Global cardiovascular and renal outcomes of reduced GFR

Bernadette A Thomas, Kunihiro Matsushita, Kalkidan Hassen Abate, Ziyad Al-Aly, Johan Ärnlöv, Kei Asayama, Robert Atkins, Alaa Badawi, Shoshana H. Ballew, Amitava Banerjee, Lars Barregård, Elizabeth Barrett-Connor, Sanjay Basu, Aminu K. Bello, Isabela M Bensenor, Jaclyn Bergstrom, Boris T Bikbov, Christopher Blosser, Hermann Brenner, Juan Jesus CarreroSteve Chadban, Massimo Cirillo, Monica Cortinovis, Karen J Courville, Lalit Dandona, Rakhi Dandona, Kara Estep, João Fernandes, Florian Fischer, Caroline Fox, Ron T Gansevoort, Philimon N. Gona, Orlando M. Gutierrez, Samer Hamidi, Sarah Wulf Hanson, Jonathan Himmelfarb, Simerjot K. Jassal, Sun Ha Jee, Vivekanand Jha, Aida Jimenez-Corona, Jost B Jonas, Andre Pascal Kengne, Yousef Khader, Young-Ho Khang, Yun Jin Kim, Barbara E K Klein, Ronald Klein, Yoshihiro Kokubo, Dhaval Kolte, Kristine Lee, Andrew S Levey, Yongmei Li, Paulo Andrade Ndrade Lotufo, Hassan Magdy Abd El Razek, Walter Mendoza, Hirohito Metoki, Yejin Mok, Isao Muraki, Paul M. Muntner, Hiroyuki Noda, Takayoshi Ohkubo, Alberto Ortiz, Norberto Perico, Kevan Polkinghorne, Rajaa Al-Radaddi, Giuseppe Remuzzi, Gregory A Roth, Dietrich Rothenbacher, Michihiro Satoh, Kai Uwe Saum, Monika Sawhney, Ben Schöttker, Anoop Shankar, Michael G Shlipak, Diego Augusto Santos Silva, Hideaki Toyoshima, Kingsley Nnanna Ukwaja, Mitsumasa Umesawa, Stein Emil Vollset, David G Warnock, Andrea Werdecker, Kazumasa Yamagishi, Yuichiro Yano, Naohiro Yonemoto, Maysaa El Sayed Zaki, Mohsen Naghavi, Mohammad H Forouzanfar, Christopher J.L. Murray, Josef Coresh, Theo Vos, on behalf of the Global Burden of Disease 2013 GFR Collaborators, CKD Prognosis Consortium, and Global Burden of Disease Genitourinary Expert Group

Research output: Contribution to journalArticleResearchpeer-review

88 Citations (Scopus)

Abstract

The burden of premature death and health loss from ESRD is well described. Less is known regarding the burden of cardiovascular disease attributable to reduced GFR. We estimated the prevalence of reduced GFR categories 3, 4, and 5 (not on RRT) for 188 countries at six time points from1990 to 2013. Relative risks of cardiovascular outcomes by three categories of reducedGFRwere calculated by pooled randomeffects meta-analysis. Results are presented as deaths for outcomes of cardiovascular disease and ESRD and as disability-adjusted life years for outcomes of cardiovascular disease,GFR categories 3, 4, and 5, and ESRD. In 2013, reduced GFR was associated with 4% of deaths worldwide, or 2.2 million deaths (95%uncertainty interval [95%UI], 2.0 to 2.4million).More than half of these attributable deathswere cardiovascular deaths (1.2million; 95%UI, 1.1 to 1.4million), whereas 0.96million (95%UI, 0.81 to 1.0 million) were ESRD-related deaths. Compared with metabolic risk factors, reduced GFR ranked below high systolic BP, high body mass index, and high fasting plasma glucose, and similarly with high total cholesterol as a risk factor for disability-adjusted life years in both developed and developing world regions. In conclusion, by 2013, cardiovascular deaths attributed to reduced GFR outnumbered ESRD deaths throughout the world. Studies are needed to evaluate the benefit of early detection of CKD and treatment to decrease these deaths.

Original languageEnglish
Pages (from-to)2167-2179
Number of pages13
JournalJournal of the American Society of Nephrology
Volume28
Issue number7
DOIs
Publication statusPublished - 1 Jul 2017

Cite this