Moderate decline in kidney function associated with poor outcomes in young adults

Even with a limited decrease in glomerular filtration rate (eGFR) to less than 80 ml/min/1.73 m22 In a large Canadian study, several poor outcomes were found to be more common, especially among young people. To detect kidney damage early and prevent complications, kidney function should be better monitored, the researchers wrote BMJ.

The researchers conducted their study retrospectively based on linked healthcare datasets in Ontario, Canada. They analyzed data on 8,703,871 adults (18-65 years) who had their glomerular filtration rate (GFR) determined at least once in outpatient settings between 2008 and 2021, but who had no history of kidney disease. Reference values ​​were established based on age: 100-110 ml/min/1.73 m2 For the age group 18-39 years, 90-100 for the age group 40-49 years, and 80-90 for the age group 50-65 years. Moderately low (age-specific) glomerular filtration rate (GFR) levels were found in 18.0% of people aged 18-39 years, 18.8% of people aged 40-49 years, and 17.0% of people They are between 50-65 years old.

The primary endpoint was a composite outcome measure of overall death, cardiovascular event or renal failure. For moderate decrease in glomerular filtration rate up to 70-80 ml/min/1.73 m2 The hazard ratio for the risk of the primary endpoint was 1.42 (95% CI 1.35-1.49; 4.39/1000 person-years) in the age group 18-39 years. For participants aged 40–49 years, this hazard ratio was 1.13 (95% CI: 1.10–1.16; 9.61/1000 person-years) and for those aged 50–65 years it was 1.08 (95% CI): . ; 23.4/1000 person-years).

The risk of poor outcomes was structurally higher in the youngest age group of 18–39 years, i.e. in all eGFR categories, than in the oldest groups. Even when individual results from the pooled endpoint were analyzed separately, this finding remained valid.

source:

Hussein J, Grubek N, Akbari A, et al. Associations between modest reductions in renal function and adverse outcomes in young adults: a retrospective population-based cohort study. BMJ 2023;381:e075062.