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Kidney function, albuminuria and life expectancy.

Tanvir Chowdhury Turin1, Sofia B Ahmed2, Marcello Tonelli3

  • 1Department of Family Medicine, University of Calgary, Room G012F, 3330 Hospital Drive Northwest, Calgary, Alberta T2N 4N1 Canada ; Department of Community Health Sciences, University of Calgary, Calgary, Alberta Canada ; Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta Canada ; Institute of Public Health, University of Calgary, Calgary, Alberta Canada.

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Lower estimated glomerular filtration rate (eGFR) and albuminuria significantly reduce life expectancy in men and women. The degree of albuminuria, especially with eGFR ≥30 mL/min/1.73 m², substantially impacts survival, highlighting its importance in chronic kidney disease prognosis.

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Area of Science:

  • Nephrology
  • Public Health
  • Epidemiology

Background:

  • Reduced estimated glomerular filtration rate (eGFR) is linked to decreased life expectancy.
  • The impact of albuminuria on this association in chronic kidney disease (CKD) remains unclear.

Purpose of the Study:

  • To estimate the life expectancy of middle-aged adults based on varying levels of eGFR and albuminuria.
  • To investigate how albuminuria modifies the relationship between eGFR and life expectancy.

Main Methods:

  • Retrospective cohort study utilizing a large, population-based registry in Alberta, Canada.
  • Analysis of adults aged ≥30 years with baseline serum creatinine and albuminuria measurements.
  • Application of the abridged life table method to calculate life expectancies across combined eGFR and albuminuria categories.

Main Results:

  • Both men and women experienced reduced life expectancy with lower eGFR and higher albuminuria levels.
  • For 50-year-old men with eGFR ≥60, heavy albuminuria reduced life expectancy by 11.3 years compared to normal albuminuria.
  • For 50-year-old women with eGFR ≥60, heavy albuminuria reduced life expectancy by 14.2 years compared to normal albuminuria.
  • A graded reduction in life expectancy was observed with increasing kidney disease severity (eGFR and albuminuria combined).

Conclusions:

  • The presence and severity of albuminuria are significantly associated with lower life expectancy in both genders.
  • This association is particularly pronounced in individuals with eGFR ≥30 mL/min/1.73 m².
  • Life expectancy varies considerably based on the interplay between eGFR and albuminuria levels.