Ratio of blood urea nitrogen to serum creatinine at initiation of dialysis is associated with mortality: A multicenter prospective cohort study

AICOPP group

研究成果: Article

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Background Some studies have shown that the estimated glomerular filtration rate (eGFR) at the time of initiating dialysis was associated with mortality. However, the relationship between ratio of blood urea nitrogen to serum creatinine (BUN/Cr) and mortality is unknown. Methods The study was a multicenter, prospective cohort analysis including 1520 patients. Patients were classified into four quartiles based on the BUN/Cr ratio at the dialysis initiation, with Q1 having the lowest ratio and Q4 the highest. All-cause mortality after initiating dialysis was compared using the log-rank test. All-cause mortality of Q1, Q2, and Q3 was compared with that of Q4 using multivariate Cox proportional hazard regression analysis. Moreover, we compared the renal parameters including BUN/Cr ratio, eGFR, and creatinine clearance for sensitivity and specificity using receiver operative characteristic (ROC) curve. Results Significant differences were observed in all-cause mortality among the four groups (p<0.001). Multivariate analysis revealed that all-cause mortality was significantly higher in Q4 than in Q1 [hazard ratio (HR) = 1.82, 95% confidence interval (CI) 1.24–2.67, p = 0.002]. The increase in BUN/Cr ratio was positively associated with mortality (HR 1.04, 95% CI 1.02–1.06, p = 0.002). The sensitivity and specificity of BUN/Cr ratio for 180, 365, 730, and 1095 days mortality ranged between 0.60–0.72 and 0.59–0.71, respectively. The area under the curve of BUN/Cr for all-cause mortality was the highest among the renal parameters. Conclusion The BUN/Cr ratio at the time of initiation of dialysis was associated with all-cause mortality.

元の言語English
ページ(範囲)353-364
ページ数12
ジャーナルClinical and Experimental Nephrology
22
発行部数2
DOI
出版物ステータスPublished - 01-01-2018

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Blood Urea Nitrogen
Dialysis
Creatinine
Cohort Studies
Prospective Studies
Mortality
Serum
Glomerular Filtration Rate
Confidence Intervals
Kidney
Sensitivity and Specificity
Area Under Curve
Multivariate Analysis
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Physiology
  • Nephrology
  • Physiology (medical)

これを引用

@article{4396144352494bf5abbefc3223fdf2a0,
title = "Ratio of blood urea nitrogen to serum creatinine at initiation of dialysis is associated with mortality: A multicenter prospective cohort study",
abstract = "Background Some studies have shown that the estimated glomerular filtration rate (eGFR) at the time of initiating dialysis was associated with mortality. However, the relationship between ratio of blood urea nitrogen to serum creatinine (BUN/Cr) and mortality is unknown. Methods The study was a multicenter, prospective cohort analysis including 1520 patients. Patients were classified into four quartiles based on the BUN/Cr ratio at the dialysis initiation, with Q1 having the lowest ratio and Q4 the highest. All-cause mortality after initiating dialysis was compared using the log-rank test. All-cause mortality of Q1, Q2, and Q3 was compared with that of Q4 using multivariate Cox proportional hazard regression analysis. Moreover, we compared the renal parameters including BUN/Cr ratio, eGFR, and creatinine clearance for sensitivity and specificity using receiver operative characteristic (ROC) curve. Results Significant differences were observed in all-cause mortality among the four groups (p<0.001). Multivariate analysis revealed that all-cause mortality was significantly higher in Q4 than in Q1 [hazard ratio (HR) = 1.82, 95{\%} confidence interval (CI) 1.24–2.67, p = 0.002]. The increase in BUN/Cr ratio was positively associated with mortality (HR 1.04, 95{\%} CI 1.02–1.06, p = 0.002). The sensitivity and specificity of BUN/Cr ratio for 180, 365, 730, and 1095 days mortality ranged between 0.60–0.72 and 0.59–0.71, respectively. The area under the curve of BUN/Cr for all-cause mortality was the highest among the renal parameters. Conclusion The BUN/Cr ratio at the time of initiation of dialysis was associated with all-cause mortality.",
author = "{AICOPP group} and Daijo Inaguma and Daijo Inaguma and Eri Ito and Kazuo Takahashi and Kazuo Takahashi and Hiroki Hayashi and Yukio Yuzawa and Yukio Yuzawa and Minako Murata and Hibiki Shinjo and Yasuhiro Otsuka and Asami Takeda and Hirofumi Tamai and Tomohiko Naruse and Kei Kurata and Hideto Oishi and Isao Aoyama and Hiroshi Ogawa and Hiroko Kushimoto and Hideaki Shimizu and Junichiro Yamamoto and Hisashi Kurata and Taishi Yamakawa and Takaaki Yaomura and Hirotake Kasuga and Shizunori Ichida and Shoichi Maruyama and Seiichi Matsuo and Noritoshi Kato",
year = "2018",
month = "1",
day = "1",
doi = "10.1007/s10157-017-1458-x",
language = "English",
volume = "22",
pages = "353--364",
journal = "Clinical and Experimental Nephrology",
issn = "1342-1751",
publisher = "Springer Japan",
number = "2",

}

TY - JOUR

T1 - Ratio of blood urea nitrogen to serum creatinine at initiation of dialysis is associated with mortality

T2 - A multicenter prospective cohort study

AU - AICOPP group

AU - Inaguma, Daijo

AU - Inaguma, Daijo

AU - Ito, Eri

AU - Takahashi, Kazuo

AU - Takahashi, Kazuo

AU - Hayashi, Hiroki

AU - Yuzawa, Yukio

AU - Yuzawa, Yukio

AU - Murata, Minako

AU - Shinjo, Hibiki

AU - Otsuka, Yasuhiro

AU - Takeda, Asami

AU - Tamai, Hirofumi

AU - Naruse, Tomohiko

AU - Kurata, Kei

AU - Oishi, Hideto

AU - Aoyama, Isao

AU - Ogawa, Hiroshi

AU - Kushimoto, Hiroko

AU - Shimizu, Hideaki

AU - Yamamoto, Junichiro

AU - Kurata, Hisashi

AU - Yamakawa, Taishi

AU - Yaomura, Takaaki

AU - Kasuga, Hirotake

AU - Ichida, Shizunori

AU - Maruyama, Shoichi

AU - Matsuo, Seiichi

AU - Kato, Noritoshi

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background Some studies have shown that the estimated glomerular filtration rate (eGFR) at the time of initiating dialysis was associated with mortality. However, the relationship between ratio of blood urea nitrogen to serum creatinine (BUN/Cr) and mortality is unknown. Methods The study was a multicenter, prospective cohort analysis including 1520 patients. Patients were classified into four quartiles based on the BUN/Cr ratio at the dialysis initiation, with Q1 having the lowest ratio and Q4 the highest. All-cause mortality after initiating dialysis was compared using the log-rank test. All-cause mortality of Q1, Q2, and Q3 was compared with that of Q4 using multivariate Cox proportional hazard regression analysis. Moreover, we compared the renal parameters including BUN/Cr ratio, eGFR, and creatinine clearance for sensitivity and specificity using receiver operative characteristic (ROC) curve. Results Significant differences were observed in all-cause mortality among the four groups (p<0.001). Multivariate analysis revealed that all-cause mortality was significantly higher in Q4 than in Q1 [hazard ratio (HR) = 1.82, 95% confidence interval (CI) 1.24–2.67, p = 0.002]. The increase in BUN/Cr ratio was positively associated with mortality (HR 1.04, 95% CI 1.02–1.06, p = 0.002). The sensitivity and specificity of BUN/Cr ratio for 180, 365, 730, and 1095 days mortality ranged between 0.60–0.72 and 0.59–0.71, respectively. The area under the curve of BUN/Cr for all-cause mortality was the highest among the renal parameters. Conclusion The BUN/Cr ratio at the time of initiation of dialysis was associated with all-cause mortality.

AB - Background Some studies have shown that the estimated glomerular filtration rate (eGFR) at the time of initiating dialysis was associated with mortality. However, the relationship between ratio of blood urea nitrogen to serum creatinine (BUN/Cr) and mortality is unknown. Methods The study was a multicenter, prospective cohort analysis including 1520 patients. Patients were classified into four quartiles based on the BUN/Cr ratio at the dialysis initiation, with Q1 having the lowest ratio and Q4 the highest. All-cause mortality after initiating dialysis was compared using the log-rank test. All-cause mortality of Q1, Q2, and Q3 was compared with that of Q4 using multivariate Cox proportional hazard regression analysis. Moreover, we compared the renal parameters including BUN/Cr ratio, eGFR, and creatinine clearance for sensitivity and specificity using receiver operative characteristic (ROC) curve. Results Significant differences were observed in all-cause mortality among the four groups (p<0.001). Multivariate analysis revealed that all-cause mortality was significantly higher in Q4 than in Q1 [hazard ratio (HR) = 1.82, 95% confidence interval (CI) 1.24–2.67, p = 0.002]. The increase in BUN/Cr ratio was positively associated with mortality (HR 1.04, 95% CI 1.02–1.06, p = 0.002). The sensitivity and specificity of BUN/Cr ratio for 180, 365, 730, and 1095 days mortality ranged between 0.60–0.72 and 0.59–0.71, respectively. The area under the curve of BUN/Cr for all-cause mortality was the highest among the renal parameters. Conclusion The BUN/Cr ratio at the time of initiation of dialysis was associated with all-cause mortality.

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U2 - 10.1007/s10157-017-1458-x

DO - 10.1007/s10157-017-1458-x

M3 - Article

C2 - 28766029

AN - SCOPUS:85026519080

VL - 22

SP - 353

EP - 364

JO - Clinical and Experimental Nephrology

JF - Clinical and Experimental Nephrology

SN - 1342-1751

IS - 2

ER -