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Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration01:28

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The Glomerular Filtration Rate (GFR) is a measure of kidney function, reflecting the volume of filtrate formed per minute in the kidneys. On average, GFR is approximately 125 mL/min in males and 105 mL/min in females. Maintaining a relatively constant GFR is essential for the kidneys to effectively regulate body fluid homeostasis and maintain extracellular stability.
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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Published on: June 16, 2014

Mild decrease in estimated glomerular filtration rate and proteinuria are associated with all-cause and

Se Won Oh1, Seon Ha Baek, Yong Chul Kim

  • 1Department of Internal Medicine, Seoul National University Bundang Hospital, Kyeong-Kido, Korea.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|December 6, 2011
PubMed
Summary

Reduced kidney function (estimated glomerular filtration rate <75 mL/min/1.73 m(2)) and proteinuria are independent risk factors for all-cause and cardiovascular mortality in the general population.

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Area of Science:

  • Nephrology
  • Public Health
  • Epidemiology

Background:

  • Previous meta-analyses identified estimated glomerular filtration rate (eGFR) and albumin-to-creatinine ratio as mortality predictors.
  • Limitations in prior studies included selection bias, cohort heterogeneity, and measurement variability.

Purpose of the Study:

  • To investigate the association between eGFR, proteinuria, and mortality in a large, homogenous Korean population.
  • To validate findings from global studies within a specific demographic context.

Main Methods:

  • Analysis of 112,115 Korean adults (≥20 years) with standardized creatinine measurements (2003-2009).
  • Assessment of proteinuria using urine dipstick (trace or more).
  • Evaluation of the independent relationship between eGFR, proteinuria, and all-cause/cardiovascular mortality.

Main Results:

  • Both reduced eGFR (<75 mL/min/1.73 m(2)) and proteinuria were independently associated with increased all-cause mortality (ACM) and cardiovascular mortality (CVM).
  • Mortality risk progressively increased with declining eGFR levels and the presence of proteinuria.
  • Compared to eGFR 90-105 mL/min/1.73 m(2), hazard ratios for ACM ranged from 1.60 to 3.77 across different eGFR categories and proteinuria status.

Conclusions:

  • Mild renal impairment (eGFR <75 mL/min/1.73 m(2)) and mild proteinuria (trace or more) are significant independent risk factors for ACM and CVM.
  • These findings highlight the increased risk of adverse outcomes in the general population with early signs of kidney disease.