Long-term renal outcomes in patients with traumatic brain injury: A nationwide population-based cohort study

Chia Lin Wu, Chew Teng Kor, Ping Fang Chiu, Chun Chieh Tsai, Iebin Lian, Tao Hsiang Yang, Der Cherng Tarng, Chia Chu Chang

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Traumatic brain injury (TBI) is an important cause of death and disability worldwide. The relationship between TBI and kidney diseases is largely unknown. Methods: We aimed to determine whether TBI is associated with long-term adverse renal outcomes. We performed a nationwide, population-based, propensity score-matched cohort study of 32,152 TBI patients and 128,608 propensity score-matched controls. Data were collected by the National Health Insurance Research Database of Taiwan from 2000 to 2012. Our clinical outcomes were chronic kidney disease (CKD), end-stage renal disease (ESRD) and the composite endpoint of ESRD or all-cause mortality. Results: The incidence rate of CKD was higher in the TBI than in the control cohort (8.99 vs. 7.4 per 1000 person-years). The TBI patients also showed higher risks of CKD (adjusted hazard ratio [aHR] 1.14, 95% confidence interval [CI] 1.08-1.20; P < 0.001) and composite endpoints (aHR 1.08, 95% CI 1.01-1.15; P = 0.022) than the control groups, but the ESRD was not significantly different between the groups. In subgroup analyses, the risks of incident CKD and composite endpoints were significantly raised in TBI patients aged < 65 years and/or without comorbidities. However, the risks of both CKD and composite outcome were little affected by the severity of TBI. Conclusions: TBI has a modest but significant effect on incident CKD and composite endpoint, but not on ESRD alone. TBI patients under 65 are at greater risk of CKD and composite outcome than their older counterparts.

Original languageEnglish
Article numbere0171999
JournalPLoS ONE
Volume12
Issue number2
DOIs
Publication statusPublished - 2017 Feb 1

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kidney diseases
cohort studies
Brain
Cohort Studies
kidneys
Chronic Renal Insufficiency
Kidney
brain
Population
Chronic Kidney Failure
endpoints
Composite materials
Propensity Score
Traumatic Brain Injury
confidence interval
Confidence Intervals
Hazards
Health insurance
health insurance
National Health Programs

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Wu, Chia Lin ; Kor, Chew Teng ; Chiu, Ping Fang ; Tsai, Chun Chieh ; Lian, Iebin ; Yang, Tao Hsiang ; Tarng, Der Cherng ; Chang, Chia Chu. / Long-term renal outcomes in patients with traumatic brain injury : A nationwide population-based cohort study. In: PLoS ONE. 2017 ; Vol. 12, No. 2.
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abstract = "Background: Traumatic brain injury (TBI) is an important cause of death and disability worldwide. The relationship between TBI and kidney diseases is largely unknown. Methods: We aimed to determine whether TBI is associated with long-term adverse renal outcomes. We performed a nationwide, population-based, propensity score-matched cohort study of 32,152 TBI patients and 128,608 propensity score-matched controls. Data were collected by the National Health Insurance Research Database of Taiwan from 2000 to 2012. Our clinical outcomes were chronic kidney disease (CKD), end-stage renal disease (ESRD) and the composite endpoint of ESRD or all-cause mortality. Results: The incidence rate of CKD was higher in the TBI than in the control cohort (8.99 vs. 7.4 per 1000 person-years). The TBI patients also showed higher risks of CKD (adjusted hazard ratio [aHR] 1.14, 95{\%} confidence interval [CI] 1.08-1.20; P < 0.001) and composite endpoints (aHR 1.08, 95{\%} CI 1.01-1.15; P = 0.022) than the control groups, but the ESRD was not significantly different between the groups. In subgroup analyses, the risks of incident CKD and composite endpoints were significantly raised in TBI patients aged < 65 years and/or without comorbidities. However, the risks of both CKD and composite outcome were little affected by the severity of TBI. Conclusions: TBI has a modest but significant effect on incident CKD and composite endpoint, but not on ESRD alone. TBI patients under 65 are at greater risk of CKD and composite outcome than their older counterparts.",
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Long-term renal outcomes in patients with traumatic brain injury : A nationwide population-based cohort study. / Wu, Chia Lin; Kor, Chew Teng; Chiu, Ping Fang; Tsai, Chun Chieh; Lian, Iebin; Yang, Tao Hsiang; Tarng, Der Cherng; Chang, Chia Chu.

In: PLoS ONE, Vol. 12, No. 2, e0171999, 01.02.2017.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Long-term renal outcomes in patients with traumatic brain injury

T2 - A nationwide population-based cohort study

AU - Wu, Chia Lin

AU - Kor, Chew Teng

AU - Chiu, Ping Fang

AU - Tsai, Chun Chieh

AU - Lian, Iebin

AU - Yang, Tao Hsiang

AU - Tarng, Der Cherng

AU - Chang, Chia Chu

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Background: Traumatic brain injury (TBI) is an important cause of death and disability worldwide. The relationship between TBI and kidney diseases is largely unknown. Methods: We aimed to determine whether TBI is associated with long-term adverse renal outcomes. We performed a nationwide, population-based, propensity score-matched cohort study of 32,152 TBI patients and 128,608 propensity score-matched controls. Data were collected by the National Health Insurance Research Database of Taiwan from 2000 to 2012. Our clinical outcomes were chronic kidney disease (CKD), end-stage renal disease (ESRD) and the composite endpoint of ESRD or all-cause mortality. Results: The incidence rate of CKD was higher in the TBI than in the control cohort (8.99 vs. 7.4 per 1000 person-years). The TBI patients also showed higher risks of CKD (adjusted hazard ratio [aHR] 1.14, 95% confidence interval [CI] 1.08-1.20; P < 0.001) and composite endpoints (aHR 1.08, 95% CI 1.01-1.15; P = 0.022) than the control groups, but the ESRD was not significantly different between the groups. In subgroup analyses, the risks of incident CKD and composite endpoints were significantly raised in TBI patients aged < 65 years and/or without comorbidities. However, the risks of both CKD and composite outcome were little affected by the severity of TBI. Conclusions: TBI has a modest but significant effect on incident CKD and composite endpoint, but not on ESRD alone. TBI patients under 65 are at greater risk of CKD and composite outcome than their older counterparts.

AB - Background: Traumatic brain injury (TBI) is an important cause of death and disability worldwide. The relationship between TBI and kidney diseases is largely unknown. Methods: We aimed to determine whether TBI is associated with long-term adverse renal outcomes. We performed a nationwide, population-based, propensity score-matched cohort study of 32,152 TBI patients and 128,608 propensity score-matched controls. Data were collected by the National Health Insurance Research Database of Taiwan from 2000 to 2012. Our clinical outcomes were chronic kidney disease (CKD), end-stage renal disease (ESRD) and the composite endpoint of ESRD or all-cause mortality. Results: The incidence rate of CKD was higher in the TBI than in the control cohort (8.99 vs. 7.4 per 1000 person-years). The TBI patients also showed higher risks of CKD (adjusted hazard ratio [aHR] 1.14, 95% confidence interval [CI] 1.08-1.20; P < 0.001) and composite endpoints (aHR 1.08, 95% CI 1.01-1.15; P = 0.022) than the control groups, but the ESRD was not significantly different between the groups. In subgroup analyses, the risks of incident CKD and composite endpoints were significantly raised in TBI patients aged < 65 years and/or without comorbidities. However, the risks of both CKD and composite outcome were little affected by the severity of TBI. Conclusions: TBI has a modest but significant effect on incident CKD and composite endpoint, but not on ESRD alone. TBI patients under 65 are at greater risk of CKD and composite outcome than their older counterparts.

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