The impact of baseline glomerular filtration rate on subsequent changes of glomerular filtration rate in patients with chronic kidney disease

Abstract Higher baseline glomerular filtration rate (GFR) may yield subsequent steeper GFR decline, especially in patients with diabetes mellitus (DM). However, this correlation in patients with chronic kidney disease (CKD) and the presence or absence of DM remains controversial. We conducted a long...

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Autores principales:	Yi-Chih Lin, Tai-Shuan Lai, Shuei-Liong Lin, Yung-Ming Chen, Tzong-Shinn Chu, Yu-Kang Tu
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/f926d961cf4f4cda88ce6612f725dda9
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spelling	oai:doaj.org-article:f926d961cf4f4cda88ce6612f725dda92021-12-02T18:03:46ZThe impact of baseline glomerular filtration rate on subsequent changes of glomerular filtration rate in patients with chronic kidney disease10.1038/s41598-021-86955-z2045-2322https://doaj.org/article/f926d961cf4f4cda88ce6612f725dda92021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-86955-zhttps://doaj.org/toc/2045-2322Abstract Higher baseline glomerular filtration rate (GFR) may yield subsequent steeper GFR decline, especially in patients with diabetes mellitus (DM). However, this correlation in patients with chronic kidney disease (CKD) and the presence or absence of DM remains controversial. We conducted a longitudinal cohort study in a single medical center between 2011 and 2018. Participants with CKD stage 1 to 3A were enrolled and divided into DM groups and non-DM groups, and then followed up at least every 6 months. We used a linear mixed regression model with centering time variable to overcome the problem of mathematical coupling in the analysis of the relation between baseline GFR and the changes, and compared the results from correct and incorrect specifications of the mixed models. A total number of 1002 patients with 285 diabetic and 717 non-diabetic persons was identified. The linear mixed regression model revealed a significantly negative correlation between baseline GFR and subsequent GFR change rate in both diabetic group and non-diabetic group (r = − 0.44 [95% confidence interval [CI], − 0.69 to − 0.09]), but no statistical significance in non-diabetic group after within-subject mean centering of time variable (r = − 0.09 [95% CI, − 0.41 to 0.25]). Our study showed that higher baseline GFR was associated with a subsequent steeper GFR decline in the DM group but not in the non-DM group among patients with early-stage CKD. Exact model specifications should be described in detail to prevent from a spurious conclusion.Yi-Chih LinTai-Shuan LaiShuei-Liong LinYung-Ming ChenTzong-Shinn ChuYu-Kang TuNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Yi-Chih Lin Tai-Shuan Lai Shuei-Liong Lin Yung-Ming Chen Tzong-Shinn Chu Yu-Kang Tu The impact of baseline glomerular filtration rate on subsequent changes of glomerular filtration rate in patients with chronic kidney disease
description	Abstract Higher baseline glomerular filtration rate (GFR) may yield subsequent steeper GFR decline, especially in patients with diabetes mellitus (DM). However, this correlation in patients with chronic kidney disease (CKD) and the presence or absence of DM remains controversial. We conducted a longitudinal cohort study in a single medical center between 2011 and 2018. Participants with CKD stage 1 to 3A were enrolled and divided into DM groups and non-DM groups, and then followed up at least every 6 months. We used a linear mixed regression model with centering time variable to overcome the problem of mathematical coupling in the analysis of the relation between baseline GFR and the changes, and compared the results from correct and incorrect specifications of the mixed models. A total number of 1002 patients with 285 diabetic and 717 non-diabetic persons was identified. The linear mixed regression model revealed a significantly negative correlation between baseline GFR and subsequent GFR change rate in both diabetic group and non-diabetic group (r = − 0.44 [95% confidence interval [CI], − 0.69 to − 0.09]), but no statistical significance in non-diabetic group after within-subject mean centering of time variable (r = − 0.09 [95% CI, − 0.41 to 0.25]). Our study showed that higher baseline GFR was associated with a subsequent steeper GFR decline in the DM group but not in the non-DM group among patients with early-stage CKD. Exact model specifications should be described in detail to prevent from a spurious conclusion.
format	article
author	Yi-Chih Lin Tai-Shuan Lai Shuei-Liong Lin Yung-Ming Chen Tzong-Shinn Chu Yu-Kang Tu
author_facet	Yi-Chih Lin Tai-Shuan Lai Shuei-Liong Lin Yung-Ming Chen Tzong-Shinn Chu Yu-Kang Tu
author_sort	Yi-Chih Lin
title	The impact of baseline glomerular filtration rate on subsequent changes of glomerular filtration rate in patients with chronic kidney disease
title_short	The impact of baseline glomerular filtration rate on subsequent changes of glomerular filtration rate in patients with chronic kidney disease
title_full	The impact of baseline glomerular filtration rate on subsequent changes of glomerular filtration rate in patients with chronic kidney disease
title_fullStr	The impact of baseline glomerular filtration rate on subsequent changes of glomerular filtration rate in patients with chronic kidney disease
title_full_unstemmed	The impact of baseline glomerular filtration rate on subsequent changes of glomerular filtration rate in patients with chronic kidney disease
title_sort	impact of baseline glomerular filtration rate on subsequent changes of glomerular filtration rate in patients with chronic kidney disease
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/f926d961cf4f4cda88ce6612f725dda9
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The impact of baseline glomerular filtration rate on subsequent changes of glomerular filtration rate in patients with chronic kidney disease

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