IDEAS home Printed from https://ideas.repec.org/a/bpj/ijbist/v7y2011i1n34.html
   My bibliography  Save this article

Antihypertensive Medication Use and Change in Kidney Function in Elderly Adults: A Marginal Structural Model Analysis

Author

Listed:
  • Odden Michelle C.
  • Tager Ira B.
  • van der Laan Mark J.
  • Delaney Joseph A.C.
  • Peralta Carmen A
  • Katz Ronit
  • Sarnak Mark J.
  • Psaty Bruce M.
  • Shlipak Michael G

Abstract

Background: The evidence for the effectiveness of antihypertensive medication use for slowing decline in kidney function in older persons is sparse. We addressed this research question by the application of novel methods in a marginal structural model.Methods: Change in kidney function was measured by two or more measures of cystatin C in 1,576 hypertensive participants in the Cardiovascular Health Study over 7 years of follow-up (1989-1997 in four U.S. communities). The exposure of interest was antihypertensive medication use. We used a novel estimator in a marginal structural model to account for bias due to confounding and informative censoring.Results: The mean annual decline in eGFR was 2.41 ± 4.91 mL/min/1.73 m2. In unadjusted analysis, antihypertensive medication use was not associated with annual change in kidney function. Traditional multivariable regression did not substantially change these estimates. Based on a marginal structural analysis, persons on antihypertensives had slower declines in kidney function; participants had an estimated 0.88 (0.13, 1.63) ml/min/1.73 m2 per year slower decline in eGFR compared with persons on no treatment. In a model that also accounted for bias due to informative censoring, the estimate for the treatment effect was 2.23 (-0.13, 4.59) ml/min/1.73 m2 per year slower decline in eGFR.Conclusion: In summary, estimates from a marginal structural model suggested that antihypertensive therapy was associated with preserved kidney function in hypertensive elderly adults. Confirmatory studies may provide power to determine the strength and validity of the findings.

Suggested Citation

  • Odden Michelle C. & Tager Ira B. & van der Laan Mark J. & Delaney Joseph A.C. & Peralta Carmen A & Katz Ronit & Sarnak Mark J. & Psaty Bruce M. & Shlipak Michael G, 2011. "Antihypertensive Medication Use and Change in Kidney Function in Elderly Adults: A Marginal Structural Model Analysis," The International Journal of Biostatistics, De Gruyter, vol. 7(1), pages 1-19, September.
  • Handle: RePEc:bpj:ijbist:v:7:y:2011:i:1:n:34
    DOI: 10.2202/1557-4679.1320
    as

    Download full text from publisher

    File URL: https://doi.org/10.2202/1557-4679.1320
    Download Restriction: For access to full text, subscription to the journal or payment for the individual article is required.

    File URL: https://libkey.io/10.2202/1557-4679.1320?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Sinisi Sandra E & van der Laan Mark J., 2004. "Deletion/Substitution/Addition Algorithm in Learning with Applications in Genomics," Statistical Applications in Genetics and Molecular Biology, De Gruyter, vol. 3(1), pages 1-40, August.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Petersen, Maya L. & Molinaro, Annette M. & Sinisi, Sandra E. & van der Laan, Mark J., 2007. "Cross-validated bagged learning," Journal of Multivariate Analysis, Elsevier, vol. 98(9), pages 1693-1704, October.
    2. Sinisi Sandra E. & Neugebauer Romain & van der Laan Mark J., 2006. "Cross-Validated Bagged Prediction of Survival," Statistical Applications in Genetics and Molecular Biology, De Gruyter, vol. 5(1), pages 1-26, May.
    3. Neugebauer Romain & Schmittdiel Julie A. & van der Laan Mark J., 2016. "A Case Study of the Impact of Data-Adaptive Versus Model-Based Estimation of the Propensity Scores on Causal Inferences from Three Inverse Probability Weighting Estimators," The International Journal of Biostatistics, De Gruyter, vol. 12(1), pages 131-155, May.
    4. Wang, Hui & Rose, Sherri & van der Laan, Mark J., 2011. "Finding quantitative trait loci genes with collaborative targeted maximum likelihood learning," Statistics & Probability Letters, Elsevier, vol. 81(7), pages 792-796, July.
    5. Elise D Riley & Torsten B Neilands & Kelly Moore & Jennifer Cohen & David R Bangsberg & Diane Havlir, 2012. "Social, Structural and Behavioral Determinants of Overall Health Status in a Cohort of Homeless and Unstably Housed HIV-Infected Men," PLOS ONE, Public Library of Science, vol. 7(4), pages 1-7, April.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:bpj:ijbist:v:7:y:2011:i:1:n:34. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Peter Golla (email available below). General contact details of provider: https://www.degruyter.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.