Relationship of Estimated GFR and Albuminuria to Concurrent Laboratory Abnormalities: An Individual Participant Data Meta-analysis in a Global Consortium.
Link: https://doi.org/S0272-6386(18)30916-8
Authors: Inker, Lesley A; Grams, Morgan E; Levey, Andrew S; Coresh, Josef; Cirillo, Massimo; Collins, John F; Gansevoort, Ron T; Gutierrez, Orlando M; Hamano, Takayuki; Heine, Gunnar H; Ishikawa, Shizukiyo; Jee, Sun Ha; Kronenberg, Florian; Landray, Martin J; Miura, Katsuyuki; Nadkarni, Girish N; Peralta, Carmen A; Rothenbacher, Dietrich; Schaeffner, Elke; Sedaghat, Sanaz; Shlipak, Michael G; Zhang, Luxia; van Zuilen, Arjan D; Hallan, Stein I; Kovesdy, Csaba P; Woodward, Mark; Levin, Adeera; ,
Abstract: Chronic kidney disease (CKD) is complicated by abnormalities that reflect disruption in filtration, tubular, and endocrine functions of the kidney. Our aim was to explore the relationship of specific laboratory result abnormalities and hypertension with the estimated glomerular filtration rate (eGFR) and albuminuria CKD staging framework. Cross-sectional individual participant-level analyses in a global consortium. 17 CKD and 38 general population and high-risk cohorts. Cohorts in the CKD Prognosis Consortium with data for eGFR and albuminuria, as well as a measurement of hemoglobin, bicarbonate, phosphorus, parathyroid hormone, potassium, or calcium, or hypertension. Data were obtained and analyzed between July 2015 and January 2018. We modeled the association of eGFR and albuminuria with hemoglobin, bicarbonate, phosphorus, parathyroid hormone, potassium, and calcium values using linear regression and with hypertension and categorical definitions of each abnormality using logistic regression. Results were pooled using random-effects meta-analyses. Variations in study era, health care delivery system, typical diet, and laboratory assays. Lower eGFR was strongly associated with higher odds of multiple laboratory result abnormalities. Knowledge of risk associations might help guide management in the heterogeneous group of patients with CKD.