Renal markers and risks of all cause and cardiovascular mortality from the Taichung community based cohort study

Lin, Cheng‐Chieh; Chen, Ting‐Yu; Li, Chia‐Ing; Liu, Chiu-Shong; Lin, Chih‐Hsueh; Wang, Mu-Cyun; Yang, Shumei; Li, Tsai‐Chung

doi:10.1038/s41598-021-93627-5

Cited by 8 publications

(8 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Besides, both the risk of all-cause and CV death caused by elevated UACR increased with the worsening of glucose regulation, with HR of all-cause death increasing from 1.81 to 2.15 and HR of CV death increasing from 2.39 to 3.39 in pre-DM and DM people respectively. Our results supported the previous studies, [15][16][17][18]30 which indicated the close relationship between elevated UACR and all-cause and CV mortality. However, most studies conformed the value of elevated UACR to predict all-cause and CV mortality in diabetic and general population.…”

Section: Discussionsupporting

confidence: 93%

“…The research of Hoorn Diabetes Care System cohort showed increased UACR (>3.0 mg/mmol) was prospectively associated with a higher risk of CV mortality in type 2 DM patients 16 . The same phenomenon was also found in general population 17 . However, a study by Siddique et al reported mildly increased albuminuria (UACR ≥10 and <30 mg/g) was a significant predictor of all‐cause and CV death in those with type 2 DM 18 .…”

Section: Introductionsupporting

confidence: 67%

“…Our findings supported the notion that the contemporary threshold for microalbuminuria might be higher than the cutoff point at which increased mortality risk begins and challenged the designation of the range <30 mg/gCr as normoalbuminuria. A few previous studies reported albuminuria levels less than the traditional cutoff value (30 mg/gCr) predicted CV mortality in both general and diabetic population 17,20,21 . The study by Zhang et al 21 found that UACR levels of 10 to <30 mg/gCr were associated with the higher risk of all‐cause mortality in Chinese community population.…”

Section: Discussionmentioning

confidence: 96%

See 2 more Smart Citations

Lower urinary albumin‐to‐creatinine ratio predicted all‐cause and cardiovascular mortality in Chinese population with diabetes and prediabetes—The Shanghai Changfeng cohort study

Chen,

Wu,

et al. 2023

Journal of Diabetes

View full text Add to dashboard Cite

IntroductionElevated urinary albumin‐to‐creatinine ratio (UACR) was associated with increased mortality in general population and diabetic patients. However, whether the association remains similar in the subjects with different status of glucose metabolism was unclear. The optimal level of UACR in predicting mortality also remained unknown. This study aims to investigate the relationship between UACR with all‐cause and cardiovascular mortality in population with different status of glucose metabolism and explore the predictive cutoff point of UACR.MethodsSix thousand three hundred and eighty‐six community‐dwelling individuals aged ≥45 years were enrolled and followed for an average of 5.3 years. Cox proportional hazards model was performed to analysis the association of baseline UACR and all‐cause as well as cardiovascular mortality according to the status of glucose metabolism. Receiver operating characteristic curve was plotted to explore the optimal predictive cutoff point of UACR.ResultsWith UACR increasing, both the prevalence of all‐cause and cardiovascular death increased. Cox analyses showed baseline UACR independently predicted the risk of all‐cause and cardiovascular mortality in the patients with prediabetes mellitus (pre‐DM) and diabetes mellitus (DM) but not in subjects with normal glucose tolerance (NGT). When divided by quartiles of UACR, the cumulative survival rate decreased acrossing the quartiles. Compared to the subjects with lowest quartile of UACR, participants with UACR ≥7.40 mg/gCr had a higher risk of all‐cause mortality, and participants with UACR ≥16.60 mg/gCr had an increased risk of cardiovascular mortality in all hyperglycemia subjects. The optimal predictive cutoff point of UACR was about 17 mg/gCr.ConclusionUACR was an independent predictor of all‐cause and cardiovascular mortality in population with pre‐DM and DM but not in the subjects with NGT. The optimal predictive cutoff point of UACR is about 17 mg/gCr, which was far below the diagnostic cutoff point of microalbuminuria. Earlier interventions of albuminuria should be initiated from very early stage of hyperglycemia to reduce the burden of death in all patients whose glucose metabolism are impaired.

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Introductionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 96%

See 1 more Smart Citation

Lower urinary albumin‐to‐creatinine ratio predicted all‐cause and cardiovascular mortality in Chinese population with diabetes and prediabetes—The Shanghai Changfeng cohort study

Chen,

Wu,

et al. 2023

Journal of Diabetes

View full text Add to dashboard Cite

show abstract

“…Our nomogram showed that the levels of hemoglobin and albumin had negative association with the risk score of mortality. BUN is a sensitive index for reflecting renal function, many studies suggested BUN was associated with increased all-cause mortality in various populations [ 55 , 56 ]. BUN could reflect the whole health status and functional level in the general older population [ 55 ].…”

Section: Discussionmentioning

confidence: 99%

Development, validation, and visualization of a web-based nomogram to predict 5-year mortality risk in older adults with hypertension

2022

View full text Add to dashboard Cite

Background Hypertension-related mortality has been increasing in older adults, resulting in serious burden to society and individual. However, how to identify older adults with hypertension at high-risk mortality remains a great challenge. The purpose of this study is to develop and validate the prediction nomogram for 5-year all-cause mortality in older adults with hypertension. Methods Data were extracted from National Health and Nutrition Examination Survey (NHANES). We recruited 2691 participants aged 65 years and over with hypertension in the NHANES 1999-2006 cycles (training cohort) and 1737 participants in the NHANES 2007-2010 cycles (validation cohort). The cohorts were selected to provide at least 5 years follow-up for evaluating all-cause mortality by linking National Death Index through December 31, 2015. We developed a web-based dynamic nomogram for predicting 5-year risk of all-cause mortality based on a logistic regression model in training cohort. We conducted internal validation by 1000 bootstrapping resamples and external validation in validation cohort. The discrimination and calibration of nomogram were evaluated using concordance index (C-index) and calibration curves. Results The final model included eleven independent predictors: age, sex, diabetes, cardiovascular disease, body mass index, smoking, lipid-lowering drugs, systolic blood pressure, hemoglobin, albumin, and blood urea nitrogen. The C-index of model in training and validation cohort were 0.759 (bootstrap-corrected C-index 0.750) and 0.740, respectively. The calibration curves also indicated that the model had satisfactory consistence in two cohorts. A web-based nomogram was established (https://hrzhang1993.shinyapps.io/dynnomapp). Conclusions The novel developed nomogram is a useful tool to accurately predict 5-year all-cause mortality in older adults with hypertension, and can provide valuable information to make individualized intervention.

show abstract

“…Blood urea nitrogen (BUN), a product of the metabolism of nitrogen compounds, was described to be associated with mortality in various human diseases. Elevated BUN regarding renal dysfunction is associated with the increased risk of incident diabetes (7) and mortality in cardiovascular diseases (8)(9)(10). A non-linear correlation between BUN and post-operative 30-day mortality was reported in patients with sepsis (11).…”

Section: Introductionmentioning

confidence: 99%

Association Between Pre-operative BUN and Post-operative 30-Day Mortality in Patients Undergoing Craniotomy for Tumors: Data From the ACS NSQIP Database

Liu

et al. 2022

Front. Neurol.

View full text Add to dashboard Cite

ObjectiveThere is limited evidence to clarify the specific relationship between pre-operative blood urea nitrogen (BUN) and post-operative 30-day mortality in patients undergoing craniotomy for tumors. Therefore, we aimed to investigate this relationship in detail.MethodsElectronic medical records of 18,642 patients undergoing craniotomy for tumors in the ACS NSQIP from 2012 to 2015 were subjected to secondary retrospective analysis. The principal exposure was pre-operative BUN. Outcome measures were post-operative 30-day mortality. We used binary logistic regression modeling to evaluate the association between them and conducted a generalized additive model and smooth curve fitting (penalized spline method) to explore the potential relationship and its explicit curve shape. We also conducted sensitivity analyses to ensure the robustness of the results and performed subgroup analyses.ResultsA total of 16,876 patients were included in this analysis. Of these, 47.48% of patients were men. The post-operative 30-day mortality of the included cases was 2.49% (420/16,876), and the mean BUN was 16.874 ± 6.648 mg/dl. After adjusting covariates, the results showed that pre-operative BUN was positively associated with post-operative 30-day mortality (OR = 1.020, 95% CI: 1.004, 1.036). There was also a non-linear relationship between BUN and post-operative 30-day mortality, and the inflection point of the BUN was 9.804. For patients with BUN < 9.804 mg/dl, a 1 unit decrease in BUN was related to a 16.8% increase in the risk of post-operative 30-day mortality (OR = 0.832, 95% CI: 0.737, 0.941); for patients with BUN > 9.804 mg/dl, a 1 unit increase in BUN was related to a 2.8% increase in the risk of post-operative 30-day mortality (OR = 1.028, 95% CI: 1.011, 1.045). The sensitivity analysis proved that the results were robust. The subgroup analysis revealed that all listed subgroups did not affect the relationship between pre-operative BUN and post-operative 30-day mortality (P > 0.05).ConclusionOur study demonstrated that pre-operative BUN (mg/dl) has specific linear and non-linear relationships with post-operative 30-day mortality in patients over 18 years of age who underwent craniotomy for tumors. Proper pre-operative management of BUN and maintenance of BUN near the inflection point (9.804 mg/dl) could reduce the risk of post-operative 30-day mortality in these cases.

show abstract

Renal markers and risks of all cause and cardiovascular mortality from the Taichung community based cohort study

Cited by 8 publications

References 35 publications

Lower urinary albumin‐to‐creatinine ratio predicted all‐cause and cardiovascular mortality in Chinese population with diabetes and prediabetes—The Shanghai Changfeng cohort study

Lower urinary albumin‐to‐creatinine ratio predicted all‐cause and cardiovascular mortality in Chinese population with diabetes and prediabetes—The Shanghai Changfeng cohort study

Development, validation, and visualization of a web-based nomogram to predict 5-year mortality risk in older adults with hypertension

Association Between Pre-operative BUN and Post-operative 30-Day Mortality in Patients Undergoing Craniotomy for Tumors: Data From the ACS NSQIP Database

Contact Info

Product

Resources

About