RT Journal Article
SR Electronic
T1 Change in GFR over time in the Oxford Renal Cohort Study
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP BJGP.2021.0477
DO 10.3399/BJGP.2021.0477
A1 Jennifer A Hirst
A1 Maarten Taal
A1 Simon D Fraser
A1 Jose Ordóñez-Mena
A1 Chris O'Callaghan
A1 Richard McManus
A1 Clare Taylor
A1 Yaling Yang
A1 Emma Ogburn
A1 FD Richard Hobbs
YR 2021
UL http://bjgp.org/content/early/2021/12/22/BJGP.2021.0477.abstract
AB Background: Decline in kidney function can result in adverse health outcomes. The OxREN study has detailed baseline assessments from 884 participants ≥60 years. Aim: To determine the proportion of participants with decline in estimated glomerular filtration rate (eGFR), identify determinants of decline and determine proportions with chronic kidney disease (CKD) remission. Design and setting: Observational cohort study in UK primary care. Methods: Data were used from baseline and annual follow-up assessments to monitor change in kidney function. Rapid eGFR decline was defined as eGFR decrease >5 ml/min/1.73m2/year, improvement as eGFR increase >5ml/min/1.73m2/year and remission in those with CKD at baseline and eGFR>60 ml/min/1.73m2 during follow-up. Cox proportional hazard models were used to identify factors associated with eGFR decline. Results: In 686 participants with a median follow-up of 2.1 years, 164 (24%) evidenced rapid GFR decline, 185 (27%) experienced eGFR improvement and 82 of 394 (21%) meeting CKD stage 1-4 at baseline experienced remission. In the multivariable analysis, smoking status, higher systolic blood pressure and being known to have CKD at cohort entry were associated with rapid GFR decline. Those with CKD stage 3 at baseline were less likely to exhibit GFR decline compared with normal kidney function. Conclusions: This study established that 24% of people evidenced rapid GFR decline whereas 21% evidenced remission of CKD. People at risk of rapid GFR decline may benefit from closer monitoring and appropriate treatment to minimise risks of adverse outcomes, though only a small proportion meet the NICE criteria for referral to secondary care.