Evidence map›Paper›PMID 23013600›Full record

SynthesisLancet (London, England)2012

Associations of kidney disease measures with mortality and end-stage renal disease in individuals with and without hypertension: a meta-analysis.

Bakhtawar K Mahmoodi, Kunihiro Matsushita, Mark Woodward, Peter J Blankestijn, Massimo Cirillo, Takayoshi Ohkubo, Peter Rossing, Mark J Sarnak, Bénédicte Stengel, Kazumasa Yamagishi and 6 more

Erratum issuedOpen access · greenAbstract readMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Lancet (London, England), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 221 papers, 16 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
221citing papers in PubMed, 16 pooled it
24.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

221 citing papers in PubMed, 16 syntheses or guidelines pooled it, 439 citations in OpenAlex.

  1. The Japanese Society of Hypertension Guidelines for the management of elevated blood pressure and hypertension 2025 (JSH2025).Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Guideline
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  6. The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2019).Hypertension research : official journal of the Japanese Society of Hypertension · 2019
    Guideline
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  9. Past Decline Versus Current eGFR and Subsequent ESRD Risk.Journal of the American Society of Nephrology : JASN · 2016
    Pooled it
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  12. A Meta-analysis of the Association of Estimated GFR, Albuminuria, Diabetes Mellitus, and Hypertension With Acute Kidney Injury.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2015
    Pooled it
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161 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors at 13 institutions in 8 countries.

Bakhtawar K MahmoodiDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
Kunihiro Matsushita
Mark Woodward
Peter J Blankestijn
Massimo Cirillo
Takayoshi Ohkubo
Peter Rossing
Mark J Sarnak
Bénédicte Stengel
Kazumasa Yamagishi
Kentaro Yamashita
Luxia Zhang
Josef Coresh
Paul E de Jong
Brad C Astor
Chronic Kidney Disease Prognosis Consortium
Johns Hopkins University · USUniversity Medical Center Groningen · NLAarhus University · DKInserm · FRNagoya University · JPOsaka Health Science University · JPPeking University · CNThe George Institute for Global Health · AUTohoku University · JPTufts Medical Center · USUniversity Medical Center Utrecht · NLUniversity of Salerno · ITUniversity of Wisconsin–Madison · US

Funding

VCID and Stroke in a Bi-racial National CohortU01NS041588 · NINDS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI CUSHMAN, MARY, HOWARD, GEORGE · 2002 to 2022
$96.0M
THE EPIDEMIOLOGY OF AGE-RELATED OCULAR DISEASEU10EY006594 · NEI · UNIVERSITY OF WISCONSIN-MADISON · PI KLEIN, RONALD · 1987 to 2018
$17.3M
Exceptional Survival: Trajectories to Functional Aging (CHS All Stars)R01AG023629 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI NEWMAN, ANNE B. · 2004 to 2016
$9.5M
CHS Events Follow-up StudyR01HL080295 · NHLBI · UNIVERSITY OF WASHINGTON · PI PSATY, BRUCE M · 2009 to 2014
$6.3M
Predictors of Alheimers Disease in Mild Cognitive ImpairmentR01AG020098 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI LOPEZ, OSCAR L. · 2002 to 2011
$3.7M
MORTALITY FOLLOW-UP AND ANALYSES OF MEN IN THE MRFITR01HL068140 · NHLBI · UNIVERSITY OF MINNESOTA TWIN CITIES · PI NEATON, JAMES DENNIS · 2001 to 2005
$2.6M
GENDER DIFFERENCES IN OSTEOPOROSISR01AG007181 · NIA · UNIVERSITY OF CALIFORNIA SAN DIEGO · PI BARRETT-CONNOR, ELIZABETH L · 1999 to 2002
$1.6M
CVD Predictors of Cognitive Function Trajectory over 20 YearsR01AG028507 · NIA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI BARRETT-CONNOR, ELIZABETH L · 2007 to 2010
$1.2M
Hormonal trajectories in agingR01AG027058 · NIA · UNIVERSITY OF PENNSYLVANIA · PI CAPPOLA, ANNE R · 2006 to 2009
$1.2M
Novel Risk Factors for Chronic Kidney DiseaseR01DK073217 · NIDDK · UNIVERSITY OF WISCONSIN-MADISON · PI KLEIN, RONALD · 2006 to 2008
$800k
Novel Cardiac Risk Factors &Endothelial Function in CKDK23DK067303 · NIDDK · TUFTS MEDICAL CENTER · PI MENON, VANDANA · 2004 to 2008
$781k
CARDIOVASCULAR RISK FACTORS--CHRONIC RENAL INSUFFICIENCYK23DK002904 · NIDDK · TUFTS MEDICAL CENTER · PI SARNAK, MARK J · 2000 to 2004
$672k
Chief Scientist Office CZH/4/656NEI NIH HHS U10 EY006594NHLBI NIH HHS HHSN268201100005CNHLBI NIH HHS HHSN268201100006CNHLBI NIH HHS HHSN268201100007CNHLBI NIH HHS HHSN268201100008CNHLBI NIH HHS HHSN268201100009CNHLBI NIH HHS HHSN268201100010CNHLBI NIH HHS HHSN268201100011CNHLBI NIH HHS HHSN268201100012CNHLBI NIH HHS HHSN268201200036CNHLBI NIH HHS N01 HC015103NHLBI NIH HHS N01 HC025195NHLBI NIH HHS N01 HC035129NHLBI NIH HHS N01 HC045133NHLBI NIH HHS N01 HC055222NHLBI NIH HHS N01 HC075150NHLBI NIH HHS N01 HC085079NHLBI NIH HHS N01 HC085086NHLBI NIH HHS N01 HC095159NHLBI NIH HHS N01 HC095169NHLBI NIH HHS R01 HL043232NHLBI NIH HHS R01 HL068140NHLBI NIH HHS R01 HL080295NIA NIH HHS R01 AG007181NIA NIH HHS R01 AG015928NIA NIH HHS R01 AG020098NIA NIH HHS R01 AG023629NIA NIH HHS R01 AG027058NIA NIH HHS R01 AG028507NIDDK NIH HHS K23 DK002904NIDDK NIH HHS K23 DK067303NIDDK NIH HHS R01 DK031801NIDDK NIH HHS R01 DK073217NIDDK NIH HHS U01 DK035073NINDS NIH HHS U01 NS041588
6 · The paper itself

Abstract

backgroundHypertension is the most prevalent comorbidity in individuals with chronic kidney disease. However, whether the association of the kidney disease measures, estimated glomerular filtration rate (eGFR) and albuminuria, with mortality or end-stage renal disease (ESRD) differs by hypertensive status is unknown.

methodsWe did a meta-analysis of studies selected according to Chronic Kidney Disease Prognosis Consortium criteria. Data transfer and analyses were done between March, 2011, and June, 2012. We used Cox proportional hazards models to estimate the hazard ratios (HR) of mortality and ESRD associated with eGFR and albuminuria in individuals with and without hypertension.

findingsWe analysed data for 45 cohorts (25 general population, seven high-risk, and 13 chronic kidney disease) with 1,127,656 participants, 364,344 of whom had hypertension. Low eGFR and high albuminuria were associated with mortality irrespective of hypertensive status in the general population and high-risk cohorts. All-cause mortality risk was 1·1-1·2 times higher in individuals with hypertension than in those without hypertension at preserved eGFR. A steeper relative risk gradient in individuals without hypertension than in those with hypertension at eGFR range 45-75 mL/min per 1·73 m(2) led to much the same mortality risk at lower eGFR. With a reference eGFR of 95 mL/min per 1·73 m(2) in each group to explicitly assess interaction, adjusted HR for all-cause mortality at eGFR 45 mL/min per 1·73 m(2) was 1·77 (95% CI 1·57-1·99) in individuals without hypertension versus 1·24 (1·11-1·39) in those with hypertension (p for overall interaction=0·0003). Similarly, for albumin-creatinine ratio of 300 mg/g (vs 5 mg/g), HR was 2·30 (1·98-2·68) in individuals without hypertension versus 2·08 (1·84-2·35) in those with hypertension (p for overall interaction=0·019). We recorded much the same results for cardiovascular mortality. The associations of eGFR and albuminuria with ESRD, however, did not differ by hypertensive status. Results for chronic kidney disease cohorts were similar to those for general and high-risk population cohorts.

interpretationChronic kidney disease should be regarded as at least an equally relevant risk factor for mortality and ESRD in individuals without hypertension as it is in those with hypertension.

fundingUS National Kidney Foundation.

Indexed as

AgedAged, 80 and overAlbuminuriaBlood PressureCause of DeathChronic DiseaseFemaleGlomerular Filtration RateHumansHypertensionKidney Failure, ChronicMaleMiddle AgedProportional Hazards ModelsRisk Factors

Identifiers

PMID23013600
PMCPMC3993095
OpenAlexW2613325828

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.