ArticleAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2016
Abrupt Decline in Kidney Function Before Initiating Hemodialysis and All-Cause Mortality: The Chronic Renal Insufficiency Cohort (CRIC) Study.
Article in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed, 37 citations in OpenAlex.
- Associations between abrupt transition, dialysis-requiring AKI, and early mortality in ESKD among U.S. veterans.BMC nephrology · 2023Article
- Machine Learning Case Study: Patterns of Kidney Function Decline and Their Association With Clinical Outcomes Within 90 Days After the Initiation of Renal Dialysis.Advances in kidney disease and health · 2023Review
- Article
- Different kidney function trajectory patterns before dialysis in elderly patients: clinical implications and outcomes.Renal failure · 2021Article
- Prognostic Factors of Fatal and Nonfatal Cardiovascular Events in Patients With Type 2 Diabetes: The Role of Renal Function Biomarkers.Clinical diabetes : a publication of the American Diabetes Association · 2021Article
- Associations Between Using Chinese Herbal Medicine and Long-Term Outcome Among Pre-dialysis Diabetic Nephropathy Patients: A Retrospective Population-Based Cohort Study.Frontiers in pharmacology · 2021Article
- Survival and analysis of predictors of mortality in patients undergoing replacement renal therapy: a 20-year cohort.BMC nephrology · 2020Article
- American Indian chronic Renal insufficiency cohort study (AI-CRIC study).BMC nephrology · 2020Article
- Research-based versus clinical serum creatinine measurements and the association of acute kidney injury with subsequent kidney function: findings from the Chronic Renal Insufficiency Cohort study.Clinical kidney journal · 2020Article
- Association of Renal Function and Direct-Acting Antiviral Agents for HCV: A Network Meta-Analysis.Journal of clinical medicine · 2018Article
- Evolution of Echocardiographic Measures of Cardiac Disease From CKD to ESRD and Risk of All-Cause Mortality: Findings From the CRIC Study.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2018Article
- Non-recovery from dialysis-requiring acute kidney injury and short-term mortality and cardiovascular risk: a cohort study.BMC nephrology · 2018Article
- Improving the prognosis of patients with severely decreased glomerular filtration rate (CKD G4+): conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference.Kidney international · 2018Article
- Longitudinal Weight Change During CKD Progression and Its Association With Subsequent Mortality.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2018Article
- Abrupt Decline in Kidney Function Precipitating Initiation of Chronic Renal Replacement Therapy.Kidney international reports · 2018Article
- Patterns of progression of chronic kidney disease at later stages.Clinical kidney journal · 2018Article
- Decline of kidney function during the pre-dialysis period in chronic kidney disease patients: a systematic review and meta-analysis.Clinical epidemiology · 2018Article
- Potential Benefit Associated With Delaying Initiation of Hemodialysis in a Japanese Cohort.Kidney international reports · 2017Article
- The Transition From the Pre-ESRD to ESRD Phase of CKD: Much Remains to Be Learned.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2017Article
- CKD to ESRD transition: does assessment of kidney function matter?Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2017Article
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Authors and funding
17 authors at 11 institutions in 1 country.
Funding
Abstract
backgroundIt is not clear whether the pattern of kidney function decline in patients with chronic kidney disease (CKD) may relate to outcomes after reaching end-stage renal disease (ESRD). We hypothesize that an abrupt decline in kidney function prior to ESRD predicts early death after initiating maintenance hemodialysis therapy. STUDY
designProspective cohort study. SETTING &
participantsThe Chronic Renal Insufficiency Cohort (CRIC) Study enrolled men and women with mild to moderate CKD. For this study, we studied 661 individuals who developed chronic kidney failure that required hemodialysis therapy initiation. PREDICTORS: The primary predictor was the presence of an abrupt decline in kidney function prior to ESRD. We incorporated annual estimated glomerular filtration rates (eGFRs) into a mixed-effects model to estimate patient-specific eGFRs at 3 months prior to initiation of hemodialysis therapy. Abrupt decline was defined as having an extrapolated eGFR≥30mL/min/1.73m(2) at that time point. OUTCOMES: All-cause mortality within 1 year after initiating hemodialysis therapy. MEASUREMENTS: Multivariable Cox proportional hazards.
resultsAmong 661 patients with CKD initiating hemodialysis therapy, 56 (8.5%) had an abrupt predialysis decline in kidney function and 69 died within 1 year after initiating hemodialysis therapy. After adjustment for demographics, cardiovascular disease, diabetes, and cancer, abrupt decline in kidney function was associated with a 3-fold higher risk for death within the first year of ESRD (adjusted HR, 3.09; 95% CI, 1.65-5.76). LIMITATIONS: Relatively small number of outcomes; infrequent (yearly) eGFR determinations; lack of more granular clinical data.
conclusionsAbrupt decline in kidney function prior to ESRD occurred in a significant minority of incident hemodialysis patients and predicted early death in ESRD.
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