Estimated glomerular filtration rate is a marker of mortality in the European Scleroderma Trials and Research Group (EUSTAR) database
Por:
Gigante A, Hoffmann-Vold AM, Fegatelli DA, Gabrielli A, Leodori G, Coleiro B, De Santis M, Dagna L, Alegre-Sancho JJ, Montecucco C, Carreira PE, Balbir-Gurman A, Doria A, Riemekasten G, Airò P, Distler J, Distler O, Rosato E and EUSTAR collaborators
Publicada:
1 ene 2022
Ahead of Print:
1 mar 2021
Resumen:
Objectives The study aim was to evaluate the estimated glomerular filtration rate (eGFR), its association with clinical disease and its predictive ability with respect to mortality in SSc patients from the European Scleroderma Trials and Research Group (EUSTAR) database. Methods SSc patients from the EUSTAR database who had items required for the calculation of eGFR at a baseline visit and a second follow-up visit available were included. A cut-off eGFR value of 60 ml/min was chosen for all SSc patients, and 30 ml/min for those with scleroderma renal crisis (SRC). Cox regression and competing risk analysis were performed to evaluate the use of eGFR as a predictive factor of mortality. Results A total of 3650 SSc patients were included in this study. The median serum level of creatinine and the mean of eGFR were 0.8 mg/dl (interquartile range = 0.6-0.9) and 86.6 +/- 23.7 ml/min, respectively. The eGFR was significantly lower in patients with pulmonary hypertension. Overall survival (OS) was significantly reduced in SSc patients with eGFR < 60 ml/min compared with patients with eGFR >= 60 ml/min [OS at 5 years 0.763 (95% CI: 0.700, 0.814) vs 0.903 (95% CI: 0.883, 0.919; P < 0.001)]. In multivariable analysis, OS was associated with male gender (P < 0.01), systolic pulmonary arterial pressure (sPAP) (P < 0.001) and eGFR (P < 0.001). The cumulative incidence of deaths due to SSc was associated with increased sPAP (P < 0.001) and reduced eGFR (P < 0.05). The OS at 5 years of 53 SRC patients was not significantly different between SSc patients with eGFR > 30 ml/min and those with eGFR Conclusion eGFR represents a predictive risk factor for overall survival in SSc. The eGFR, however, does not represent a risk factor for death in SRC.
Filiaciones:
Gigante A:
Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
Hoffmann-Vold AM:
Department of Rheumatology, Oslo University Hospital, Norway
Fegatelli DA:
Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
Gabrielli A:
Istituto di Clinica Medica Generale, Ematologia ed Immunologia Clinica, Università Politecnica delle Marche, University of Ancona, Italy
Leodori G:
Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
Coleiro B:
Stella Maris Kannizzata Street, Balzan-Malta
De Santis M:
Division Rheumatology and Clinical Immunology Department, Humanitas Clinical and Research Center- IRCCS, Rozzano, Italy, Milan
Dagna L:
Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR) San Raffaele Hospital-Vita-Salute San Raffaele University, Milan, Italy
:
Hospital Universitario Dr Peset Avda. Gaspar Aguilar, Valencia, Spain
Montecucco C:
Unità Operativa e Cattedra di Reumatologia, IRCCS Policlinico S Matteo, Pavia, Italy
Carreira PE:
Servicio de Reumatología, Hospital 12 de Octubre. Avda. De Córdoba s/n, Madrid, Spain
Balbir-Gurman A:
B. Shine Rheumatology Institute, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion, Haifa, Israel
Doria A:
Department of Clinical and Experimental Medicine University of Padova, Rheumatology Unit, Italy
Riemekasten G:
Dept Rheumatology and Clinical Immunology, University clinic Schleswig-Holstein, Lübeck, University of Lübeck, Lübeck, Germany
Airò P:
UOC Reumatologia ed Immunologia Clinica, Spedali Civili, Brescia, Italy
Distler J:
Department of Internal Medicine 3 Universitätsklinikum Erlangen Ulmenweg, Germany
Distler O:
Department of Rheumatology, University Hospital Zürich Gloriastr, Switzerland
Rosato E:
Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
Green Accepted, Green Published
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