Global cardiovascular and renal outcomes of reduced GFR

On behalf of the Global Burden of Disease 2013 GFR Collaborators, CKD Prognosis Consortium, and Global Burden of Disease Genitourinary Expert Group
,
Bernadette Thomas(corresponding author)(Author)
,
Kunihiro Matsushita(Author)
,
Kalkidan Hassen Abate(Author)
,
Ziyad Al-Aly(Author)
,
Johan Ärnlöv(Author)

*Corresponding author for this work

University of Washington
,
University of Washington
,
Johns Hopkins University
,
Jimma University
,
Washington University in Saint Louis
,
Karolinska Institutet

Research Output:

Contribution to journal

Article

Peer-review

Open access

Publication Information

Output type

Research Output:

Contribution to journal

Article

Peer-review

Original language

English

Pages from-to (Number of pages)

Pages 2167-2179 (13 pages)

Journal (Volume, Issue Number)

Journal of the American Society of Nephrology (Volume 28, Issue 7)

Publication milestones

Published - 07/2017

Publication status

Published - 07/2017

ISSN

1046-6673

Publication IDs

Scopus: 85021768228
PubMed: 28408440

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.