Mortality Risks for All Causes and Cardiovascular Diseases and Reduced GFR in a Middle-aged Working Population in Taiwan

Cheng, Ting‐Yuan David; Wen, Sung-Feng; Astor, Brad C.; Tao, Xuguang Grant; Samet, Jonathan M.; Wen, Chi Pang

doi:10.1053/j.ajkd.2008.05.030

Cited by 77 publications

(88 citation statements)

References 53 publications

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“…9,10 Cheng et al 9 reported that a decrease in eGFR Ͼ20% during 18 mo of follow-up was associated with a higher risk for cardiovascular and all-cause mortality in a middle-aged Taiwanese population. Rifkin et al 10 demonstrated that an annual decrease in eGFR Ͼ3 ml/min per 1.73 m 2 over 3 to 7 yr was associated with a higher risk for all-cause and cardiovascular mortality in elderly adults.…”

Section: Discussionmentioning

confidence: 99%

“…A few studies have reported that deterioration in kidney function is associated with CVD. 9 -13 Interestingly, two studies showed that change in kidney function was a better predictor of clinical outcomes than baseline kidney function 12,13 ; however, previous studies were conducted among select populations of Eastern Asian individuals, 9 elderly Americans, 10 or patients with hypertension or diabetes. [11][12][13] Furthermore, only a few studies have investigated the association between a rapid decline in estimated GFR (eGFR), the best overall measure of kidney function, and future outcomes.…”

mentioning

confidence: 99%

“…[11][12][13] Furthermore, only a few studies have investigated the association between a rapid decline in estimated GFR (eGFR), the best overall measure of kidney function, and future outcomes. 9,10 Although Go et al 14 reported that low eGFR is associated with adverse outcomes independent of time-varying conventional risk factors, no study, to our knowledge, has taken into account the deteriorations of other risk factors to evaluate the independent association of a change in eGFR with cardiovascular outcomes.…”

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confidence: 99%

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Change in Estimated GFR Associates with Coronary Heart Disease and Mortality

Matsushita¹,

Selvin²,

Bash³

et al. 2009

Journal of the American Society of Nephrology

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242

244

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Kidney function predicts cardiovascular and all-cause mortality, but little is known about the association of changes in estimated GFR (eGFR) with clinical outcomes. We investigated whether 3-and 9-yr changes in eGFR associated with risk for coronary heart disease (CHD) and all-cause mortality among 13,029 participants of the Atherosclerosis Risk in Communities (ARIC) Study. After adjustment for baseline covariates including eGFR in Cox proportional hazards models, the quartile of participants with the greatest annual decline (annual decline Ն5.65%) in eGFR were at significantly greater risk for CHD and all-cause mortality (hazard ratio 1.30 [95% confidence interval 1.11 to 1.52] and 1.22 [95% confidence interval 1.06 to 1.41], respectively) compared with the third quartile (annual decline between 0.33 and 0.47%). We observed similar results when we analyzed 9-yr changes in eGFR. Adjustment for covariates at the second eGFR used to estimate change reduced the association with CHD but not with mortality. Among participants with stage 3 chronic kidney disease, an increase in eGFR during the first 3 yr also associated with a higher risk for mortality, perhaps as a result of clinical instability. In conclusion, a steeper than average decline in eGFR associates with a higher risk for CHD and all-cause mortality. Increases in eGFR among participants with chronic kidney disease associate with similar increased risks.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

mentioning

confidence: 99%

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Change in Estimated GFR Associates with Coronary Heart Disease and Mortality

Matsushita¹,

Selvin²,

Bash³

et al. 2009

Journal of the American Society of Nephrology

Self Cite

242

244

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“…Nowadays, it is unavoidable that a large number of asymptomatic workers with elevated ALT (e-ALT), regardless of the underlying cause, are asked do rotating shift work (RSW) on 24-h production lines [3] . In previous studies, e-ALT [4,5] and shift work [6,7] had been independently assessed for their associations with metabolic syndrome (MetS), which has been linked with cardiovascular disease (CVD) [8,9] , one of the leading death causes among working populations [10] . However, for early middle-aged workers with e-ALT in baseline conditions, few longterm follow-up studies assessed the association between RSW and MetS development.…”

Section: Introductionmentioning

confidence: 99%

Shift work aggravates metabolic syndrome developmentamong early-middle-aged males with elevated ALT

Lin¹,

Hsiao²,

Chen³

2009

WJG

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AIM:To examine whether shift work accelerates metabolic syndrome (MetS) development among early middle-aged males with elevated alanine aminotransferase (e-ALT). METHODS:A retrospective, observational followup study on MetS development at a 5-year interval was conducted using health examination data. Nine hundred and ninety six male employees not fulfilling MetS criteria at screening were enrolled. Age, MetScomponents, liver enzymes, serological markers for viral hepatitis, abdominal ultrasound, insulin resistance status, lifestyles, and workplace factors were analyzed. RESULTS:The prevalence of elevated serum ALT (> 40 U/L, e-ALT) at baseline was 19.1%. There were 381 (38.3%) workers with long-term exposures to daynight rotating shift work (RSW). 14.2% of subjects developed MetS during follow-up. After 5 years, the workers with e-ALT had significantly unfavorable changes in MetS-components, and higher rates of MetS development, vs subjects with normal baseline ALT levels. Workers with both baseline e-ALT and 5-year persistent RSW (pRSW) exposure had the highest rate of MetS development. Also, e-ALT-plus-pRSW workers had a significant increase in MetS-components at follow-up, compared with the other subgroups. After controlling for potential confounders, e-ALT-plus-pRSW workers posed a significant risk for MetS development (odds ratio, 2.7; 95% confidence interval, 1.4-5.3, vs workers without baseline e-ALT nor pRSW). CONCLUSION:We suggest that all early middleaged male employees with e-ALT should be evaluated and managed for MetS. Particularly in terms of job arrangements, impacts of long-term RSW on MetS development should be assessed for all male employees having baseline e-ALT.

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“…1,2 Numerous studies have reported the significant association of low eGFR at a single time point with mortality, [3][4][5][6][7][8][9] a more frequent occurrence than ESRD, even among patients with late stages of CKD. 10 Recently, there has been great interest in whether a decline in eGFR adds information to mortality risk assessment beyond eGFR at a single time point.…”

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confidence: 99%

Past Decline Versus Current eGFR and Subsequent Mortality Risk

Naimark

Grams

Matsushita

et al. 2015

JASN

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A single determination of eGFR associates with subsequent mortality risk. Prior decline in eGFR indicates loss of kidney function, but the relationship to mortality risk is uncertain. We conducted an individual-level meta-analysis of the risk of mortality associated with antecedent eGFR slope, adjusting for established risk factors, including last eGFR, among 1.2 million subjects from 12 CKD and 22 other cohorts within the CKD Prognosis Consortium. Over a 3-year antecedent period, 12% of participants in the CKD cohorts and 11% in the other cohorts had an eGFR slope ,25 ml/min per 1.73 m 2 per year, whereas 7% and 4% had a slope .5 ml/min per 1.73 m 2 per year, respectively. Compared with a slope of 0 ml/min per 1.73 m 2 per year, a slope of 26 ml/min per 1.73 m 2 per year associated with adjusted hazard ratios for all-cause mortality of 1.25 (95% confidence interval [95% CI], 1.09 to 1.44) among CKD cohorts and 1.15 (95% CI, 1.01 to 1.31) among other cohorts during a follow-up of 3.2 years. A slope of +6 ml/min per 1.73 m 2 per year also associated with higher all-cause mortality risk, with adjusted hazard ratios of 1.58 (95% CI, 1.29 to 1.95) among CKD cohorts and 1.43 (95% CI, 1.11 to 1.84) among other cohorts. Results were similar for cardiovascular and noncardiovascular causes of death and stronger for longer antecedent periods (3 versus ,3 years). We conclude that prior decline or rise in eGFR associates with an increased risk of mortality, independent of current eGFR.

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Mortality Risks for All Causes and Cardiovascular Diseases and Reduced GFR in a Middle-aged Working Population in Taiwan

Cited by 77 publications

References 53 publications

Change in Estimated GFR Associates with Coronary Heart Disease and Mortality

Change in Estimated GFR Associates with Coronary Heart Disease and Mortality

Shift work aggravates metabolic syndrome developmentamong early-middle-aged males with elevated ALT

Past Decline Versus Current eGFR and Subsequent Mortality Risk

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