Table 3.
Risk of Incident ESRD and All-Cause Mortality Associated with Decline in Measured and Estimated GFR Over a One-Year Period Adjusted for First Measurement of mGFR
| MDRD | AASK | |||||
|---|---|---|---|---|---|---|
|
| ||||||
| Outcome and Filtration Marker | IRRa (95% CI) per 30% decline | P | P vs mGFRb | IRRa (95% CI) per 30% decline | P | P vs mGFRb |
| ESRD | ||||||
|
| ||||||
| mGFR | 1.91 (1.39–2.61) | <0.001 | -- | 3.03 (1.76–5.23) | <0.001 | -- |
| eGFRcr | 2.33 (1.78–3.04) | <0.001 | 0.3 | 3.06 (1.70–5.53) | <0.001 | 0.9 |
| eGFRcys | 2.23 (1.59–3.15) | <0.001 | 0.5 | 1.76 (0.91–3.41) | 0.09 | 0.09 |
| eGFRBTP | 2.78 (1.66–4.67) | <0.001 | 0.1 | 2.79 (1.45–5.37) | 0.002 | 0.8 |
| eGFRB2M | 2.17 (1.55–3.04) | <0.001 | 0.5 | 1.81 (0.95–3.43) | 0.07 | 0.1 |
| Average of 4 markersc | 2.76 (1.92–3.97) | <0.001 | 0.1 | 3.30 (1.56–6.97) | 0.002 | 0.8 |
|
| ||||||
| Mortality | ||||||
|
| ||||||
| mGFR | 1.09 (0.69–1.72) | 0.7 | -- | 2.05 (0.86–4.91) | 0.1 | -- |
| eGFRcr | 1.01 (0.67–1.53) | 0.9 | 0.7 | 3.74 (1.57–8.87) | 0.003 | 0.2 |
| eGFRcys | 1.07 (0.61–1.86) | 0.8 | 0.9 | 1.59 (0.58–4.34) | 0.4 | 0.7 |
| eGFRBTP | 1.50 (0.71–3.18) | 0.3 | 0.3 | 1.58 (0.55–4.56) | 0.4 | 0.7 |
| eGFRB2M | 0.90 (0.53–1.51) | 0.7 | 0.4 | 1.77 (0.68–4.65) | 0.3 | 0.8 |
| Average of 4 markersc | 1.02 (0.57–1.83) | 0.9 | 0.8 | 2.65 (0.84–8.33) | 0.1 | 0.7 |
IRR expressed per 30% decline in mGFR or eGFR calculated by modeling percent change in mGFR or eGFR below 0% (linear spline term with a knot at 0%); adjusted for age, sex, race, body mass index, systolic blood pressure, diabetes, total cholesterol, randomized treatment group, study group (for MDRD Study only), and first assessment of mGFR
P-value from seemingly unrelated regression comparing IRR for decline in the respective filtration marker vs. IRR for decline in mGFR
Average of 4 markers = (% Δ eGFRcr + % Δ eGFRcys + % Δ eGFRBTP + % Δ eGFRB2M)/4
AASK, African American Study of Kidney Disease and Hypertension; CI, confidence interval; eGFR, estimated glomerular filtration rate; ESRD, end-stage renal disease; IRR, incidence rate ratio; MDRD, Modification of Diet in Renal Disease; mGFR, measured glomerular filtration rate; eGFRcr, creatinine-based eGFR; eGFRcys, cystatin C–based eGFR; eGFRBTP, β-trace protein–based eGFR; eGFRB2M, β2-microglobulin-based eGFR