Association between GFR estimated by multiple methods at dialysis commencement and patient survival

Wong M.G., Pollock C.A., Cooper B.A., Branley P., Collins J.F., Craig J.C., Kesselhut J., Luxton G., Pilmore A., Harris D.C. and Johnson D.W. (2014) Association between GFR estimated by multiple methods at dialysis commencement and patient survival. Clinical Journal of the American Society of Nephrology, 9 1: 135-142. doi:10.2215/CJN.02310213


Author Wong M.G.
Pollock C.A.
Cooper B.A.
Branley P.
Collins J.F.
Craig J.C.
Kesselhut J.
Luxton G.
Pilmore A.
Harris D.C.
Johnson D.W.
Title Association between GFR estimated by multiple methods at dialysis commencement and patient survival
Journal name Clinical Journal of the American Society of Nephrology   Check publisher's open access policy
ISSN 1555-9041
1555-905X
Publication date 2014-01-07
Sub-type Article (original research)
DOI 10.2215/CJN.02310213
Open Access Status
Volume 9
Issue 1
Start page 135
End page 142
Total pages 8
Place of publication Washington, DC, U.S.A.
Publisher American Society of Nephrology
Collection year 2015
Language eng
Subject 2727 Nephrology
2747 Transplantation
2713 Epidemiology
2706 Critical Care and Intensive Care Medicine
Abstract Background and objectives The Initiating Dialysis Early and Late study showed that planned early or late initiation of dialysis, based on the Cockcroft and Gault estimation of GFR, was associated with identical clinical outcomes. This study examined the association of all-cause mortality with estimated GFR at dialysis commencement, which was determined using multiple formulas. Design, setting, participants, & measurements Initiating Dialysis Early and Late trial participants were stratified into tertiles according to the estimated GFR measured by Cockcroft and Gault, Modification of Diet in Renal Disease, or Chronic Kidney Disease-Epidemiology Collaboration formula at dialysis commencement. Patient survival was determined using multivariable Cox proportional hazards model regression. Results Only Initiating Dialysis Early and Late trial participants who commenced on dialysis were included in this study (n=768). A total of 275 patients died during the study. After adjustment for age, sex, racial origin, body mass index, diabetes, and cardiovascular disease, no significant differences in survival were observed between estimated GFR tertiles determined by Cockcroft and Gault (lowest tertile adjusted hazard ratio, 1.11; 95% confidence interval, 0.82 to 1.49; middle tertile hazard ratio, 1.29; 95% confidence interval, 0.96 to 1.74; highest tertile reference), Modification of Diet in Renal Disease (lowest tertile hazard ratio, 0.88; 95% confidence interval, 0.63 to 1.24; middle tertile hazard ratio, 1.20; 95% confidence interval, 0.90 to 1.61; highest tertile reference), and Chronic Kidney Disease-Epidemiology Collaboration equations (lowest tertile hazard ratio, 0.93; 95% confidence interval, 0.67 to 1.27; middle tertile hazard ratio, 1.15; 95% confidence interval, 0.86 to 1.54; highest tertile reference). Conclusion Estimated GFR at dialysis commencement was not significantly associated with patient survival, regardless of the formula used. However, a clinically important association cannot be excluded, because observed confidence intervals were wide.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
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Created: Wed, 01 Apr 2015, 10:56:46 EST by Matthew Lamb on behalf of School of Medicine