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The minimum-mortality estimated glomerular filtration rate percentile shifts upward in the aged population: a nationwide population-based study

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Author(s)
Yaerim KimSoojin LeeYeonhee LeeSehoon ParkSanghyun ParkJin Hyuk PaekWoo Yeong ParkKyubok JinSeungyeup HanYong Chul KimSeung Seok HanHajeong LeeJung Pyo LeeKwon Wook JooChun Soo LimYon Su KimKyungdo HanDong Ki Kim
Keimyung Author(s)
Kim, Yae RimPaek, Jin HyukPark, Woo YoungJin, Kyu BokHan, Seung Yeup
Department
Dept. of Internal Medicine (내과학)
Journal Title
Clin Kidney J
Issued Date
2021
Volume
14
Issue
5
Keyword
all-cause mortalityestimated glomerular filtration rateelderly
Abstract
Background:
The estimated glomerular filtration rate (eGFR) is a biomarker not only for kidney function, but also for major clinical outcomes. We aimed to evaluate the patterns of mortality across the entire eGFR percentile spectrum using a population-based dataset.

Methods:
We retrospectively reviewed the National Health Insurance Service (NHIS) database for people who received nationwide health check-ups from 2009 to 2012. Subjects who were ≥45 years old and had one or more serum creatinine values available were included in the study. The primary outcome was all-cause mortality as a function of eGFR percentile.

Results:
The middle-aged group (45–64 years) showed a U-shaped pattern of association between eGFR percentile and all-cause mortality. The minimum-mortality eGFR percentile was shifted upward in the elderly group (≥65 years). Specifically, the minimum-mortality eGFR percentiles were the 28th percentile (83.8 mL/min/1.73 m2) for middle-aged males, the 63rd percentile (86.2 mL/min/1.73 m2) for elderly males, the 42nd percentile (102.8 mL/min/1.73 m2) for middle-aged females and the 75th percentile (90.1 mL/min/1.73 m2) for elderly females. Diabetes and hypertension shifted the minimum-mortality eGFR percentile upward in the middle-aged group. This pattern was attenuated in the elderly group.

Conclusions:
The eGFR percentile showing minimum mortality moves upward in the aged population as well as patients with diabetes and hypertension, which might reduce the clinical significance of hyperfiltration. Risk stratification for mortality should be approached differently according to the specific conditions of the patient group.
Keimyung Author(s)(Kor)
김예림
백진혁
박우영
진규복
한승엽
Publisher
School of Medicine (의과대학)
Citation
Yaerim Kim et al. (2021). The minimum-mortality estimated glomerular filtration rate percentile shifts upward in the aged population: a nationwide population-based study. Clin Kidney J, 14(5), 1356–1363. doi: 10.1093/ckj/sfaa238
Type
Article
ISSN
2048-8513
Source
https://academic.oup.com/ckj/article/14/5/1356/6055034
DOI
10.1093/ckj/sfaa238
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43787
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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