대한신장학회

논문분류	춘계학술대회 초록집
제목	Risks of mortality and causes of death according to kidney function parameters: A nationwide observational study in Korea
저자	Sehyun Jung,Soojin Lee,Yaerim Kim,Semin Cho,Hyeok Huh,Dong Ki Kim,Kyungdo Han,Sehoon Park
출판정보	2022; 2022(1):
키워드
초록	Objectives: The association between the eGFR and death risks was reported to be U-shaped in previous studies. In addition, previous studies have reported the clinical significance of albuminuria in the general population, and the quantified albuminuria showed a linear association with mortality. However, as mortality occurs due to various causes, additional study is warranted to investigate the association between kidney function parameters and death by specific causes. Methods: We screened 10,585,843 adult (age ≥ 20 years old) who received health examinations conducted in 2009 using the National Health Insurance Database (NHID). After exclusion of those previously diagnosed with renal failure and those with missing data, 9,917,838 individuals with available baseline kidney function measurements were included. The primary outcome was mortality and cause-specific death identified through the death certificates based on the ICD-10 diagnostic codes performed until 2019. Multivariable Cox regression analysis adjusted for various clinicodemographic and social characteristics was used to assess the risks of mortality. Results: Figure 1 shows the heatmap according to risk relationships for all-cause mortality. The risks of mortality were divided by eGFR according to the presence or absence of albuminuria, as shown in Table 1. Most causes of death showed a U-shaped association with eGFR in both univariable and multivariable regression analyses, regardless of the presence or absence of albuminuria. Namely, both eGFR ranges < 60 and ≥ 120 mL/min/1.73 m2 were associated with a higher risk of death by various causes. Those with baseline albuminuria, regardless of eGFR, showed a significantly higher risk of all-cause mortality and deaths by diverse causes than those with eGFR in the reference range (90-120 mL/min/1.73 m2) without albuminuria. Conclusions: We reconfirmed the significant association between eGFR, albuminuria, and mortality. Health care providers should keep in mind that albuminuria and decreased eGFR as well as kidney hyperfiltration are independent predictors of mortality.
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