Association between higher variability in kidney function and long-term mortality

Area of Science:

• Nephrology
• Epidemiology
• Public Health

Background:

• Kidney function is typically assessed using estimated glomerular filtration rate (eGFR).
• Variability in eGFR measurements over time may reflect underlying health status or disease progression.
• Understanding factors associated with mortality is crucial for public health initiatives.

Purpose of the Study:

• To investigate the association between estimated glomerular filtration rate variability and all-cause mortality in a general population.
• To determine if eGFR variability is an independent predictor of mortality.

Main Methods:

• Utilized health examination data from 7842 adults (>20 years) with at least three eGFR measurements over a minimum of 6-month intervals.
• Calculated eGFR variability using the coefficient of variation (standard deviation/mean * 100).
• Stratified participants into tertiles of eGFR variability and compared mortality risks using survival analysis.

Main Results:

• The highest eGFR variability group (mean CV: 14.4%) exhibited a 1.3-fold increased risk of all-cause mortality compared to the lowest variability group.
• This association remained significant after adjusting for potential confounders.
• Elevated eGFR variability was also associated with increased mortality risk in subgroups, including patients with diabetes and individuals over 60 years old.

Conclusions:

• Higher estimated glomerular filtration rate variability is significantly associated with increased 10-year all-cause mortality in the general population.
• Despite typically small fluctuations, eGFR variability is a significant indicator for long-term prognosis.
• eGFR variability may serve as a valuable marker for assessing mortality risk.