Kidney function and anemia as risk factors for coronary heart disease and mortality: The Atherosclerosis Risk in Communities (ARIC) Study

Astor, Brad C.; Coresh, Josef; Heiss, Gerardo; Pettitt, Dan; Sarnak, Mark J.

doi:10.1016/j.ahj.2005.03.055

Cited by 167 publications

(122 citation statements)

References 41 publications

Supporting

Mentioning

118

Contrasting

Unclassified

Order By: Relevance

“…CKD is associated with risk of cardiovascular disease (3,4), peripheral vascular disease (5), and all-cause mortality (6,7). Hypertension and diabetes are two key risk factors for the development of CKD (8).…”

Section: Introductionmentioning

confidence: 99%

Serum Metabolomic Profiling and Incident CKD among African Americans

Zheng

Nettleton

et al. 2014

Clinical Journal of the American Society of Nephrology

Self Cite

View full text Add to dashboard Cite

Background and objectives Novel biomarkers that more accurately reflect kidney function and predict future CKD are needed. The human metabolome is the product of multiple physiologic or pathophysiologic processes and may provide novel insight into disease etiology and progression. This study investigated whether estimated kidney function would be associated with multiple metabolites and whether selected metabolomic factors would be independent risk factors for incident CKD.Design, setting, participants, & measurements In total, 1921 African Americans free of CKD with a median of 19.6 years follow-up among the Atherosclerosis Risk in Communities Study were included. A total of 204 serum metabolites quantified by untargeted gas chromatography-mass spectrometry and liquid chromatographymass spectrometry was analyzed by both linear regression for the cross-sectional associations with eGFR (specified by the Chronic Kidney Disease Epidemiology Collaboration equation) and Cox proportional hazards model for the longitudinal associations with incident CKD.Results Forty named and 34 unnamed metabolites were found to be associated with eGFR specified by the Chronic Kidney Disease Epidemiology Collaboration equation with creatine and 3-indoxyl sulfate showing the strongest positive (2.8 ml/min per 1.73 m 2 per +1 SD; 95% confidence interval, 2.1 to 3.5) and negative association (214.2 ml/min per 1.73 m 2 per +1 SD; 95% confidence interval, 217.0 to 211.3), respectively. Two hundred four incident CKD events with a median follow-up time of 19.6 years were included in the survival analyses. Higher levels of 5-oxoproline (hazard ratio, 0.70; 95% confidence interval, 0.60 to 0.82) and 1,5-anhydroglucitol (hazard ratio, 0.68; 95% confidence interval, 0.58 to 0.80) were significantly related to lower risk of incident CKD, and the associations did not appreciably change when mutually adjusted.Conclusions These data identify a large number of metabolites associated with kidney function as well as two metabolites that are candidate risk factors for CKD and may provide new insights into CKD biomarker identification.

show abstract

Section: Introductionmentioning

confidence: 99%

Serum Metabolomic Profiling and Incident CKD among African Americans

Zheng

Nettleton

et al. 2014

Clinical Journal of the American Society of Nephrology

Self Cite

View full text Add to dashboard Cite

show abstract

“…n patients who have chronic kidney disease (CKD) and are not yet on hemodialysis (HD), anemia has a significant prevalence, rising from approximately 15 to 70% in stages 3 to 5 (1-4), and acts as an independent risk factor for cardiovascular disease (2,(5)(6)(7)(8) and ESRD (8 -10). These findings have led to the recommendations, recently reiterated by European (European Best Practice Guidelines) and US (Kidney Disease Outcomes Quality Initiative) clinical practice guidelines (11,12), to prescribe erythropoiesis-stimulating agents (ESA) to maintain hemoglobin Ն11 g/dl in all patients with CKD.…”

mentioning

confidence: 99%

Stability of Target Hemoglobin Levels during the First Year of Epoetin Treatment in Patients with Chronic Kidney Disease

Nicola¹,

Conte²,

Chiodini³

et al. 2007

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

Background and Objectives: Instability of hemoglobin levels during epoetin therapy is a new problem in hemodialysis. We evaluated extent and correlates of time in target, that is, the time spent with hemoglobin >11 g/dl during the first year of epoetin and its association with renal survival.Design, Setting, Participants, & Measurements: Data were collected in 917 visits for 12.0 mo in 119 patients with chronic kidney disease; thereafter, patients started renal survival analysis for 10.1 mo. At baseline, hemoglobin was 10.0 ؎ 0.8 g/dl and GFR was 22.1 ؎ 14.2 ml/min per 1.73 m 2 . Results: Hemoglobin target, reached in 1.5 mo, was steadily maintained in only 24% of patients. Time in target was not merely due to differences in time to target; after first achievement of target, in fact, a reduction of hemoglobin <11 g/dl occurred in 51% of patients. At multivariate analysis, male gender, basal GFR and hemoglobin levels, first epoetin dose, and iron supplementation were directly associated with length of time in target. A lower risk for renal death (dialysis n ‫؍‬ 53; death n ‫؍‬ 8) was detected in the higher tertile of time in target (11.3 mo) versus lower tertile (3.2 mo). This difference persisted at Cox analysis after adjustment for age, gender, GFR, BP, and proteinuria.Conclusions: In chronic kidney disease, time in target during the first year of epoetin therapy is frequently short depending not only on time to target but also on post-target hemoglobin reductions, correlates with male gender, timing, and intensity of initial therapy and is coupled with better renal survival.

show abstract

“…5 In addition, anemia also has important effects on the cardiovascular system, increasing the risk of left ventricular hypertrophy 6,7 and leading to reduced survival. 7,8 Recombinant erythropoietins, which are produced in Chinese hamster ovary (CHO) cell lines, have been available for the treatment of anemia since the 1980s. Epoetin δ (Dynepo ® , Shire plc.)…”

Section: Introductionmentioning

confidence: 99%

Anemia management in patients on peritoneal dialysis: efficacy and safety of epoetin

Spinowitz¹

2008

Haematologica

View full text Add to dashboard Cite

In a one-year, multicenter, open-label, uncontrolled trial, epoetin δ was given subcutaneously, 1-3-times weekly to peritoneal dialysis patients who had previously received an epoetin. Dose was adjusted to maintain hemoglobin at 10.0-12.0 g/dL. The primary endpoint was mean hemoglobin over weeks 12-24. Safety was assessed. Mean±SD baseline hemoglobin was 11.2±0.9 g/dL. Hemoglobin over weeks 12-24 was 11.6±1.1 g/dL. Adverse events were those expected in this patient population. No life-threatening adverse events occurred. Subcutaneous epoetin δ was effective and well tolerated for the treatment of anemia in peritoneal dialysis patients.

show abstract

Kidney function and anemia as risk factors for coronary heart disease and mortality: The Atherosclerosis Risk in Communities (ARIC) Study

Cited by 167 publications

References 41 publications

Serum Metabolomic Profiling and Incident CKD among African Americans

Serum Metabolomic Profiling and Incident CKD among African Americans

Stability of Target Hemoglobin Levels during the First Year of Epoetin Treatment in Patients with Chronic Kidney Disease

Anemia management in patients on peritoneal dialysis: efficacy and safety of epoetin

Contact Info

Product

Resources

About