Risk of ESRD and Mortality Associated With Change in Filtration Markers

摘要: Background Using change in estimated glomerular filtration rate (eGFR) based on creatinine concentration as a surrogate outcome clinical trials of chronic kidney disease has been proposed. Risk for end-stage renal (ESRD) and all-cause mortality associated with concentrations other markers not studied populations. Study Design Observational analysis 2 trials. Setting & Participants the MDRD (Modification Diet Renal Disease; n=317) AASK (African American Kidney Disease Hypertension; n=373). Predictors Creatinine, cystatin C, β-trace protein (BTP), β -microglobulin (B2M) were measured serum samples collected at 12- 24-month follow-up visits, along GFR (mGFR) these time points. Outcomes ESRD mortality. Measurements Poisson regression was used to estimate incidence ratios 95% CIs during long-term (10-16 years) per 30% decline mGFR or eGFR each marker average all 4 markers. Results 1-year mGFR, cr , BTP significantly increased risk incident both studies (all P ≤0.02). Compared only statistically more strongly (both ≤0.03). Decline but markers, (incidence ratio decline, 4.17; CI, 1.78-9.74; =0.2). Limitations Small sample size. Conclusions Declines (creatinine, BTP, B2M) consistently progression ESRD.