Association of reduced estimated GFR with mortality in men and women across the adult age spectrum in the Optum Labs Data Warehouse.

Josef Coresh, Yingying Sang, Shoshana H Ballew, Aditya Surapaneni, Morgan E Grams
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Abstract

Chronic kidney disease (CKD) is associated with multiple adverse outcomes. This study quantifies the mortality risk associated with CKD, characterized by an estimated glomerular filtration rate (eGFR) of <60 ml/min/1.73m2, utilizing de-identified electronic health record data from the Optum Labs Data Warehouse in 4,788,021 men and 5,766,551 women. Mortality rates were estimated per 1000 person-years by sex and 5-year age group and absolute risk difference were estimated as attributable risk per 1000 person-years. Elevated mortality rates were seen among individuals with reduced eGFR for all age groups and for both men and women. The analysis revealed a linear decline in the incidence rate ratios of mortality with advancing age, while attributable risks increased due to the marked increase in mortality with age. These sex-specific risk estimates from a large sample enhance previous findings and are crucial for refining global burden of disease metrics and health economic evaluations of CKD.

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在Optum实验室数据仓库中,估计GFR降低与成年年龄段男性和女性死亡率的关系。
慢性肾脏病(CKD)与多种不良后果相关。本研究利用 Optum 实验室数据仓库中 4,788,021 名男性和 5,766,551 名女性的去标识化电子健康记录数据,量化了与 CKD 相关的死亡风险,CKD 的特征是估计肾小球滤过率(eGFR)为 2。按性别和 5 岁年龄组估算了每千人年的死亡率,并将绝对风险差异估算为每千人年的归因风险。在所有年龄组中,eGFR 降低的男性和女性死亡率均有所升高。分析表明,随着年龄的增长,死亡率的发生率比呈线性下降,而由于死亡率随年龄的增长而显著增加,归因风险也随之增加。这些从大量样本中得出的性别特异性风险估计值增强了之前的研究结果,对于完善全球疾病负担指标和慢性肾功能衰竭的健康经济评估至关重要。
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