Work

Impact of Different CKD Definitions on Long-Term Renal Function and Mortality in a Population-Based Cohort Study

Year: 2024

Type: article

Abstract: Introduction: The adoption of age or individualized body surface area (i-BSA) estimated glomerular filtration rate (eGFR) thresholds could influence the prevalence and prognosis of chronic kidney disease (CKD). This longitudinal study with up to 15 years of follow-up in the general population, compares different eGFR thresholds for CKD definition: standard, corrected to i-BSA, and age-stratified. For each, we assessed the prevalence of CKD and the combined impact on rapid renal function decline (RRFD) and mortality. Methods: if aged < 40 years, 40 to 65 years, and > 65 years, respectively. We performed adjusted Cox regression analyses to predict RRFD and global mortality. Results: We analyzed 4952 participants (54% women; mean age: 52 years). Age-stratified definition resulted in 24 of 677 participants aged < 40 years reclassified as CKD, with no adverse outcomes; whereas 55 of 713 participants aged > 65 years were reclassified as non-CKD, with 12 deaths and 1 RRFD. After multivariate adjustment, the CKD group had a poorer prognosis compared with the non-CKD group independently of the definition used; hazard ratio (HR) and 95% confidence interval (CI) were 2.23 (1.59-3.12), 2.06 (1.46-2.90), and 1.64 (1.13-2.38) for the standard, corrected to i-BSA, and age-stratified definitions, respectively. Conclusion: In our study, classification of CKD by age or i-BSA does not appear to improve prediction of RRFD and mortality.

Source: Kidney International Reports

DOI: 10.1016/j.ekir.2024.11.027