title: Five-year decline in estimated glomerular filtration rate associated with a higher risk of renal disease and atherosclerotic vascular disease clinical events in elderly women.
abstract: BACKGROUND
  Estimated glomerular filtration rate (eGFR) has been demonstrated to predict atherosclerotic vascular disease (ASVD)-associated clinical events independent of traditional vascular risk factors. Recent studies have demonstrated that eGFR decline over time may improve prediction of ASVD-associated mortality risk in chronic kidney disease (CKD) patients.
  
  
  OBJECTIVE
  The aim of this study is to evaluate the association between 5-year change in eGFR with renal disease and ASVD-associated clinical events.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  A total of 1012 women over the age of 70 years from the Calcium Intake Fracture Outcome Study were included. Baseline characteristics including baseline and 5-year creatinine, participants' comorbidities and complete verified 10-year records for ASVD and renal disease-associated hospitalization and/or mortality were obtained using the Western Australian Data Linkage System.
  
  
  RESULTS
  Participants were stratified according to annual rate of eGFR change in quartiles [≤-1.2 (first quartile), >-1.2 to 0.1 (second quartile), >0.1-1.7 (third quartile) and >1.7 ml/min/1.73 m(2)/year (fourth quartile)]. In the adjusted model, compared with participants in the fourth quartile, those in the first and/or second quartiles of annual eGFR change had significantly higher risk of renal disease and/or ASVD-associated clinical events. However, the association with renal clinical events was more pparent in participants with baseline eGFR of <60 ml/min/1.73 m(2).
  
  
  CONCLUSIONS
  The results of this study suggest that the inclusion of long-term eGFR change over time might augment prognostication for renal disease and ASVD-associated clinical events in elderly women.
authors: University of Western Australia School of Medicine and Pharmacology, Sir Charles Gairdner Hospital Unit, Perth, Western Australia, Australia. wai.lim@health.wa.gov.au
authors: W H
authors: WH
authors: Lim
authors: J R
authors: JR
authors: Lewis
authors: G
authors: G
authors: Wong
authors: G K
authors: GK
authors: Dogra
authors: K
authors: K
authors: Zhu
authors: E M
authors: EM
authors: Lim
authors: S S
authors: SS
authors: Dhaliwal
authors: R L
authors: RL
authors: Prince
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D001315:Australia / Q000453:epidemiology; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D011379:Prognosis; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology