Table 3.

Findings of studies that investigated outcomes in relation to GFR in general populations

Author (reference)	Study Name	eGFR/ACR (GFR equation)	Outcome Studied (ACM or CVM)	Comparison Made and Reference Category	Adjusted Hazard Ratios in Exposure Categories	Comments
Manjunath et al.35	Cardiovascular Health Study	MDRD	ACM	90–130 ml/min per 1.73 m2	60–89 ml/min 1.05 (0.78–1.41) 15–59 ml/min 1.47 (1.05–2.06)
Go et al.29	Kaiser Permanente Renal Registry	MDRD	ACM CV events	≥60 ml/min per 1.73 m2	ACM:	In a subgroup where chronicity was confirmed (repeated serum creatinine measurements) (n=172,144), eGFR at 45–59 ml/min was not associated with ACM 1.0 (1.0–1.1)
					45–59 ml/min 1.2 (1.1–1.2)
					30–44 ml/min 1.8 (1.7–1.9)
					15–29 ml/min 3.2 (3.1–3.4)
					<15 ml/min 5.9 (5.4–6.5)
					CV events:
					45–59 ml/min 1.4 (1.4–1.5)
					30–44 ml/min 2.0 (1.9–2.1)
					15–29 ml/min 2.8 (2.6–2.9)
					<15 ml/min 3.4 (3.1–3.8)
O’Hare et al.36	Department of Veterans Affairs	MDRD	ACM	≥60 ml/min per 1.73 m2	18–44 yr:	In younger age categories, adjusted HRs were higher and statistically significant already from 50 to 59 ml/min. In younger people and elderly with stable eGFR adjusted HRs were lower in all eGFR categories, 50–59 ml/min was not associated with ACM. Findings suggest that mortality risk stratification in younger and elderly people should not be based on the same eGFR cut-off points
					50–59 ml/min 1.56 (1.30–1.88)
					40–49 ml/min 1.90 (1.35–2.67)
					30–39 ml/min 3.58 (2.54–5.05)
					45–54 yr:
					50–59 ml/min 1.27 (1.19–1.36)
					40–49 ml/min 1.89 (1.74–2.06)
					30–39 ml/min 2.89 (2.63–3.18)
					55–64 yr:
					50–59 ml/min 1.18 (1.13–1.23)
					40–49 ml/min 1.75 (1.65–1.85)
					30–39 ml/min 2.43 (2.27–2.59)
					65–74 yr:
					50–59 ml/min 1.02 (0.99–1.05)
					40–49 ml/min 1.35 (1.32–1.39)
					30–39 ml/min 1.81 (1.75–1.87)
					75–84 yr:
					50–59 ml/min 1.02 (0.99–1.04)
					40–49 ml/min 1.21 (1.18–1.23)
					30–39 ml/min 1.55 (1.51–1.58)
					85+ yr:
					50–59 ml/min 1.02 (0.97–1.06)
					40–49 ml/min 1.10 (1.05–1.15)
					30–39 ml/min 1.36 (1.29–1.44)
Maaravi et al.37	Jerusalem Seventy-Year-Old Longitudinal Study	MDRD CG Mayo Clinic	ACM	≥60 ml/min per 1.73 m2 Results presented for MDRD	<60 ml/min 1.19 (0.83–1.71)
Hallan et al.38	HUNT II	MDRD	CVM	≥75 ml/min per 1.73 m2 and optimal ACR; ACR below sex-specific median (<5 and 7 mg/g in men and women)	<70 yr:
					Optimal ACR:
					60–74 ml/min 1.17 (0.35–3.91)
					45–59 ml/min 0.73 (0.26–2.02)
					<45 ml/min 1.08 (0.19–6.10)
					High normal ACR:
					60–74 ml/min 1.53 (0.55–4.26)
					45–59 ml/min 3.29 (1.02–10.6)
					<45 ml/min 2.57 (0.88–7.51)
					Micro-albuminuria:
					60–74 ml/min 1.92 (0.71–5.16)
					45–59 ml/min 2.22 (0.87–5.70)
					<45 ml/min 5.94 (2.06–17.2)
					≥70 yr:
					Optimal ACR:
					60–74 ml/min 0.79 (0.30–2.10)
					45–59 ml/min 2.48 (0.76–8.13)
					<45 ml/min 1.49 (0.46–4.86)
					High normal ACR:
					60–74 ml/min 1.68 (0.61–4.69)
					45–59 ml/min 1.93 (0.63–5.92)
					<45 ml/min 4.70 (1.57–14.1)
					Micro-albuminuria:
					60–74 ml/min 3.80 (1.33–10.80)
					45–59 ml/min 4.09 (1.52–10.90)
					<45 ml/min 8.38 (2.83–24.9)
Raymond et al.56	NA	MDRD	ACM	≥60 ml/min per 1.73 m2	20–44 yr:
					Stage 3a 13.6 (6.2–29.8)
					Stage 3b 12.1 (4.0–36.5)
					Stage 4 17.4 (5.9–51.4)
					Stage 5 26.1 (9.1–74.8)
					45–54 yr:
					Stage 3a 7.5 (4.4–12.6)
					Stage 3b 13.6 (7.5–24.7)
					Stage 4 4.6 (1.2–17.4)
					Stage 5 28.6 (17.4–47.2)
					55–64 yr:
					Stage 3a 3.0 (2.2–4.1)
					Stage 3b 5.9 (3.9–8.9)
					Stage 4 9.3 (6.1–14.2)
					Stage 5 18.2 (13.9–23.9)
					65–74 yr:
					Stage 3a 1.8 (1.5–2.1)
					Stage 3b 3.2 (2.6–3.9)
					Stage 4 5.2 (4.1–6.5)
					Stage 5 7.6 (5.7–10.1)
					75–84 yr:
					Stage 3a 1.2 (1.0–1.3)
					Stage 3b 1.9 (1.7–2.1)
					Stage 4 3.3 (2.9–3.8)
					Stage 5 4.4 (3.7–5.3)
					85+ yr:
					Stage 3a 0.9 (0.8–1.0)
					Stage 3b 1.3 (1.2–1.5)
					Stage 4 1.8 (1.7–2.0)
					Stage 5 2.5 (2.3–2.8)
Brantsma et al.39	PREVEND	MDRD ACR	CVM and CV hospitalization combined	No CKD	Stage 1 2.2 (1.5–3.3)
					Stage 2 1.6 (1.3–2.0)
					Stage 3 1.3 (1.0–1.7)
					Stage 3 with UAE <30 mg/24 h 1.0 (0.7–1.4)
					Stage 3 with UAE >30 mg/24 h 1.6 (1.1–2.3)
Hwang et al.40	Elderly Health Examination Program	MDRD	ACM CVM	≥60 ml/min per 1.73 m2	ACM:
					45–59 ml/min 1.10 (1.0–1.2)
					30–44 ml/min 1.52 (1.3–1.8)
					15–29 ml/min 2.1 (1.7–2.6)
					<15 ml/min 2.55 (1.8–3.6)
					CVM:
					45–59 ml/min 1.30 (1.0–1.7)
					30–44 ml/min 2.42 (1.7–3.4)
					15–29 ml/min 3.62 (2.3–5.8)
					<15 ml/min 3.22 (1.3–8.3)
Roderick et al.41	MRC General Practice Research Framework	MDRD Dipstick proteinuria	ACM CVM in those without CVD at baseline	≥60 ml/min per 1.73 m2; proteinuria negative	ACM after 0–2 yr:	Short-term (0–2 yr) eGFR-related risk is higher than long term (>2 yr) risk (not shown)
					Men:
					45–59 ml/min 1.13 (0.93–1.37)
					30–44 ml/min 1.69 (1.26–2.28)
					<30 ml/min 3.87 (2.78–5.38)
					Women:
					45–59 ml/min 1.14 (0.93–1.40)
					30–44 ml/min 1.33 (1.06–1.68)
					<30 ml/min 2.44 (1.68–3.56)
					CVM after 0–2 yr:
					Men:
					45–59 ml/min 1.67 (1.15–2.43)
					30–44 ml/min 1.60 (0.94–2.73)
					<30 ml/min 2.89 (1.22–6.84)
					Women:
					45–59 ml/min 1.59 (1.01–2.50)
					30–44 ml/min 1.45 (0.93–2.28)
					<30 ml/min 3.80 (1.87–7.75)
					ACM:
					Men:
					Proteinuria positive
					>60 ml/min 1.29 (1.07–1.56)
					45–59 ml/min 1.25 (1.02–1.52)
					30–44 ml/min 1.08 (0.82–1.42)
					<30 ml/min 0.95 (0.56–1.59)
					Women:
					Proteinuria positive
					>60 ml/min 1.19 (0.96–1.47)
					45–59 ml/min 0.94 (0.77–1.15)
					30–44 ml/min 1.39 (1.10–1.77)
					<30 ml/min 1.70 (1.15–2.52)
					CVM:
					Men:
					Proteinuria positive
					>60 ml/min 1.05 (0.70–1.57)
					45–59 ml/min 1.31 (0.91–1.89)
					30–44 ml/min 0.83 (0.47–1.46)
					<30 ml/min 0.97 (0.35–2.68)
					Women:
					Proteinuria positive
					>60 ml/min 1.18 (0.80–1.74)
					45–59 ml/min 0.93 (0.65–1.32)
					30–44 ml/min 1.34 (0.88–2.03)
					<30 ml/min 2.79 (1.40–5.54)
Van der Velde et al.42	PREVEND	MDRD CKD-EPI SCr CysC SCr-CysC Creatinine clearance	Fatal and nonfatal CV events	+10 ml/min per 1.73 m2 increase in eGFR. Results presented for CKD-EPI	<60 yr:	The association between eGFR and risk of CV events is weaker in elderly subjects than in younger subjects
					0.70 (0.62–0.79)
					≥60 yr:
					1.02 (0.92–1.13)
Muntner et al.43	REGARDS	CKD-EPI ACR	ACM	≥60 ml/min per 1.73 m2	45–59 yr:	If ACR is <10 mg/g, the results are similar:
						45–59 yr:
					45–60 ml/min 2.5 (1.3–4.6)	45–60 ml/min 4.5 (1.8–11.1)
					<45 ml/min 3.5 (1.8–6.8)	<45 ml/min 4.7 (0.7–34.2)
					60–69 yr:	60–69 yr:
					45–60 ml/min 1.7 (1.3–2.3)	45–60 ml/min 1.9 (1.2–3.1)
					<45 ml/min 2.2 (1.6–3.0)	<45 ml/min 2.5 (1.0–6.1)
					70–79 yr:	70–79 yr:
					45–60 ml/min 1.1 (0.9–1.3)	45–60 ml/min 1.1 (0.8–1.6)
					<45 ml/min 1.9 (1.5–2.4)	<45 ml/min 2.1 (1.2–3.6)
					≥80 yr:	≥80 yr:
					45–60 ml/min 1.3 (1.0–1.7)	45–60 ml/min 1.4 (0.9–2.2)
					<45 ml/min 1.5 (1.1–2.0)	<45 ml/min 1.6 (0.9–2.8)
Stengel et al.44	Three-City	CKD-EPI MDRD	ACM CVM	≥75–89 ml/min per 1.73 m2; results presented for CKD-EPI	ACM:
					60–74 ml/min 0.9 (0.8–1.1)
					45–59 ml/min 1.1 (0.9–1.3)
					30–44 ml/min 2.0 (1.5–2.7)
					<30 ml/min 3.3 (2.0–5.5)
					CVM:
					60–74 ml/min 0.9 (0.6–1.3)
					45–59 ml/min 1.6 (1.1–2.3)
					30–44 ml/min 3.1 (1.8–5.0)
					<30 ml/min 4.3 (1.8–10.2)
Van Pottelbergh et al.45	BELFRAIL	MDRD CKD-EPI SCr CKD-EPI CysC CKD-EPI SCr-CysC BIS-2 SCr-CysC	ACM and RRT combined	60–90 ml/min per 1.73 m2; results presented for CKD-EPI SCr	45–60 ml/min 1.65 (1.05–2.61)
					30–45 ml/min 1.72 (1.03–2.88)
					<30 ml/min 5.04 (2.95–8.60)
Oh et al.46	KLoSHA	CKD-EPI Disptick proteinuria	ACM	≥90 ml/min per 1.73 m2; proteinuria negative	60–89 ml/min 1.37 (0.75–2.52)	If proteinuria: Trace 1.24 (0.78–1.96) ≥1+1.73 (1.13–2.63)
					45–59 ml/min 1.65 (0.84–3.25)
					<45 ml/min 2.36 (1.17–4.75)
Minutolo et al.47	Health Search/Cegedim Strategic Data Longitudinal Patient Database	MDRD	ACM	≥60 ml/min per 1.73 m2	ACM:
					Stage 3a 1.11 (0.99–1.23)
					Stage 3b 1.66 (1.49–1.86)
					Stage 4 2.75 (2.41–3.13)
					Stage 5 2.54 (2.01–3.22)
Malmgren et al.48	OPRA	CKD-EPI MDRD Revised Lund-Malmö BIS-1 CG	ACM	≥60 ml/min per 1.73 m2; results presented for CKD-EPI	75–80 yr:
					45–60 ml/min 1.1 (0.6–2.0)
					0–45 ml/min 4.5 (2.2–9.2)
					75–85 yr:
					45–60 ml/min 1.4 (1.0–1.9)
					0–45 ml/min 3.5 (2.1–5.8)
					80–85 yr:
					45–60 ml/min 1.7 (1.1–2.6)
					0–45 ml/min 2.6 (1.4–5.0)
Chowdhury et al.49	ANBP2	MDRD CKD-EPI	ACM CVM	≥60 ml/min per 1.73 m2; results presented for CKD-EPI	ACM:
					45–59 ml/min 1.13 (1.01–1.27)
					30–44 ml/min 1.65 (1.37–1.99)
					<30 ml/min 5.16 (3.17–8.42)
					CVM:
					45–59 ml/min 1.05 (0.89–1.23)
					30–44 ml/min 1.64 (1.27–2.13)
					<30 ml/min 5.60 (2.32–13.51)
Nagai et al.50	Ibaraki Prefecture	MDRD	ACM CVM	≥60 ml/min per 1.73 m2	ACM:
					Men:
					40–69 yr:
					45–49 ml/min 1.33 (1.06–1.67)
					30–44 ml/min 1.53 (1.20–1.96)
					70–80 yr:
					45–49 ml/min 1.02 (0.82–1.25)
					30–44 ml/min 1.63 (1.33–2.00)
					Women:
					40–69 yr:
					45–49 ml/min 1.50 (1.27–1.78)
					30–44 ml/min 2.21 (1.81–2.71)
					70–80 yr:
					45–49 ml/min 1.19 (1.02–1.38)
					30–44 ml/min 1.53 (1.31–1.79)
					CVM:
					Men:
					40–69 yr:
					45–49 ml/min 1.82 (1.23–2.69)
					30–44 ml/min 1.65 (1.04–2.62)
					70–80 yr:
					45–49 ml/min 1.03 (0.72–1.48)
					30–44 ml/min 1.37 (0.93–2.02)
					Women:
					40–69 yr:
					45–49 ml/min 1.34 (0.98–1.82)
					30–44 ml/min 2.24 (1.58–3.17)
					70–80 yr:
					45–49 ml/min 1.43 (1.14–1.79)
					30–44 ml/min 1.57 (1.23–2.00)
Corsonello et al.51	InChianti	CKD-EPI SCr BIS-1 SCr FAS CKD-EPI SCr-CysC BIS-2 SCr-CysC	ACM	≥90 ml/min per 1.73 m2; results presented for CKD-EPI SCr	60–89.9 ml/min 1.63 (0.84–3.17)
					45–59.9 ml/min 2.50 (1.21–5.15)
					30–44.9 ml/min 5.44 (1.10–27.7)
					<30 ml/min 7.42 (1.79–30.6)
Wu et al.52	Kailuan Study	CKD-EPI Dipstick proteinuria	ACM	≥ 90 ml/min per 1.73 m2	All:
					60–89 ml/min 1.01 (0.93–1.09)
					45–59 ml/min 1.11 (0.99–1.24)
					<45 ml/min 1.51 (1.30–1.74)
					Men:
					60–89 ml/min 1.01 (0.94–1.10)
					45–59 ml/min 1.11 (0.99–1.23)
					<45 ml/min 1.35 (1.17–1.57)
					Women:
					60–89 ml/min 1.65 (1.16–2.34)
					45–59 ml/min 1.92 (1.25–2.96)
					<45 ml/min 4.11 (2.50–6.76)

ACM, all-cause mortality; CVM, cardiovascular mortality; MDRD, Modified Diet in Renal Disease Study equation; CV, cardiovascular; HR, hazard ratio; CG, Cockcroft and Gault formula; MRC, Medical Research Council; CVD, cardiovascular disease; HUNT, Nord-Trøndelag Health Study; PREVEND, Prevention of Renal and Vascular Endstage Disease; CysC, cystatin C; REGARDS, Reasons for Geographic and Racial Differences in Stroke; KLoSHA, Korean Longitudinal Study on Health and Aging; NA, not available; OPRA, Osteoporosis Risk Assessment; ANBP2, Second Australian National Blood Pressure Study; SCr, serum creatinine; BIS1, Berlin Initiative Study; FAS, full age spectrum.