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Association of estimated glomerular filtration rate with all‐cause and cardiovascular mortality: the role of malnutrition–inflammation–cachexia syndrome

BACKGROUND: Previous studies have demonstrated that high estimated glomerular filtration rate (eGFR) is paradoxically associated with an increased risk of mortality, and the association becomes more predominant in older people. However, the role of malnutrition–inflammation–cachexia syndrome (MICS)...

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Autores principales: Ou, Shuo‐Ming, Chen, Yung‐Tai, Hung, Szu‐Chun, Shih, Chia‐Jen, Lin, Chi‐Hung, Chiang, Chih‐Kang, Tarng, Der‐Cherng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4864176/
https://www.ncbi.nlm.nih.gov/pubmed/27493868
http://dx.doi.org/10.1002/jcsm.12053
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author Ou, Shuo‐Ming
Chen, Yung‐Tai
Hung, Szu‐Chun
Shih, Chia‐Jen
Lin, Chi‐Hung
Chiang, Chih‐Kang
Tarng, Der‐Cherng
author_facet Ou, Shuo‐Ming
Chen, Yung‐Tai
Hung, Szu‐Chun
Shih, Chia‐Jen
Lin, Chi‐Hung
Chiang, Chih‐Kang
Tarng, Der‐Cherng
author_sort Ou, Shuo‐Ming
collection PubMed
description BACKGROUND: Previous studies have demonstrated that high estimated glomerular filtration rate (eGFR) is paradoxically associated with an increased risk of mortality, and the association becomes more predominant in older people. However, the role of malnutrition–inflammation–cachexia syndrome (MICS) in the association between eGFR and mortality has never been explored. METHODS: We conducted a community‐based cohort study using data from the Taipei City Elderly Health Examination Database, collected during the period 2001–10. All participants aged ≥65 years were included and stratified by the absence or presence of MICS, which is defined as the presence of at least one of the following markers: body mass index <22 kg/m(2), serum albumin <3.0 mg/dL, or Geriatric Nutritional Risk Index (GNRI) <98. The study endpoints were all‐cause and cardiovascular mortality. RESULTS: A total of 131 354 participants were identified and categorized according to the chronic kidney disease stage based on eGFR. Compared with the reference eGFR of 60–89 mL/min/1.73 m(2), the overall and cardiovascular mortality risks were markedly high in the groups with eGFR of <30 mL/min/1.73 m(2) [overall: adjusted hazard ratio (aHR), 1.86; 95% confidence interval (CI), 1.72–2.00; cardiovascular: aHR, 1.87; 95% CI, 1.60–2.19] and ≥90 mL/min/1.73 m(2) (overall: aHR, 1.23; 95% CI, 1.13–1.34; cardiovascular: aHR, 1.28; 95% CI, 1.06–1.54). In the absence of MICS, high eGFR was associated with lower mortality risk (aHR, 0.71; 95% CI, 0.62–0.80), and the U‐shaped relationship disappeared. Subgroup analyses produced consistent results. CONCLUSIONS: MICS could influence the association observed between high eGFR and mortality in older people, particularly in those with low body mass index, albumin level, GNRI, and very low serum creatinine level.
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spelling pubmed-48641762016-05-27 Association of estimated glomerular filtration rate with all‐cause and cardiovascular mortality: the role of malnutrition–inflammation–cachexia syndrome Ou, Shuo‐Ming Chen, Yung‐Tai Hung, Szu‐Chun Shih, Chia‐Jen Lin, Chi‐Hung Chiang, Chih‐Kang Tarng, Der‐Cherng J Cachexia Sarcopenia Muscle Original Articles BACKGROUND: Previous studies have demonstrated that high estimated glomerular filtration rate (eGFR) is paradoxically associated with an increased risk of mortality, and the association becomes more predominant in older people. However, the role of malnutrition–inflammation–cachexia syndrome (MICS) in the association between eGFR and mortality has never been explored. METHODS: We conducted a community‐based cohort study using data from the Taipei City Elderly Health Examination Database, collected during the period 2001–10. All participants aged ≥65 years were included and stratified by the absence or presence of MICS, which is defined as the presence of at least one of the following markers: body mass index <22 kg/m(2), serum albumin <3.0 mg/dL, or Geriatric Nutritional Risk Index (GNRI) <98. The study endpoints were all‐cause and cardiovascular mortality. RESULTS: A total of 131 354 participants were identified and categorized according to the chronic kidney disease stage based on eGFR. Compared with the reference eGFR of 60–89 mL/min/1.73 m(2), the overall and cardiovascular mortality risks were markedly high in the groups with eGFR of <30 mL/min/1.73 m(2) [overall: adjusted hazard ratio (aHR), 1.86; 95% confidence interval (CI), 1.72–2.00; cardiovascular: aHR, 1.87; 95% CI, 1.60–2.19] and ≥90 mL/min/1.73 m(2) (overall: aHR, 1.23; 95% CI, 1.13–1.34; cardiovascular: aHR, 1.28; 95% CI, 1.06–1.54). In the absence of MICS, high eGFR was associated with lower mortality risk (aHR, 0.71; 95% CI, 0.62–0.80), and the U‐shaped relationship disappeared. Subgroup analyses produced consistent results. CONCLUSIONS: MICS could influence the association observed between high eGFR and mortality in older people, particularly in those with low body mass index, albumin level, GNRI, and very low serum creatinine level. John Wiley and Sons Inc. 2016-01-05 2016-05 /pmc/articles/PMC4864176/ /pubmed/27493868 http://dx.doi.org/10.1002/jcsm.12053 Text en © 2015 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society of Sarcopenia, Cachexia and Wasting Disorders This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Ou, Shuo‐Ming
Chen, Yung‐Tai
Hung, Szu‐Chun
Shih, Chia‐Jen
Lin, Chi‐Hung
Chiang, Chih‐Kang
Tarng, Der‐Cherng
Association of estimated glomerular filtration rate with all‐cause and cardiovascular mortality: the role of malnutrition–inflammation–cachexia syndrome
title Association of estimated glomerular filtration rate with all‐cause and cardiovascular mortality: the role of malnutrition–inflammation–cachexia syndrome
title_full Association of estimated glomerular filtration rate with all‐cause and cardiovascular mortality: the role of malnutrition–inflammation–cachexia syndrome
title_fullStr Association of estimated glomerular filtration rate with all‐cause and cardiovascular mortality: the role of malnutrition–inflammation–cachexia syndrome
title_full_unstemmed Association of estimated glomerular filtration rate with all‐cause and cardiovascular mortality: the role of malnutrition–inflammation–cachexia syndrome
title_short Association of estimated glomerular filtration rate with all‐cause and cardiovascular mortality: the role of malnutrition–inflammation–cachexia syndrome
title_sort association of estimated glomerular filtration rate with all‐cause and cardiovascular mortality: the role of malnutrition–inflammation–cachexia syndrome
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4864176/
https://www.ncbi.nlm.nih.gov/pubmed/27493868
http://dx.doi.org/10.1002/jcsm.12053
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