Glomerular filtration rate and proteinuria: association with mortality and renal progression in a prospective cohort of a community-based elderly population.
Limited prospective data are available on the importance of estimated glomerular filtration rate (GFR) and proteinuria in the prediction of all-cause mortality (ACM) in community-based elderly populations. We examined the relationship between GFR or proteinuria and ACM in 949 randomly selected community-dwelling elderly subjects (aged ≥65 years) over a 5-year period. A spot urine sample was used to measure proteinuria by the dipstick test, and GFR was estimated using the chronic kidney disease-epidemiology collaboration (CKD-EPI) equation. Information about mortality and causes of death was collected by direct enquiry with the subjects and from the national mortality data. Compared to subjects without proteinuria, those with proteinuria of grade ≥1+ had a 1.725-fold (1.134-2.625) higher risk of ACM. Compared to subjects with GFR ≥90 ml/min/1.73 m2, those with GFR<45 ml/min/1.73 m2 had a 2.357 -fold (1.170-4.750) higher risk for ACM. Among the 403 subjects included in the analysis of renal progression, the annual rate of GFR change during follow-up period was -0.52±2.35 ml/min/1.73 m2/year. The renal progression rate was 7.315-fold (1.841-29.071) higher in subjects with GFR<60 ml/min/1.73 m2 than in those with GFR ≥60 ml/min/1.73 m2. Among a community-dwelling elderly Korean population, decreased GFR of <45 ml/min/1.73 m2 and proteinuria were independent risk factors for ACM.
Department of Internal Medicine, Inje University College of Medicine, Goyang City, Gyeonggi-do, Korea.
Se Won
SW
Oh
Department of Internal Medicine, Seoul National University Bundang Hopsital, Seong-Nam, Korea.
Sejoong
S
Kim
Department of Internal Medicine, Seoul National University Bundang Hopsital, Seong-Nam, Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Ki Young
KY
Na
Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea.
Ki Woong
KW
Kim
Department of Internal Medicine, Seoul National University Bundang Hopsital, Seong-Nam, Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Dong-Wan
DW
Chae
Department of Internal Medicine, Seoul National University Bundang Hopsital, Seong-Nam, Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Ho Jun
HJ
Chin
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000150:complications* / Q000503:physiopathology; D008297:Male; D011446:Prospective Studies; D011507:Proteinuria / Q000150:complications / Q000401:mortality* / Q000503:physiopathology*; D012111:Residence Characteristics