Predictors of new-onset decline in kidney function in a general middle-european population

被引:148
作者
Obermayr, Rudolf P. [1 ]
Temml, Christian [2 ]
Knechtelsdorfer, Maarten [1 ]
Gutjahr, Georg [3 ]
Kletzmayr, Josef [1 ]
Heiss, Susanne [1 ]
Ponholzer, Anton [4 ]
Madersbacher, Stephan [4 ]
Oberbauer, Rainer [5 ,6 ]
Klauser-Braun, Renate [1 ]
机构
[1] Donauspital, Sozialmed Zentrum Ost Stadt Wien, Dept Med 3, Div Nephrol Diabet & Hypertens, A-1220 Vienna, Austria
[2] Dept Hlth Prevent, A-1010 Vienna, Austria
[3] Univ Vienna, Dept Stat & Decis Support, A-1090 Vienna, Austria
[4] Donauspital, Sozialmed Zentrum Ost Stadt Wien, Dept Urol & Androl, A-1220 Vienna, Austria
[5] Krankenhaus Elisabethinen, Dept Nephrol, A-4010 Linz, Austria
[6] Med Univ Vienna, A-1090 Vienna, Austria
关键词
caucasian middle-European population; epidemiology; estimated glomerular filtration rate; new-onset kidney disease; predictors;
D O I
10.1093/ndt/gfm790
中图分类号
R3 [基础医学]; R4 [临床医学];
学科分类号
1001 ; 1002 ; 100602 ;
摘要
Background. Limited epidemiological data are available on predictors of new-onset kidney disease. Methods. In this longitudinal cohort study, 17 375 apparently healthy volunteers of the general Viennese population (46.4% women, age range 20-84 years, men 20-89 years) performed a baseline examination at some time within the study period ( 1990-2005) and completed a median of two follow-up examinations [interquartile range (IQR) 1 to 4]; the median follow-up period was 7 years ( IQR 4 to 11). The outcome of interest was the development of kidney disease, defined as a decrease of the glomerular filtration rate (GFR) < 60 ml/min/1.73 m(2) at the follow-up examinations [ calculated by the abbreviated modification of diet in renal disease (MDRD) equation]. Logistic generalized estimating equations were used to analyse the relationship between the covariates and the outcome variable. Results. The following parameters [ odds ratios ( OR) with 95% confidence intervals] predicted new-onset kidney disease: Age ( increase by 5 years), OR = 1.36 ( 1.34-1.40); National Kidney Foundation-chronic kidney disease (NKF-CKD) stage 1 with proteinuria (+), OR= 1.39 (1.10-1.75); NKF-CKD stage 1 with proteinuria (>=++), OR = 2.07 (1.11-3.87); NKF-CKD stage 2 with proteinuria (+), OR= 2.71 (2.10-3.51); NKF-CKD stage 2 with proteinuria (>=++), OR = 3.80 (2.29-6.31); body mass index, OR = 1.04 (1.02-1.06); current-smoker, OR = 1.20 (1.01-1.43); performing no sports, OR = 1.57 ( 1.27-1.95); uric acid ( increase by 2 mg/dl), OR = 1.69 (1.59-1.80); HDL-cholesterol ( decrease by 10mg/dl), OR= 1.12 (1.07-1.17); hypertension stage 1, OR = 1.35 (1.08-1.67); hypertension stage 2, OR = 2.01 (1.62-2.51); diabetes mellitus, OR = 1.44 (1.07-1.93). Conclusions. Cardiovascular risk factors as well as NKF-CKD stages 1 and 2 and proteinuria, the more the higher and an entirely novel finding, performing no sports, predicted new-onset kidney disease.
引用
收藏
页码:1265 / 1273
页数:9
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