Cystatin C and long-term mortality among subjects with normal creatinine-based estimated glomerular filtration rates: NHANES III (Third National Health and Nutrition Examination Survey)

摘要: Objectives The objective was to test the association of cystatin C (Cys-C) with long-term mortality risk in subjects normal creatinine-based estimated glomerular filtration rates (eGFR). Background Cys-C has been proposed as a sensitive indicator renal dysfunction that is associated cardiovascular events. predictive value for (both and noncardiovascular) its utility among persons kidney function remains unclear. Methods analysis included 2,990 over 40 years age eGFR who participated NHANES III (Third National Health Nutrition Examination Survey). Normal defined by Modification Diet Renal Disease (MDRD) equation ≥60 ml/min/1.73 m2. Serum categorized high, medium, or low. In 1 analysis, high low groups were top bottom 10%, second they upper lower thirds. All-cause cause-specific obtained from III–linked follow-up file through December 31, 2006. Multivariate Cox regression models applied assess interest. Results Within an average 13.7 follow-up, 488 719 noncardiovascular deaths occurred. When first last deciles compared, relative risks all increased statistically follows: all-cause, 4.36 (95% confidence interval [CI]: 2.52 7.82); cardiovascular, 7.44 CI: 3.06 18.1); cancer, 2.45 0.85 7.04); 3.15 1.53 6.49) mortalities. Relative moderated values when comparisons expanded include Similar associations still present modeled on continuous scale, suggesting linear relationship between outcomes. Conclusions prognostic relatively function, independent MDRD albuminuria.