Journal
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY
Volume 28, Issue 7, Pages 2167-2179Publisher
AMER SOC NEPHROLOGY
DOI: 10.1681/ASN.2016050562
Keywords
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Categories
Funding
- National Heart, Lung, and Blood Institute (NHLBI) [HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201100008C, HHSN268201100009C, HHSN268201100010C, HHSN268201100011C, HHSN268201100012C]
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
- National Health andMedical Research Council of Australia [233200]
- Amgen Australia
- Kidney Health Australia
- Royal Prince Alfred Hospital, Sydney, Australia
- National Institutes of Health (NIH)
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) [NIH/NIDDK DK7321, NIH/NEI EY F06594]
- Research to Prevent Blindness
- Ministry of Research, Science and the Arts Baden-Wurttemberg (Stuttgart, Germany)
- Federal Ministry of Education and Research (Berlin, Germany)
- Federal Ministry of Family Affairs, Senior Citizens, Women and Youth (Berlin, Germany)
- European Commission FP7 framework programme of DG-Research (Consortium on Health and Ageing: Network of Cohorts in Europe and the United States Project).
- DadeBehring, Marburg, Germany
- European Union [703226]
- Bill andMelinda Gates Foundation
- National Center for Research Resources [UL1-RR-000040, UL1-RR-025005]
- Ministry ofHealth, Labor andWelfare, Health and Labor Sciences ResearchGrants, Japan [H20-22Junkankitou [Seishuu]-Ippan-009, 013, H23Junkankitou [Senshuu]-Ippan-005]
- Japan Atherosclerosis Prevention Fund
- Swedish Research Council
- SwedishHeart-Lung Foundation
- Marianne and MarcusWallenberg Foundation
- Dalarna University
- Uppsala University
- Dutch Kidney Foundation
- Dutch Heart Foundation
- Dutch Government
- NIH
- University Medical Center Groningen, The Netherlands
- National Institute of Neurological Disorders and Stroke, NIH, Department of Health and Human Service [U01 NS041588]
- NHLBI [R01 HL080477]
- Seoul City RAMP
- BD program, Korea [10526]
- National RAMP
- D Program for Cancer Control, Ministry for Health, Welfare and Family Affairs, Republic of Korea [1220180]
- National Research Foundation of Korea grant funded by the Korean Government [2011-0029348]
- Municipal and Health Authorities of Gubbio, Italy
- Federico II University, Naples, Italy
- University of Milan, Milan, Italy
- Istituto Superiore di Sanita, Rome, Italy
- Northwestern University, Chicago
- University of Salerno, Italy
- Merck Sharp Dohme, Italy
- International Society of Nephrology, Research and Prevention Committee, Brussels, Belgium
- Istituto di Ricerche Farmacologiche Mario Negri, Clinical Research Center for Rare Diseases Aldo e Cele Dacco, Bergamo, Italy
- National Institute on Aging [AG07181, AG028507 NIDDK DK31801]
- National Research Foundation of Korea [2011-0029348] Funding Source: Korea Institute of Science & Technology Information (KISTI), National Science & Technology Information Service (NTIS)
- Marie Curie Actions (MSCA) [703226] Funding Source: Marie Curie Actions (MSCA)
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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.
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