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Updated: Jan 30, 2026
Transdermal Measurement of Glomerular Filtration Rate in Mice
Published on: October 21, 2018
Visit-to-visit variability in estimated glomerular filtration rate predicts hospitalization and death due to
Akira Suzuki1, Yoshitsugu Obi2, Terumasa Hayashi3
1Department of Internal Medicine, Japan Community Healthcare Organization Osaka Hospital, 4-2-78 Fukushima Fukushima-ku, Osaka, 553-0003, Japan. suzuki-akira@osaka.jcho.go.jp.
Insights
Greater variability in estimated glomerular filtration rate (eGFR) in chronic kidney disease (CKD) patients predicts cardiovascular events. However, eGFR variability did not associate with end-stage kidney disease progression.
Area of Science:
- Nephrology
- Cardiology
- Clinical Epidemiology
Background:
- Estimated glomerular filtration rate (eGFR) variability is linked to mortality in chronic kidney disease (CKD).
- The specific association between eGFR variability and cardiovascular (CV) mortality or end-stage kidney disease (ESKD) in CKD patients remains unclear.
- Clarifying this association is crucial for risk stratification and management.
Purpose of the Study:
- To investigate the relationship between eGFR variability and adverse cardiovascular and renal outcomes in Asian patients with CKD.
- To determine if higher eGFR variability predicts increased risk of CV events or kidney disease progression.
- To stratify patients based on eGFR variability and assess associated risks.
Main Methods:
- Analysis of 2869 Asian CKD patients, stratified into tertiles based on eGFR variability in the first year.
- Median follow-up of 3.15 years, with primary endpoints including CV hospitalization/death and renal endpoints (doubling of serum creatinine or ESKD).
- Multivariate Cox hazard models, adjusted for risk factors and eGFR slope, were used to evaluate risks.
Main Results:
- Patients in the highest tertile of eGFR variability had a significantly higher risk of CV events (HR 1.90; 95% CI 1.03-3.71) compared to the lowest tertile.
- CV endpoints occurred in 2.89%, 5.69%, and 10.79% of patients across the lowest, intermediate, and highest tertiles, respectively.
- No significant association was found between eGFR variability and renal composite endpoints.
Conclusions:
- Variability in estimated glomerular filtration rate (eGFR) is a significant predictor of cardiovascular outcomes in patients with chronic kidney disease (CKD).
- eGFR variability does not appear to be associated with the progression to end-stage kidney disease (ESKD) or doubling of serum creatinine.
- These findings highlight the importance of monitoring eGFR fluctuations for cardiovascular risk assessment in CKD patients.
Background:
Greater variability in estimated glomerular filtration rate (eGFR) is associated with mortality in patients with chronic kidney disease (CKD). However, the association between eGFR variability and cardiovascular (CV) mortality and/or end-stage kidney disease (ESKD) in the CKD population is not very clear. This study aimed to clarify whether such an association exists.
Methods:
We analyzed a final cohort of 2869 eligible Asian patients with CKD. Patients were stratified into three groups according to eGFR variability during the first year and were followed-up for a median of 3.15 years. Primary CV composite endpoints were hospitalization or death due to CV events, and renal composite endpoints were doubling of serum creatinine levels or ESKD. Multivariate Cox hazard models adjusted for classical risk factors and eGFR slope were used to examine the CV and renal risk associated with eGFR variability.
Results:
CV endpoints were observed in 14 (2.89%), 25 (5.69%), and 41 (10.79%) patients and renal endpoints were observed in 165 (27.6%), 235 (39.0%), and 298 patients (50.9%) in the lowest, intermediate, and highest tertiles of eGFR variability, respectively. Patients in the highest tertile were at a significantly higher risk for CV events (hazard ratio 1.90; 95% confidence interval 1.03-3.71) than those in the lowest tertile. However, there was no association between eGFR variability and renal endpoints.
Conclusions:
Variability in eGFR can predict CV outcomes among patients with CKD.
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