly associated with increased complications, cardiovascular events, and all-cause mortality [ 10 ]. Uric acid is the end product of purine metabolism in the human body, and it exhibits antioxidant activities within the normal physiological range [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Correlation between the increase in serum uric acid and the rapid decline in kidney function in adults with normal kidney function: a retrospective study in Urumqi, China

Yang

et al. 2023

BMC Nephrol

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Background To examine the association between elevated serum uric acid (SUA) levels and the rapid decline in kidney function by conducting a retrospective cohort study on a physically healthy population in Urumqi, China. Methods A cohort study of 2,802 physically healthy people with a normal estimated glomerular filtration rate (eGFR) was investigated from 2018 to 2021. The examination procedure included using questionnaires, taking physical measurements, and blood sampling. The rapid decline in kidney function was defined as eGFR > 5 mL·min–1 ·(1.73 m2 )–1 year. The relationship between elevated SUA levels and the rapid decline in kidney function was assessed. Results When performing the three-year retrospective analysis, 688 (28.55%) cases experienced a rapid decline in kidney function, and 52 (1.9%) cases developed chronic kidney disease (CKD). They were divided into the stable group and the rapidly declining kidney function group according to eGFR > 15 mL·min–1·(1.73 m2 )–1. The comparison revealed a greater increase in uric acid in the rapidly declining kidney function group [0.30 (-0.29, 0.82) mg/dL vs. − 0.07(-0.54, 0.37) mg/dL, Z = − 8.822, P < 0.001]. The participants were further divided into four groups according to their uric acid levels in 2018 and 2021, which included the normal to normal (N-N) group, the normal to hyperuricemia (HUA) (N-H) group, the HUA to normal (H-N) group, and the persistently HUA (H-H) group. The decrease in eGFR was significantly higher in the N-H group than in the other three groups (χ2 = 20.580, P < 0.001). The results of the multifactorial logistic regression analysis showed that elevated uric acid was a risk factor for the rapid decline in kidney function (OR = 1.640, P < 0.001). Conclusion Elevated SUA levels were a risk factor for the rapid decline in kidney function in the Chinese health examination population. Higher SUA levels might predict the occurrence of progressive kidney impairment.

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“…More severe CKD increases the risk of adverse clinical outcomes, in particular cardiovascular disease (CVD) and mortality [6,7], and necessitates more intensive and more expensive therapy, including renal replacement therapy (RRT) such as dialysis or kidney transplant [8]. For example, among commercially insured US patients with CKD, microalbuminuria, and T2DM, per-person per-year costs were USD 18,529 in patients with CKD stage 1, compared with USD 110,210 in patients with CKD stage 5 [4].…”

Section: Introductionmentioning

confidence: 99%

Modeling Chronic Kidney Disease in Type 2 Diabetes Mellitus: A Systematic Literature Review of Models, Data Sources, and Derivation Cohorts

Pöhlmann¹,

Bergenheim

Sánchez

et al. 2022

Diabetes Ther

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Introduction: As novel therapies for chronic kidney disease (CKD) in type 2 diabetes mellitus (T2DM) become available, their long-term benefits should be evaluated using CKD progression models. Existing models offer different modeling approaches that could be reused, but it may be challenging for modelers to assess commonalities and differences between the many available models. Additionally, the data and underlying population characteristics informing model parameters may not always be evident. Therefore, this study reviewed and summarized existing modeling approaches and data sources for CKD in T2DM, as a reference for future model development.Methods: This systematic literature review included computer simulation models of CKD in T2DM populations. Searches were implemented in PubMed (including MEDLINE), Embase, and the Cochrane Library, up to October 2021. Models were classified as cohort state-transition models (cSTM) or individual patient simulation (IPS) models. Information was extracted on modeled kidney disease states, risk equations for CKD, data sources, and baseline characteristics of derivation cohorts in primary data sources. Results: The review identified 49 models (21 IPS, 28 cSTM). A five-state structure was standard among state-transition models, comprising one kidney disease-free state, three kidney disease states [frequently including albuminuria and end-stage kidney disease (ESKD)], and one death state. Five models captured CKD regression and three included cardiovascular disease (CVD). Risk equations most commonly predicted albuminuria and ESKD incidence, while the most predicted CKD sequelae were mortality and CVD. Most data sources were

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Association between renal function and cardiovascular mortality: a retrospective cohort study of elderly from health check-up

Cited by 6 publications

References 43 publications

Impact of comorbid renal dysfunction in patients with hepatocellular carcinoma on long-term outcomes after curative resection

Impact of comorbid renal dysfunction in patients with hepatocellular carcinoma on long-term outcomes after curative resection

Correlation between the increase in serum uric acid and the rapid decline in kidney function in adults with normal kidney function: a retrospective study in Urumqi, China

Modeling Chronic Kidney Disease in Type 2 Diabetes Mellitus: A Systematic Literature Review of Models, Data Sources, and Derivation Cohorts

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