Kidney Function and Mortality in Octogenarians: Cardiovascular Health Study All Stars
Year: 2012
Type: article
Abstract: OBJECTIVES: To examine the association between kidney function and all-cause mortality in octogenarians. DESIGN: Retrospective analysis of prospectively collected data. SETTING: Community. PARTICIPANTS: Serum creatinine and cystatin C were measured in 1,053 Cardiovascular Health Study (CHS) All Stars participants. MEASUREMENTS: Estimated glomerular filtration rate (eGFR) was determined using the Chronic Kidney Disease Epidemiology Collaboration creatinine (eGFR(CR) ) and cystatin C one-variable (eGFR(CYS) ) equations. The association between quintiles of kidney function and all-cause mortality was analyzed using unadjusted and adjusted Cox proportional hazards models. RESULTS: Mean age of the participants was 85, 64% were female, 66% had hypertension, 14% had diabetes mellitus, and 39% had prevalent cardiovascular disease. There were 154 deaths over a median follow-up of 2.6 years. The association between eGFR(CR) and all-cause mortality was U-shaped. In comparison with the reference quintile (64-75 mL/min per 1.73 m(2) ), the highest (≥ 75 mL/min per 1.73 m(2) ) and lowest (≤ 43 mL/min per 1.73 m(2) ) quintiles of eGFR(CR) were independently associated with mortality (hazard ratio (HR) = 2.49, 95% confidence interval (CI) = 1.36-4.55; HR = 2.28, 95% CI = 1.26-4.10, respectively). The association between eGFR(CYS) and all-cause mortality was linear in those with eGFR(CYS) of less than 60 mL/min per 1.73 m(2) , and in the multivariate analyses, the lowest quintile of eGFR(CYS) (<52 mL/min per 1.73 m(2) ) was significantly associated with mortality (HR = 2.04, 95% CI = 1.12-3.71) compared with the highest quintile (>0.88 mL/min per 1.73 m(2) ). CONCLUSION: Moderate reduction in kidney function is a risk factor for all-cause mortality in octogenarians. The association between eGFR(CR) and all-cause mortality differed from that observed with eGFR(CYS) ; the relationship was U-shaped for eGFR(CR) , whereas the risk was primarily present in the lowest quintile for eGFR(CYS) .
Institutions: The University of Texas Southwestern Medical Center, University of Washington, University of California San Diego, University of Pittsburgh, VA Pittsburgh Healthcare System, Oregon State University, University of California, San Francisco, University of Colorado Denver, Tufts Medical Center
Language: English
Subfield: Nephrology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: G1002540797, G109016790, G1177103769, G1220223050, CORONARY HEART DISEASE AND STROKE, CORONARY HEART DISEASE &STROKE IN PEOPLE AGED 65-84, G1345547317, CHS-ULTRASOUND READING, CORONARY HEART DISEASE AND STROKE, MRI READING CENTER FOR THE CARDIOVASCULAR HEALTH STUDY, G1727292203, G2194386449, CORONARY HEART DISEASE &STROKE IN PEOPLE AGED 65-84, G236442059, G2391884931, G247538147, Exceptional Survival: Trajectories to Functional Aging (CHS All Stars), CORONARY HEART DISEASE &STROKE IN THE ELDERLY, G277826483, G2800149121, G3045517347, G3220743633, G328935669, G3960759621, CENTRAL BLOOD ANALYSIS LABORATORY FOR CHS, Predictors of Alheimers Disease in Mild Cognitive Impairment, G4048755144, G423252844, Subcortical Hyperintensities in Sleep Apnea Syndrome, G5217882744, G573134505, G581887176, CHS Events Follow-up Study, G61834786, G6226795708, Predictors of Alzheimers Disease in Mild Cognitive Impairment, G640327682, CHS-Transition Phase, G7176672723, CHS RETINAL READING CENTER, CARDIOVASCULAR HEALTH STUDY--ECHOCARDIOGRAPHY, G777822606, CHS Events Follow-up Study, G7999488110, G8593276544, Pittsburgh Older Americans Independence Center, G905887895
OpenAlex ID: W2013446790