Epidemiology and Public Health Concerns of CKD in Older Adults

Fung, Enrica; Tamura, Manjula Kurella

doi:10.1053/j.ackd.2015.10.001

Cited by 28 publications

(25 citation statements)

References 37 publications

(35 reference statements)

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“…The current study showed that people aged ≥65 years had a higher likelihood of CKD. Age was found to be a risk factor of CKD in previous studies [24][25][26]. Additionally, our study showed that men have a higher probability of having CKD than women.…”

Section: Discussionsupporting

confidence: 71%

Associations of Waist Circumference, Socioeconomic, Environmental, and Behavioral Factors with Chronic Kidney Disease in Normal Weight, Overweight, and Obese People

Duong

Yang

et al. 2019

IJERPH

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Background: Chronic kidney disease (CKD) places a heavy burden on the healthcare system worldwide. The risk factors may vary by body adiposity. We aimed to investigate the associations of socioeconomic, environmental, and behavioral factors with CKD in different groups of body mass indexes (BMI). Methods: A case-control study was conducted in 3280 participants (1048 CKD and 2232 non-CKD) from seven hospitals and nearby communities from May 2012 to August 2015. Personal characteristics, anthropometrics, environmental exposures, and health−related behaviors were assessed using a structured questionnaire. The logistic regression models were utilized for analysis. Results: Older age (odd ratio, OR = 2.85; p < 0.001), being men (OR = 4.23; p < 0.001), smoking (OR = 3.36; p < 0.001), stable income (OR = 0.33; p < 0.001), higher education (OR = 0.37~0.38; p < 0.001), and daily adequate water intake (OR = 0.64; p = 0.010) were associated with CKD in normal weight people. Older age (OR = 2.49; p < 0.001), being men (OR = 3.36; p < 0.001), education (OR = 0.44, p = 0.004), hypertension (OR = 2.93; p < 0.001), diabetes (OR = 1.83; p = 0.004), and using traditional Chinese medicine (OR = 2.03, p = 0.014) were associated with CKD in overweight people. Older age (OR = 2.71; p < 0.001), being men (OR = 2.69; p < 0.001), hypertension (OR = 2.93; p < 0.001), diabetes (OR = 1.94; p = 0.001) were associated with CKD in obese people. Conclusions: The associated factors of CKD varied by different groups of BMI. These findings may help to develop potential interventions to manage CKD.Participants recruited were Taiwanese citizens aged 18 years or older, who understand Mandarin Chinese. We excluded participants who were diagnosed as CKD stage 5 or end-stage renal disease (ESRD), or who lacked renal function parameters. Cases were patients with chronic kidney disease stage 1 to stage 4. Controls were non-CKD patients, relatives of CKD patients, healthy people who underwent annual health checks, and in the communities around the selected hospitals. The final sample for analysis was 3280 participants with N = 1048 cases, and N = 2232 controls (Figure 1).

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Section: Discussionsupporting

confidence: 71%

Associations of Waist Circumference, Socioeconomic, Environmental, and Behavioral Factors with Chronic Kidney Disease in Normal Weight, Overweight, and Obese People

Duong

Yang

et al. 2019

IJERPH

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“…2 Chronic kidney disease, which is characterized by albuminuria or proteinuria, and estimated glomerular filtration rate (eGFR) <60 mL/min per 1.73 m 2 , is also increasingly recognized as a substantial public health problem. Since the prevalence of chronic kidney disease has been increasing in the elderly, 3 we must determine its influence on the risk of dementia. To date, several prospective epidemiologic studies have explored the association of albuminuria and low eGFR with cognitive decline [4][5][6][7] and dementia.…”

mentioning

confidence: 99%

Albuminuria Increases the Risks for Both Alzheimer Disease and Vascular Dementia in Community‐Dwelling Japanese Elderly: The Hisayama Study

Takae

Hata

Ohara

et al. 2018

JAHA

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BackgroundEpidemiologic evidence has emerged to reveal an association of albuminuria and low estimated glomerular filtration rate (eGFR) with dementia, but the findings are inconsistent. In addition, there are limited studies addressing the association between albuminuria and Alzheimer disease (AD).Methods and ResultsA total of 1562 community‐dwelling Japanese subjects aged ≥60 years without dementia were followed up for 10 years. The outcomes were incidence of all‐cause dementia and its subtypes, namely, AD and vascular dementia (VaD). The hazard ratios for the outcomes were estimated according to urine albumin–creatinine ratio (UACR) and eGFR levels using a Cox proportional hazards model. During the follow‐up, 358 subjects developed all‐cause dementia (238 AD and 93 VaD). Higher UACR level was significantly associated with greater multivariable‐adjusted risks of all‐cause dementia (hazard ratios [95% confidence intervals]: 1.00 [reference], 1.12 [0.78–1.60], 1.65 [1.18–2.30], and 1.56 [1.11–2.19] for UACR of ≤6.9, 7.0–12.7, 12.8–29.9, and ≥30.0 mg/g, respectively), AD (1.00 [reference], 1.20 [0.77–1.86], 1.75 [1.16–2.64], and 1.58 [1.03–2.41], respectively), and VaD (1.00 [reference], 1.03 [0.46–2.29], 1.94 [0.96–3.95], and 2.19 [1.09–4.38], respectively). On the other hand, lower eGFR level was marginally associated with greater risk of VaD, but not AD. Subjects with UACR ≥12.8 mg/g and eGFR of <60 mL/min per 1.73 m2 had 3.3‐fold greater risk of VaD than those with UACR <12.8 mg/g and eGFR of ≥60 mL/min per 1.73 m2.ConclusionsAlbuminuria is a significant risk factor for the development of both AD and VaD in community‐dwelling Japanese elderly. Moreover, albuminuria and low eGFR are mutually associated with a greater risk of VaD.

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“…hronic kidney disease (CKD) is a major health problem with rising incidence and prevalence for which currently no effective therapy other than renal replacement therapy (RRT) exists. 1 However, available RRTs (i.e., hemodialysis and renal transplantation) are accompanied by a major economic and health burden, and the number of transplantable donor kidneys does not match the need. 2,3 As such, increasing effort is being put into the development of therapeutic interventional strategies to prevent CKD occurrence or limit progression to end-stage renal disease.…”

mentioning

confidence: 99%

Connective tissue growth factor regulates fibrosis-associated renal lymphangiogenesis

Kinashi

Falke

Nguyen

et al. 2017

Kidney International

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Lymphangiogenesis is correlated with the degree of renal interstitial fibrosis. Pro-fibrotic transforming growth factor β induces VEGF-C production, the main driver of lymphangiogenesis. Connective tissue growth factor (CTGF) is an important determinant of fibrotic tissue remodeling, but its possible involvement in lymphangiogenesis has not been explored. We found prominent lymphangiogenesis during tubulointerstitial fibrosis to be associated with increased expression of CTGF and VEGF-C in human obstructed nephropathy as well as in diabetic kidney disease. Using CTGF knockout mice, we investigated the involvement of CTGF in development of fibrosis and associated lymphangiogenesis in obstructive nephropathy. The increase of lymphatic vessels and VEGF-C in obstructed kidneys was significantly reduced in CTGF knockout compared to wild-type mice. Also in mouse kidneys subjected to ischemia-reperfusion injury, CTGF knockdown was associated with reduced lymphangiogenesis. In vitro, CTGF induced VEGF-C production in HK-2 cells, while CTGF siRNA suppressed transforming growth factor β1-induced VEGF-C upregulation. Furthermore, surface plasmon resonance analysis showed that CTGF and VEGF-C directly interact. Interestingly, VEGF-C-induced capillary-like tube formation by human lymphatic endothelial cells was suppressed by full-length CTGF but not by naturally occurring proteolytic CTGF fragments. Thus, CTGF is significantly involved in fibrosis-associated renal lymphangiogenesis through regulation of, and direct interaction with, VEGF-C.

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Epidemiology and Public Health Concerns of CKD in Older Adults

Cited by 28 publications

References 37 publications

Associations of Waist Circumference, Socioeconomic, Environmental, and Behavioral Factors with Chronic Kidney Disease in Normal Weight, Overweight, and Obese People

Associations of Waist Circumference, Socioeconomic, Environmental, and Behavioral Factors with Chronic Kidney Disease in Normal Weight, Overweight, and Obese People

Albuminuria Increases the Risks for Both Alzheimer Disease and Vascular Dementia in Community‐Dwelling Japanese Elderly: The Hisayama Study

Connective tissue growth factor regulates fibrosis-associated renal lymphangiogenesis

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