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Assessment of Kidney Function in Mouse Models of Glomerular Disease
Published on: June 30, 2018
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估计的淋巴膜过率,白膜尿和不良结果:个体参与者数据的元分析
, Morgan E Grams1,2, Josef Coresh2
1Division of Precision Medicine, Department of Medicine, Grossman School of Medicine, New York University, New York, New York.
JAMA
|October 3, 2023
概括
估计较低的膜过率 (eGFR) 和较高的白尿与脏疾病,心血管疾病和住院的风险增加有关. 这些发现强调了即使在轻度慢性病中,监测功能的重要性.
科学领域:
- 肝脏病学
- 心血管医学
- 流行病学
背景情况:
- 慢性病 (CKD) 影响了14%的美国成年人,其特征是估计低球过率 (eGFR) 或白膜尿.
- 早期检测和风险评估对于治疗慢性病及其相关并发症至关重要.
研究的目的:
- 评估较低的EGFR (单独使用肌素或与囊素C结合使用) 和较高的白蛋白尿与不良脏和心血管结局之间的关联.
- 评估其他健康结果的风险,包括全因死亡率和住院病例.
主要方法:
- 对来自114个全球群体的2700多万个体 (eGFR 通过肌素) 和来自20个群体的720736个体 (eGFR 通过肌素和囊素 C) 的个人数据进行了元分析.
- 用尿中的白蛋白与肌素比率 (UACR) 来评估白蛋白尿.
- 用随机效应的元分析来总结功能衰竭,死亡率,心血管事件和住院的风险.
主要成果:
- 较低的EGFR和较高的UACR与所有10个研究的不良结果的风险增加有显著的关联.
- 即使是轻微的CKD类别也显示出显著更高的风险;例如,与更高的EGFR水平相比,45-59毫升/分钟/1.73平方米的EGFR与更高的住院率有关.
- 不同的eGFR估计方法和albuminuria水平的相关性是一致的.
结论:
- 降低EGFR和升高UACR独立地与出现不良结局,心血管疾病和住院住院的风险相比较高.
- 这些发现强调了慢性病查和风险分层的重要性,即使在轻度功能下降或尿症患者中也是如此.
- 这项研究强调了eGFR和UACR对长期健康结果的预测价值.
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