Kidney Week

Abstract: FR-PO945

A Distribution-Based Approach to Age Associations Between Continuous Kidney Function and Adverse Events in the General Population

Session Information

• CKD Epidemiology, Risk Factors, Prevention - II
  November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Sood, Manish M., University of Ottawa School of Epidemiology and Public Health, Ottawa, Ontario, Canada

Manish M. Sood,

• Hussain, Junayd, University of Ottawa School of Epidemiology and Public Health, Ottawa, Ontario, Canada

Junayd Hussain,

• Canney, Mark, University of Ottawa School of Epidemiology and Public Health, Ottawa, Ontario, Canada

Mark Canney,

• Elliott, Meghan J., University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada

Meghan J. Elliott,

• Hundemer, Gregory L., University of Ottawa School of Epidemiology and Public Health, Ottawa, Ontario, Canada

Gregory L. Hundemer,

• Tangri, Navdeep, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada

Navdeep Tangri,

Background

Whether having a low eGFR value relative to age-based medians is associated with a higher risk of an adverse event is yet to be explored. We aim to derive continuous age-specific associations between percentiles (1^st, 2.5^th, 5^th, 10^th) of eGFR and any adverse outcome (first of death, cardiovascular events, end-stage kidney disease), and obtain corresponding eGFR values.

Methods

We included 8.7 million adults (aged 18-65) with ≥1 eGFR value during January 2008-March 2020 in Ontario. Adjusted Cox models were used to estimate the association of a lower eGFR percentile (1^st, 2.5^th, 5^th, 10^th) and an adverse event by age from 18 to 65 relative to the age based median.

Results

Overall eGFR values declined with age and the risk of an adverse event was higher with an eGFR in the 10^th percentile of lower across all age groups (see Figure). In younger individuals, lower percentiles of eGFR occurred at higher eGFR cutoffs relative to older individuals and were associated with an elevated risk of an adverse event. For example, an eGFR in the lowest 5^th percentile would occur < 93 ml/min at age 20, < 80 ml/min at age 40, and below 65 ml/min at age 60 with corresponding adjusted HRs for an adverse event of 1.42, 1.28 and 1.32, respectively.

Conclusion

An age distribution-based approach to identifying lower eGFR values and their associated risk of an adverse event may improve care.

Figure: Trends in index estimated glomerular filtration rate (eGFR, in mL/min/1.73m²) and associated adjusted HRs of any adverse outcome (first of death, cardiovascular events, end-stage kidney disease) by continuous age