Tobacco, hypertension, and vascular disease: Risk factors for renal functional decline in an older population

被引:184
作者
Bleyer, AJ
Shemanski, LR
Burke, GL
Hansen, KJ
Appel, RG
机构
[1] Wake Forest Univ, Bowman Gray Sch Med, Dept Publ Hlth Sci, Nephrol Sect, Winston Salem, NC 27157 USA
[2] Wake Forest Univ, Bowman Gray Sch Med, Dept Surg Sci, Winston Salem, NC 27157 USA
[3] Univ Washington, Dept Biostat, Seattle, WA 98195 USA
关键词
smoking; prevention of renal disease; blood pressure; cigarettes; carotid artery intimal thickness; ESRD;
D O I
10.1046/j.1523-1755.2000.00056.x
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 [临床医学]; 100201 [内科学];
摘要
Background. A decline in renal function with age has been noted in some but not all individuals. The purpose of this study was to identify risk factors associated with a clinically significant increase in serum creatinine (of at least 0.3 mg/dL) in an older nondiabetic population. Methods. A retrospective case-control study was performed analyzing data obtained from 4142 nondiabetic participants of the Cardiovascular Health Study Cohort, all at least 65 years of age, who had two measurements of serum creatinine performed at least three years apart. Cases were identified as participants who developed an increase in serum creatinine of at least 0.3 mg/dL, with controls including participants who did not sustain such an increase. Results. There was an increase in the serum creatinine of at least 0.3 mg/dL in 2.8% of the population. in a multivariate "best-fit" model adjusted for gender, weight, black race, baseline serum creatinine, and age, the following factors were associated with an increase in serum creatinine: number of cigarettes smoked per day, systolic blood pressure, and maximum internal carotid artery intimal thickness. Conclusions. These data suggest that three very preventable or treatable conditions-hypertension, smoking, and prevalent vascular disease, which are associated with large and small vessel disease-are highly associated with clinically important changes in renal function in an older population.
引用
收藏
页码:2072 / 2079
页数:8
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