Portal de Periódicos da CAPES

Global Cardiovascular and Renal Outcomes of Reduced GFR

2017; American Society of Nephrology; Volume: 28; Issue: 7 Linguagem: Inglês

10.1681/asn.2016050562

1533-3450

Bernadette Thomas, Kunihiro Matsushita, Kalkidan Hassen Abate, Ziyad Al‐Aly, Johan Ärnlöv, Kei Asayama, Robert C. Atkins, Alaa Badawi, Shoshana H. Ballew, Amitava Banerjee, Lars Barregård, Elizabeth Barrett‐Connor, Sanjay Basu, Aminu K. Bello, Isabela M. Benseñor, Jaclyn Bergstrom, Boris Bikbov, Christopher D. Blosser, Hermann Brenner, Juan Jesús Carrero, Steven J. Chadban, Massimo Círillo, Monica Cortinovis, Karen Courville, Lalit Dandona, Rakhi Dandona, Kara Estep, João Carlos Fernandes, Florian Fischer, Caroline S. Fox, Ron T. Gansevoort, Philimon Gona, Orlando M. Gutiérrez, Samer Hamidi, Sarah Wulf Hanson, Jonathan Himmelfarb, Simerjot K Jassal, Sun Ha Jee, Vivekanand Jha, Aída Jiménez-Corona, Jost B. Jonas, André Pascal Kengne, Yousef Khader, Young‐Ho Khang, Young‐Eun Kim, Barbara E.K. Klein, Ronald Klein, Yoshihiro Kokubo, Dhaval Kolte, Kristine Lee, Andrew S. Levey, Yongmei Li, Paulo A. Lotufo, Hassan Magdy Abd El Razek, Walter Mendoza, Hirohito Metoki, Yejin Mok, Isao Muraki, Paul Muntner, Hiroyuki Noda, Takayoshi Ohkubo, Alberto Ortíz, Norberto Perico, Kevan R. Polkinghorne, Rajaa Al-Radaddi, Giuseppe Remuzzi, Gregory A. Roth, Dietrich Rothenbacher, Michihiro Satoh, Kai‐Uwe Saum, Monika Sawhney, Ben Schöttker, Anoop Shankar, Michael Shlipak, Diego Augusto Santos Silva, Hideaki Toyoshima, Kingsley Nnanna Ukwaja, Mitsumasa Umesawa, Dan J. Stein, David G. Warnock, Andrea Werdecker, Kazumasa Yamagishi, Yuichiro Yano, Naohiro Yonemoto, Maysaa El Sayed Zaki, Mohsen Naghavi, Mohammad H Forouzanfar, Christopher J L Murray, Josef Coresh, Theo Vos,

Dialysis and Renal Disease Management

The burden of premature death and health loss from ESRD is well described. Less is known regarding the burden of cardiovascular disease attributable to reduced GFR. We estimated the prevalence of reduced GFR categories 3, 4, and 5 (not on RRT) for 188 countries at six time points from 1990 to 2013. Relative risks of cardiovascular outcomes by three categories of reduced GFR were calculated by pooled random effects meta-analysis. Results are presented as deaths for outcomes of cardiovascular disease and ESRD and as disability-adjusted life years for outcomes of cardiovascular disease, GFR categories 3, 4, and 5, and ESRD. In 2013, reduced GFR was associated with 4% of deaths worldwide, or 2.2 million deaths (95% uncertainty interval [95% UI], 2.0 to 2.4 million). More than half of these attributable deaths were cardiovascular deaths (1.2 million; 95% UI, 1.1 to 1.4 million), whereas 0.96 million (95% UI, 0.81 to 1.0 million) were ESRD-related deaths. Compared with metabolic risk factors, reduced GFR ranked below high systolic BP, high body mass index, and high fasting plasma glucose, and similarly with high total cholesterol as a risk factor for disability-adjusted life years in both developed and developing world regions. In conclusion, by 2013, cardiovascular deaths attributed to reduced GFR outnumbered ESRD deaths throughout the world. Studies are needed to evaluate the benefit of early detection of CKD and treatment to decrease these deaths.