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  • Joo, Kwon Wook  (3)
  • Lee, Yeonhee  (3)
  • 1
    In: Clinical Kidney Journal, Oxford University Press (OUP), Vol. 14, No. 5 ( 2021-04-30), p. 1356-1363
    Abstract: The estimated glomerular filtration rate (eGFR) is a biomarker not only for kidney function, but also for major clinical outcomes. We aimed to evaluate the patterns of mortality across the entire eGFR percentile spectrum using a population-based dataset. Methods We retrospectively reviewed the National Health Insurance Service (NHIS) database for people who received nationwide health check-ups from 2009 to 2012. Subjects who were ≥45 years old and had one or more serum creatinine values available were included in the study. The primary outcome was all-cause mortality as a function of eGFR percentile. Results The middle-aged group (45–64 years) showed a U-shaped pattern of association between eGFR percentile and all-cause mortality. The minimum-mortality eGFR percentile was shifted upward in the elderly group (≥65 years). Specifically, the minimum-mortality eGFR percentiles were the 28th percentile (83.8 mL/min/1.73 m2) for middle-aged males, the 63rd percentile (86.2 mL/min/1.73 m2) for elderly males, the 42nd percentile (102.8 mL/min/1.73 m2) for middle-aged females and the 75th percentile (90.1 mL/min/1.73 m2) for elderly females. Diabetes and hypertension shifted the minimum-mortality eGFR percentile upward in the middle-aged group. This pattern was attenuated in the elderly group. Conclusions The eGFR percentile showing minimum mortality moves upward in the aged population as well as patients with diabetes and hypertension, which might reduce the clinical significance of hyperfiltration. Risk stratification for mortality should be approached differently according to the specific conditions of the patient group.
    Type of Medium: Online Resource
    ISSN: 2048-8513
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2656786-6
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  • 2
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2020
    In:  Cancer Epidemiology, Biomarkers & Prevention Vol. 29, No. 10 ( 2020-10-01), p. 2070-2077
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 29, No. 10 ( 2020-10-01), p. 2070-2077
    Abstract: Glomerular hyperfiltration is associated with all-cause mortality. Herein, we evaluated the association between glomerular hyperfiltration and the development of cancer, the most common cause of death, in an Asian population. Methods: We retrospectively reviewed the National Health Insurance Service database of Korea for people who received national health screenings from 2012 to 2013. Glomerular hyperfiltration was defined as the 95th percentile and greater after stratification by sex and age decile. We performed a multivariate Cox regression analysis using glomerular hyperfiltration at the first health screening as the exposure variable and cancer development as the outcome variable to evaluate the impact of glomerular hyperfiltration on the development of cancer. Results: A total of 1,953,123 examinations for patients with a median follow-up time of 4.4 years were included in this study. Among the 8 different site-specific cancer categories, digestive organs showed significant associations between glomerular hyperfiltration and cancer. The population with glomerular hyperfiltration showed an increased risk for stomach cancer [adjusted hazard ratio (aHR) = 1.22], colorectal cancer (aHR = 1.16), and liver or intrahepatic malignancy (aHR = 1.35). Conclusions: Glomerular hyperfiltration was associated with an increased risk for the development of cancer in specific organs, such as the stomach, colorectum, and liver and intrahepatic organ. Impact: Glomerular hyperfiltration needs to be considered a significant sign of the need to evaluate the possibility of hidden adverse health conditions, including malignancies.
    Type of Medium: Online Resource
    ISSN: 1055-9965 , 1538-7755
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2020
    detail.hit.zdb_id: 2036781-8
    detail.hit.zdb_id: 1153420-5
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  • 3
    In: Clinical Kidney Journal, Oxford University Press (OUP), Vol. 14, No. 8 ( 2021-07-29), p. 1961-1968
    Abstract: Dyslipidemia is an essential parameter in the prediction of cardiovascular disease (CVD). We aimed to explore whether lipid profiles could predict major outcomes in patients with advanced chronic kidney disease (CKD). Methods We retrospectively reviewed the National Health Insurance Service database for people who received nationwide health screening in 2009. All subjects exposed to a lipid-lowering agent before screening were excluded. The population was divided into control, early [estimated glomerular filtration rate (eGFR) 45–59 mL/min/1.73 m2] and advanced (eGFR  & lt;45 mL/min/1.73 m2) CKD groups. The hazard ratios (HRs) of outcomes were calculated using multivariate Cox regression models. Results A total of 3 634 873 participants were included in this study, with 404 298 (11.1%) and 66 805 (1.8%) having early and advanced CKD, respectively. For all populations, levels of triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) showed a linear association with major cardiovascular and cerebrovascular events (MACCEs) and all-cause mortality, while low-density lipoprotein cholesterol (LDL-C) showed a different pattern of association with MACCEs (linear association) from all-cause mortality (U-shaped association). The significance between the levels of LDL-C and outcomes was attenuated in the advanced CKD group. For TG/HDL-C, although the significance was decreased, the linear patterns with both MACCEs and all-cause mortality were maintained in the advanced CKD group. Conclusions The pattern and significance of lipid profiles were different according to the grade of kidney function. TG/HDL-C should be additionally considered as a predictive marker for CVD and mortality along with LDL-C in patients with CKD.
    Type of Medium: Online Resource
    ISSN: 2048-8513
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2656786-6
    Location Call Number Limitation Availability
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