Kidney function and mortality in octogenarians: Cardiovascular Health Study All Stars

Shani Shastri; Ronit Katz; Dena E. Rifkin; Linda F. Fried; Michelle C. Odden; Carmen A. Peralta; Michel Chonchol; David Siscovick; Michael G. Shlipak; Anne B. Newman; Mark J. Sarnak

doi:10.1111/j.1532-5415.2012.04046.x

Kidney function and mortality in octogenarians: Cardiovascular Health Study All Stars

Shani Shastri, Ronit Katz, Dena E. Rifkin, Linda F. Fried, Michelle C. Odden, Carmen A. Peralta, Michel Chonchol, David Siscovick, Michael G. Shlipak, Anne B. Newman, Mark J. Sarnak

Research output: Contribution to journal › Article › peer-review

39 Scopus citations

Abstract

Objectives To examine the association between kidney function and all-cause mortality in octogenarians. Design Retrospective analysis of prospectively collected data. Setting Community. Participants Serum creatinine and cystatin C were measured in 1,053 Cardiovascular Health Study (CHS) All Stars participants. Measurements Estimated glomerular filtration rate (eGFR) was determined using the Chronic Kidney Disease Epidemiology Collaboration creatinine (eGFR _CR) and cystatin C one-variable (eGFR_CYS) equations. The association between quintiles of kidney function and all-cause mortality was analyzed using unadjusted and adjusted Cox proportional hazards models. Results Mean age of the participants was 85, 64% were female, 66% had hypertension, 14% had diabetes mellitus, and 39% had prevalent cardiovascular disease. There were 154 deaths over a median follow-up of 2.6 years. The association between eGFR_CR and all-cause mortality was U-shaped. In comparison with the reference quintile (64-75 mL/min per 1.73 m²), the highest (≥75 mL/min per 1.73 m²) and lowest (≤43 mL/min per 1.73 m²) quintiles of eGFR_CR were independently associated with mortality (hazard ratio (HR) = 2.49, 95% confidence interval (CI) = 1.36-4.55; HR = 2.28, 95% CI = 1.26-4.10, respectively). The association between eGFR_CR and all-cause mortality was linear in those with eGFR_CYS of less than 60 mL/min per 1.73 m², and in the multivariate analyses, the lowest quintile of eGFR_CYS (>52 mL/min per 1.73 m²) was significantly associated with mortality (HR = 2.04, 95% CI = 1.12-3.71) compared with the highest quintile (>0.88 mL/min per 1.73 m²). Conclusion Moderate reduction in kidney function is a risk factor for all-cause mortality in octogenarians. The association between eGFR_CYS and all-cause mortality differed from that observed with eGFR_CYS; the relationship was U-shaped for eGFR_CR, whereas the risk was primarily present in the lowest quintile for eGFR_CYS.

Original language	English (US)
Pages (from-to)	1201-1207
Number of pages	7
Journal	Journal of the American Geriatrics Society
Volume	60
Issue number	7
DOIs	https://doi.org/10.1111/j.1532-5415.2012.04046.x
State	Published - Jul 2012

Keywords

kidney function
mortality
octogenarians

ASJC Scopus subject areas

Geriatrics and Gerontology

Access to Document

10.1111/j.1532-5415.2012.04046.x

Cite this

@article{3bf9bb0c98c04db9a94a8a5b1b7b841f,

title = "Kidney function and mortality in octogenarians: Cardiovascular Health Study All Stars",

abstract = "Objectives To examine the association between kidney function and all-cause mortality in octogenarians. Design Retrospective analysis of prospectively collected data. Setting Community. Participants Serum creatinine and cystatin C were measured in 1,053 Cardiovascular Health Study (CHS) All Stars participants. Measurements Estimated glomerular filtration rate (eGFR) was determined using the Chronic Kidney Disease Epidemiology Collaboration creatinine (eGFR CR) and cystatin C one-variable (eGFRCYS) equations. The association between quintiles of kidney function and all-cause mortality was analyzed using unadjusted and adjusted Cox proportional hazards models. Results Mean age of the participants was 85, 64% were female, 66% had hypertension, 14% had diabetes mellitus, and 39% had prevalent cardiovascular disease. There were 154 deaths over a median follow-up of 2.6 years. The association between eGFRCR and all-cause mortality was U-shaped. In comparison with the reference quintile (64-75 mL/min per 1.73 m2), the highest (≥75 mL/min per 1.73 m2) and lowest (≤43 mL/min per 1.73 m2) quintiles of eGFRCR were independently associated with mortality (hazard ratio (HR) = 2.49, 95% confidence interval (CI) = 1.36-4.55; HR = 2.28, 95% CI = 1.26-4.10, respectively). The association between eGFRCR and all-cause mortality was linear in those with eGFRCYS of less than 60 mL/min per 1.73 m2, and in the multivariate analyses, the lowest quintile of eGFRCYS (>52 mL/min per 1.73 m2) was significantly associated with mortality (HR = 2.04, 95% CI = 1.12-3.71) compared with the highest quintile (>0.88 mL/min per 1.73 m2). Conclusion Moderate reduction in kidney function is a risk factor for all-cause mortality in octogenarians. The association between eGFRCYS and all-cause mortality differed from that observed with eGFRCYS; the relationship was U-shaped for eGFRCR, whereas the risk was primarily present in the lowest quintile for eGFRCYS.",

keywords = "kidney function, mortality, octogenarians",

author = "Shani Shastri and Ronit Katz and Rifkin, {Dena E.} and Fried, {Linda F.} and Odden, {Michelle C.} and Peralta, {Carmen A.} and Michel Chonchol and David Siscovick and Shlipak, {Michael G.} and Newman, {Anne B.} and Sarnak, {Mark J.}",

year = "2012",

month = jul,

doi = "10.1111/j.1532-5415.2012.04046.x",

language = "English (US)",

volume = "60",

pages = "1201--1207",

journal = "Journal of the American Geriatrics Society",

issn = "0002-8614",

publisher = "Wiley-Blackwell",

number = "7",

}

TY - JOUR

T1 - Kidney function and mortality in octogenarians

T2 - Cardiovascular Health Study All Stars

AU - Shastri, Shani

AU - Katz, Ronit

AU - Rifkin, Dena E.

AU - Fried, Linda F.

AU - Odden, Michelle C.

AU - Peralta, Carmen A.

AU - Chonchol, Michel

AU - Siscovick, David

AU - Shlipak, Michael G.

AU - Newman, Anne B.

AU - Sarnak, Mark J.

PY - 2012/7

Y1 - 2012/7

N2 - Objectives To examine the association between kidney function and all-cause mortality in octogenarians. Design Retrospective analysis of prospectively collected data. Setting Community. Participants Serum creatinine and cystatin C were measured in 1,053 Cardiovascular Health Study (CHS) All Stars participants. Measurements Estimated glomerular filtration rate (eGFR) was determined using the Chronic Kidney Disease Epidemiology Collaboration creatinine (eGFR CR) and cystatin C one-variable (eGFRCYS) equations. The association between quintiles of kidney function and all-cause mortality was analyzed using unadjusted and adjusted Cox proportional hazards models. Results Mean age of the participants was 85, 64% were female, 66% had hypertension, 14% had diabetes mellitus, and 39% had prevalent cardiovascular disease. There were 154 deaths over a median follow-up of 2.6 years. The association between eGFRCR and all-cause mortality was U-shaped. In comparison with the reference quintile (64-75 mL/min per 1.73 m2), the highest (≥75 mL/min per 1.73 m2) and lowest (≤43 mL/min per 1.73 m2) quintiles of eGFRCR were independently associated with mortality (hazard ratio (HR) = 2.49, 95% confidence interval (CI) = 1.36-4.55; HR = 2.28, 95% CI = 1.26-4.10, respectively). The association between eGFRCR and all-cause mortality was linear in those with eGFRCYS of less than 60 mL/min per 1.73 m2, and in the multivariate analyses, the lowest quintile of eGFRCYS (>52 mL/min per 1.73 m2) was significantly associated with mortality (HR = 2.04, 95% CI = 1.12-3.71) compared with the highest quintile (>0.88 mL/min per 1.73 m2). Conclusion Moderate reduction in kidney function is a risk factor for all-cause mortality in octogenarians. The association between eGFRCYS and all-cause mortality differed from that observed with eGFRCYS; the relationship was U-shaped for eGFRCR, whereas the risk was primarily present in the lowest quintile for eGFRCYS.

AB - Objectives To examine the association between kidney function and all-cause mortality in octogenarians. Design Retrospective analysis of prospectively collected data. Setting Community. Participants Serum creatinine and cystatin C were measured in 1,053 Cardiovascular Health Study (CHS) All Stars participants. Measurements Estimated glomerular filtration rate (eGFR) was determined using the Chronic Kidney Disease Epidemiology Collaboration creatinine (eGFR CR) and cystatin C one-variable (eGFRCYS) equations. The association between quintiles of kidney function and all-cause mortality was analyzed using unadjusted and adjusted Cox proportional hazards models. Results Mean age of the participants was 85, 64% were female, 66% had hypertension, 14% had diabetes mellitus, and 39% had prevalent cardiovascular disease. There were 154 deaths over a median follow-up of 2.6 years. The association between eGFRCR and all-cause mortality was U-shaped. In comparison with the reference quintile (64-75 mL/min per 1.73 m2), the highest (≥75 mL/min per 1.73 m2) and lowest (≤43 mL/min per 1.73 m2) quintiles of eGFRCR were independently associated with mortality (hazard ratio (HR) = 2.49, 95% confidence interval (CI) = 1.36-4.55; HR = 2.28, 95% CI = 1.26-4.10, respectively). The association between eGFRCR and all-cause mortality was linear in those with eGFRCYS of less than 60 mL/min per 1.73 m2, and in the multivariate analyses, the lowest quintile of eGFRCYS (>52 mL/min per 1.73 m2) was significantly associated with mortality (HR = 2.04, 95% CI = 1.12-3.71) compared with the highest quintile (>0.88 mL/min per 1.73 m2). Conclusion Moderate reduction in kidney function is a risk factor for all-cause mortality in octogenarians. The association between eGFRCYS and all-cause mortality differed from that observed with eGFRCYS; the relationship was U-shaped for eGFRCR, whereas the risk was primarily present in the lowest quintile for eGFRCYS.

KW - kidney function

KW - mortality

KW - octogenarians

UR - http://www.scopus.com/inward/record.url?scp=84863834560&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84863834560&partnerID=8YFLogxK

U2 - 10.1111/j.1532-5415.2012.04046.x

DO - 10.1111/j.1532-5415.2012.04046.x

M3 - Article

C2 - 22724391

AN - SCOPUS:84863834560

SN - 0002-8614

VL - 60

SP - 1201

EP - 1207

JO - Journal of the American Geriatrics Society

JF - Journal of the American Geriatrics Society

IS - 7

ER -

Kidney function and mortality in octogenarians: Cardiovascular Health Study All Stars

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this