Ryu Jiwon, Park Yujin, Kim Hye Won, Kim Nak-Hyun, Kim Su Hwan, Lee Seung Min, Bae Ye Seul, Yoon Hyung-Jin
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, South Korea.
Nephrology (Carlton). 2022 Jun;27(6):519-527. doi: 10.1111/nep.14037. Epub 2022 Mar 20.
We evaluated whether estimated glomerular filtration rate variability in the general population could be associated with all-cause mortality.
Health examination data from 7842 individuals aged >20 years who visited for health check-ups at least thrice at ≥6-month intervals between May 1, 1995 and November 30, 2010 were collected. Estimated glomerular filtration rate variability was defined as the coefficient of variation of the estimated glomerular filtration rate, that is, standard deviation/mean value multiplied by 100. The study population was divided into three groups based on the coefficient of variation tertiles, and the mortality risks were compared across groups.
The mean duration from the final visit to the outcome was 10.3 ± 2.9 years. The mean coefficient of variations of estimated glomerular filtration rate variability from the lowest to the highest variability group were 5.1 ± 1.8%, 9.0 ± 1.0%, and 14.4 ± 3.9%, respectively. There was a 1.3 times higher risk of mortality in the group with the highest variability (hazard ratio: 1.300, 95% confidence interval: 1.013-1.669) after adjustment. The findings were similar in patients with diabetes and those >60 years old (hazard ratio: 1.635, 95% confidence interval: 1.076-2.483; hazard ratio: 1.585, 95% confidence interval: 1.107-2.269).
Higher estimated glomerular filtration rate variability was associated with increased 10-year mortality in the general population. This variability was very small, but considering the patients' long-term prognoses, it was significant.
我们评估了普通人群中估算肾小球滤过率变异性是否与全因死亡率相关。
收集了1995年5月1日至2010年11月30日期间7842名年龄大于20岁、至少每6个月进行一次健康检查且至少进行过三次健康检查的个体的健康检查数据。估算肾小球滤过率变异性定义为估算肾小球滤过率的变异系数，即标准差/平均值乘以100。根据变异系数三分位数将研究人群分为三组，并比较各组的死亡风险。
从最后一次随访到出现结局的平均时间为10.3±2.9年。从最低变异性组到最高变异性组，估算肾小球滤过率变异性的平均变异系数分别为5.1±1.8%、9.0±1.0%和14.4±3.9%。调整后，变异性最高组的死亡风险高1.3倍（风险比：1.300，95%置信区间：1.013-1.669）。在糖尿病患者和60岁以上患者中，结果相似（风险比：1.635，95%置信区间：1.076-2.483；风险比：1.585，95%置信区间：1.107-2.269）。
较高的估算肾小球滤过率变异性与普通人群10年死亡率增加相关。这种变异性非常小，但考虑到患者的长期预后，它具有重要意义。
