Kidney Week 2019 — eGFR variability increases risk of cardiovascular events and all-cause mortality


  • Marielle Fares, Pharm.D.
  • Conference Reports
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Takeaway

  • Estimated glomerular filtration rate (eGFR) variability associated with a higher risk of all-cause mortality independent of baseline eGFR.
  • Further studies are required to evaluate mechanisms for these associations.

Why this matters

  • High variability exists in eGFR during an individual patient's kidney disease course.
  • Low eGFR is an independent cardiovascular risk factor, but the clinical significance of changes in eGFR over time is unknown.

Study design

  • The SPRINT trial enrolled 7520 participants.
  • Researchers used proportional hazards models to estimate associations between eGFR variability (coefficient of variation, CV) and subsequent cardiovascular disease (CVD) events and all-cause mortality.
  • The CV (standard deviation [SD]/mean) was calculated from eGFR values measured at 6-, 12-, and 18-month study visits.
  • CVD was defined as the composite of myocardial infarction, acute coronary syndrome, stroke, heart failure, or CVD death.

Key results

  • The mean eGFR was 73±21 mL/minute/1.73 m2 at 6 months.
  • A total of 370 CVD events and 154 deaths occurred at 2.4 years.
  • Greater eGFR variability was associated with all-cause mortality (HR per SD increase in eGFR-CV [0.06],1.28; 95% CI, 1.14-1.44) with weaker associations for CVD events (HR 1.06, 0.96-1.17).
  • Associations were similar across treatment arms and baseline chronic kidney disease status.