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Kidney age - chronological age difference (KCD) score provides an age-adapted measure of kidney function

BACKGROUND: Given the age-related decline in glomerular filtration rate (GFR) in healthy individuals, we examined the association of all-cause death or cardiovascular event with the Kidney age - Chronological age Difference (KCD) score, whereby an individual’s kidney age is estimated from their esti...

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Autores principales: Campbell, Duncan J., Coller, Jennifer M., Gong, Fei Fei, McGrady, Michele, Boffa, Umberto, Shiel, Louise, Liew, Danny, Stewart, Simon, Owen, Alice J., Krum, Henry, Reid, Christopher M., Prior, David L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8077774/
https://www.ncbi.nlm.nih.gov/pubmed/33902478
http://dx.doi.org/10.1186/s12882-021-02324-y
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author Campbell, Duncan J.
Coller, Jennifer M.
Gong, Fei Fei
McGrady, Michele
Boffa, Umberto
Shiel, Louise
Liew, Danny
Stewart, Simon
Owen, Alice J.
Krum, Henry
Reid, Christopher M.
Prior, David L.
author_facet Campbell, Duncan J.
Coller, Jennifer M.
Gong, Fei Fei
McGrady, Michele
Boffa, Umberto
Shiel, Louise
Liew, Danny
Stewart, Simon
Owen, Alice J.
Krum, Henry
Reid, Christopher M.
Prior, David L.
author_sort Campbell, Duncan J.
collection PubMed
description BACKGROUND: Given the age-related decline in glomerular filtration rate (GFR) in healthy individuals, we examined the association of all-cause death or cardiovascular event with the Kidney age - Chronological age Difference (KCD) score, whereby an individual’s kidney age is estimated from their estimated GFR (eGFR) and the age-dependent eGFR decline reported for healthy living potential kidney donors. METHODS: We examined the association between death or cardiovascular event and KCD score, age-dependent stepped eGFR criteria (eGFRstep), and eGFR < 60 ml/min/1.73 m(2) (eGFR60) in a community-based high cardiovascular risk cohort of 3837 individuals aged ≥60 (median 70, interquartile range 65, 75) years, followed for a median of 5.6 years. RESULTS: In proportional hazards analysis, KCD score ≥ 20 years (KCD20) was associated with increased risk of death or cardiovascular event in unadjusted analysis and after adjustment for age, sex and cardiovascular risk factors. Addition of KCD20, eGFRstep or eGFR60 to a cardiovascular risk factor model did not improve area under the curve for identification of individuals who experienced death or cardiovascular event in receiver operating characteristic curve analysis. However, addition of KCD20 or eGFR60, but not eGFRstep, to a cardiovascular risk factor model improved net reclassification and integrated discrimination. KCD20 identified individuals who experienced death or cardiovascular event with greater sensitivity than eGFRstep for all participants, and with greater sensitivity than eGFR60 for participants aged 60–69 years, with similar sensitivities for men and women. CONCLUSIONS: In this high cardiovascular risk cohort aged ≥60 years, the KCD score provided an age-adapted measure of kidney function that may assist patient education, and KCD20 provided an age-adapted criterion of eGFR-related increased risk of death or cardiovascular event. Further studies that include the full age spectrum are required to examine the optimal KCD score cut point that identifies increased risk of death or cardiovascular event, and kidney events, associated with impaired kidney function, and whether the optimal KCD score cut point is similar for men and women. TRIAL REGISTRATION: ClinicalTrials.gov NCT00400257, NCT00604006, and NCT01581827. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12882-021-02324-y.
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spelling pubmed-80777742021-04-29 Kidney age - chronological age difference (KCD) score provides an age-adapted measure of kidney function Campbell, Duncan J. Coller, Jennifer M. Gong, Fei Fei McGrady, Michele Boffa, Umberto Shiel, Louise Liew, Danny Stewart, Simon Owen, Alice J. Krum, Henry Reid, Christopher M. Prior, David L. BMC Nephrol Research Article BACKGROUND: Given the age-related decline in glomerular filtration rate (GFR) in healthy individuals, we examined the association of all-cause death or cardiovascular event with the Kidney age - Chronological age Difference (KCD) score, whereby an individual’s kidney age is estimated from their estimated GFR (eGFR) and the age-dependent eGFR decline reported for healthy living potential kidney donors. METHODS: We examined the association between death or cardiovascular event and KCD score, age-dependent stepped eGFR criteria (eGFRstep), and eGFR < 60 ml/min/1.73 m(2) (eGFR60) in a community-based high cardiovascular risk cohort of 3837 individuals aged ≥60 (median 70, interquartile range 65, 75) years, followed for a median of 5.6 years. RESULTS: In proportional hazards analysis, KCD score ≥ 20 years (KCD20) was associated with increased risk of death or cardiovascular event in unadjusted analysis and after adjustment for age, sex and cardiovascular risk factors. Addition of KCD20, eGFRstep or eGFR60 to a cardiovascular risk factor model did not improve area under the curve for identification of individuals who experienced death or cardiovascular event in receiver operating characteristic curve analysis. However, addition of KCD20 or eGFR60, but not eGFRstep, to a cardiovascular risk factor model improved net reclassification and integrated discrimination. KCD20 identified individuals who experienced death or cardiovascular event with greater sensitivity than eGFRstep for all participants, and with greater sensitivity than eGFR60 for participants aged 60–69 years, with similar sensitivities for men and women. CONCLUSIONS: In this high cardiovascular risk cohort aged ≥60 years, the KCD score provided an age-adapted measure of kidney function that may assist patient education, and KCD20 provided an age-adapted criterion of eGFR-related increased risk of death or cardiovascular event. Further studies that include the full age spectrum are required to examine the optimal KCD score cut point that identifies increased risk of death or cardiovascular event, and kidney events, associated with impaired kidney function, and whether the optimal KCD score cut point is similar for men and women. TRIAL REGISTRATION: ClinicalTrials.gov NCT00400257, NCT00604006, and NCT01581827. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12882-021-02324-y. BioMed Central 2021-04-26 /pmc/articles/PMC8077774/ /pubmed/33902478 http://dx.doi.org/10.1186/s12882-021-02324-y Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Campbell, Duncan J.
Coller, Jennifer M.
Gong, Fei Fei
McGrady, Michele
Boffa, Umberto
Shiel, Louise
Liew, Danny
Stewart, Simon
Owen, Alice J.
Krum, Henry
Reid, Christopher M.
Prior, David L.
Kidney age - chronological age difference (KCD) score provides an age-adapted measure of kidney function
title Kidney age - chronological age difference (KCD) score provides an age-adapted measure of kidney function
title_full Kidney age - chronological age difference (KCD) score provides an age-adapted measure of kidney function
title_fullStr Kidney age - chronological age difference (KCD) score provides an age-adapted measure of kidney function
title_full_unstemmed Kidney age - chronological age difference (KCD) score provides an age-adapted measure of kidney function
title_short Kidney age - chronological age difference (KCD) score provides an age-adapted measure of kidney function
title_sort kidney age - chronological age difference (kcd) score provides an age-adapted measure of kidney function
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8077774/
https://www.ncbi.nlm.nih.gov/pubmed/33902478
http://dx.doi.org/10.1186/s12882-021-02324-y
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