RENAL RESEARCH INSTITUTE SYMPOSIUM: The Longitudinal Chronic Kidney Disease Study: A Prospective Cohort Study of Predialysis Renal Failure

Perlman, Rachel L.; Kiser, Margaret; Finkelstein, Fredric O.; Eisele, George; Roys, Erik; Liu, Lei; Burrows-Hudson, Sally; Port, Friedrich K.; Messana, Joseph M.; Bailie, George R.; Rajagopalan, Sanjay; Saran, Rajiv

doi:10.1046/j.1525-139x.2003.16093.x

Cited by 26 publications

(18 citation statements)

References 23 publications

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“…Although we did not detect a temporal pattern of increasing use of ACEi/ARBs within the relatively short timeframe of the administrative analysis, our literature review suggested a linear trend of increasing reported use of these medications among CKD patients over a broader observation period spanning 1990-2003 [31,33,39,42]. Concern for side effects may explain lack of administration to some CKD patients.…”

Section: Discussionmentioning

confidence: 55%

Delivery patterns of recommended chronic kidney disease care in clinical practice: administrative claims-based analysis and systematic literature review

et al. 2008

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Section: Discussionmentioning

confidence: 55%

Delivery patterns of recommended chronic kidney disease care in clinical practice: administrative claims-based analysis and systematic literature review

et al. 2008

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“…Data from all nephrology clinic visits were, therefore, recorded. Details of the study design have been previously published [10]. …”

Section: Methodsmentioning

confidence: 99%

Serum Sodium Levels and Patient Outcomes in an Ambulatory Clinic-Based Chronic Kidney Disease Cohort

et al. 2015

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Background: Chronic kidney disease (CKD) patients are prone to both hypo- and hypernatremia. Little has been published on the epidemiology of hypo- and hypernatremia in ambulatory patients with non-dialysis CKD. Methods: Data collected in two contemporaneous CKD cohort studies, the Renal Research Institute (RRI)-CKD study (n = 834) and the Study of Treatment of Renal Insufficiency: Data and Evaluation (STRIDE) (n = 1,348) were combined and analyzed to study the association between serum sodium (Na⁺) and clinical outcomes. Results: Baseline estimated glomerular filtration rate (eGFR) and Na⁺ were 26 ± 11 ml/min/1.73 m² and 140.2 ± 3.4 mEq/l, respectively. The prevalence of Na⁺ ≤135 mEq/l and ≥144 mEq/l was 6 and 16%, respectively. Higher baseline Na⁺ was significantly associated with male sex, older age, systolic blood pressure, BMI, serum albumin, presence of heart failure, and lower eGFR. The risk of end-stage renal disease (ESRD) was marginally significantly higher among patients with Na⁺ ≤135 mEq/l, compared with 140< Na⁺ <144 mEq/l (referent), in time-dependent models (adjusted hazard ratio, HR = 1.52, p = 0.06). Mortality risk was significantly greater at 135< Na⁺ ≤140 mEq/l (adjusted HR = 1.68, p = 0.02) and Na⁺ ≥144 mEq/l (adjusted HR = 2.01, p = 0.01). Conclusion: CKD patients with Na⁺ ≤135 mEq/l were at a higher risk for progression to ESRD, whereas both lower and higher Na⁺ levels were associated with a higher risk of mortality. While caring for CKD patients, greater attention to serum sodium levels by clinicians is warranted and could potentially help improve patient outcomes.

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“…The institutional review boards at all participating sites approved the study, and all patients provided written informed consent. Details of the study design have been published previously (10).…”

Section: Data Source: the Renal Research Institute Ckd Studymentioning

confidence: 99%

Serum Potassium and Outcomes in CKD

Korgaonkar¹,

Tilea²,

Gillespie³

et al. 2010

Clinical Journal of the American Society of Nephrology

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Background and objectives:The relationship between serum potassium (S K ) and mortality in chronic kidney disease (CKD) has not been systematically investigated.Design, setting, participants, & measurements: We examined the predictors and mortality association of S K in the Renal Research Institute CKD Study cohort, wherein 820 patients with CKD were prospectively followed at four US centers for an average of 2.6 years. Predictors of S K were investigated using linear and repeated measures regression models. Associations between S K and mortality, the outcomes of ESRD, and cardiovascular events in time-dependent Cox models were examined.Results: The mean age was 60.5 years, 80% were white, 90% had hypertension, 36% had diabetes, the average estimated GFR was 25.4 ml/min per 1.73 m 2 , and mean baseline S K was 4.6 mmol/L. Higher S K was associated with male gender, lower estimated GFR and serum bicarbonate, absence of diuretic and calcium channel blocker use, diabetes, and use of angiotensinconverting enzyme inhibitors and/or statins. A U-shaped relationship between S K and mortality was observed, with mortality risk significantly greater at S K <4.0 mmol/L compared with 4.0 to 5.5 mmol/L. Risk for ESRD was elevated at S K <4 mmol/L in S K categorical models. Only the composite of cardiovascular events or death as an outcome was associated with higher S K (>5.5).Conclusions: Although clinical practice usually emphasizes greater attention to elevated S K in the setting of CKD, our results suggest that patients who have CKD and low or even low-normal S K are at higher risk for dying than those with mild to moderate hyperkalemia.

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RENAL RESEARCH INSTITUTE SYMPOSIUM: The Longitudinal Chronic Kidney Disease Study: A Prospective Cohort Study of Predialysis Renal Failure

Cited by 26 publications

References 23 publications

Delivery patterns of recommended chronic kidney disease care in clinical practice: administrative claims-based analysis and systematic literature review

Delivery patterns of recommended chronic kidney disease care in clinical practice: administrative claims-based analysis and systematic literature review

Serum Sodium Levels and Patient Outcomes in an Ambulatory Clinic-Based Chronic Kidney Disease Cohort

Serum Potassium and Outcomes in CKD

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