Risk Factors for Development of Decreased Kidney Function in a Southeast Asian Population

Domrongkitchaiporn, Somnuek; Sritara, Piyamitr; Kitiyakara, Chagriya; Stitchantrakul, Wasana; Krittaphol, Vorasakdi; Lolekha, Porntip H.; Cheepudomwit, Sayan; Yipintsoi, Tada

doi:10.1681/asn.2004030208

Cited by 192 publications

(155 citation statements)

References 40 publications

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“…Keeping in mind the generally known influence of alcohol consumption on UA levels as well as its possible protective influence on the outcome, we found an evaluation of its influence interesting. 13 In this study, the effect was weak, the OR for the outcome variable remained nearly unchanged, and confounding could have been explained by only 2% in both elevated UA groups.…”

Section: Discussioncontrasting

confidence: 48%

“…A few studies have found that hyperuricemia is associated with an increased risk for new-onset kidney disease, 13,14 but this association could be confounded by some metabolic factors and other risk factors that were not included in these previous studies. A confounder model was performed to provide epidemiologic evidence for UA as a possible independent risk factor for the development of incident kidney disease.…”

Section: Discussionmentioning

confidence: 99%

“…10 Recent epidemiologic and experimental evidence suggests a role for UA not only as a marker of reduced kidney function and an independent cardiovascular risk factor 11 but also as a causal risk factor for the development and progression of renal disease. 5,9,12 Two large epidemiologic studies demonstrated that UA was a major predictor for the development of incident renal disease, 13,14 but none of these studies evaluated the amount of its real role as an independent risk factor. Furthermore, hyperuricemia is associated with a greater incidence of ESRD.…”

mentioning

confidence: 99%

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Elevated Uric Acid Increases the Risk for Kidney Disease

Obermayr¹,

Temml²,

Gutjahr³

et al. 2008

Journal of the American Society of Nephrology

556

362

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Recent epidemiologic studies suggest that uric acid predicts the development of new-onset kidney disease, but it is unclear whether uric acid is an independent risk factor. In this study, data from 21,475 healthy volunteers who were followed prospectively for a median of 7 yr were analyzed to examine the association between uric acid level and incident kidney disease (estimated GFR [eGFR] Ͻ60 ml/min per 1.73 m 2 ). After adjustment for baseline eGFR, a slightly elevated uric acid level (7.0 to 8.9 mg/dl) was associated with a nearly doubled risk for incident kidney disease (odds ratio 1.74; 95% confidence interval 1.45 to 2.09), and an elevated uric acid (Ն9.0 mg/dl) was associated with a tripled risk (odds ratio 3.12; 95% confidence interval 2.29 to 4.25). These increases in risk remained significant even after adjustment for baseline eGFR, gender, age, antihypertensive drugs, and components of the metabolic syndrome (waist circumference, HDL cholesterol, blood glucose, triglycerides, and BP). In a fully adjusted spline model, the risk for incident kidney disease increased roughly linearly with uric acid level to a level of approximately 6 to 7 mg/dl in women and 7 to 8 mg/dl in men; above these levels, the associated risk increased rapidly. In conclusion, elevated levels of uric acid independently increase the risk for new-onset kidney disease.

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Section: Discussioncontrasting

confidence: 48%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Elevated Uric Acid Increases the Risk for Kidney Disease

Obermayr¹,

Temml²,

Gutjahr³

et al. 2008

Journal of the American Society of Nephrology

556

362

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“…Similar results were also found in Japan and Thailand. 20,21 Hence, the level of serum uric acid in CKD patients, especially in those with eGFR <90 mL/min/1.73 m 2 , should be appropriately monitored during the management of CKD. CVD and cerebrovascular diseases are risk factors associated with early renal injury in patients with CKD in our study.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Early Kidney Damage in Hospitalized Patients with Chronic Kidney Disease: A Multicenter Study

Chen

Pan

et al. 2012

Renal Failure

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Background: To identify the risk factors for early kidney damage in hospitalized Chinese patients with chronic kidney disease (CKD). Methods: A total of 12 multicenter cross-sectional studies were conducted between January 2005 and January 2006 in Chinese CKD patients with estimated glomerular filtration rate (eGFR) equal to or more than 30 mL/min/1.73 m 2 in Shanghai. CKD was defined according to the K/DOQI guideline. GFR was estimated by the simplified modification of diet in renal disease equation. The demographic, clinical, and laboratory data were collected through a questionnaire and analyzed among eligible patients stratified by three different CKD groups (CKD stages 1, 2, and 3). The relevant clinical and laboratory risk factors for early kidney damage with a GFR < 90 mL/min/1.73 m 2 were determined by logistic regression. Results: A total of 822 CKD patients were enrolled in this study. There were significant differences in age and gender among patients with CKD stages 1, 2, and 3. The prevalence of hypertension, cardiovascular disease, cerebral vascular disease, anemia, and hyperuricemia increases when the eGFR declines. Logistic analysis showed that age, hypertension, anemia, and hyperuricemia were independently associated with early kidney damage. Conclusions: In CKD patients, we have identified only age, hypertension, anemia, and hyperuricemia as the risk factors for early kidney damage. Risk factors should be managed to prevent accelerated kidney damage in CKD patients.

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“…In addition, a subdivision of the previously described GFR stage 3 has been proposed to help further define the severity of kidney dysfunction in patients with CKD 25 . Risk factors for the development of reduced kidney function in Southeast Asian populations have been identified and include the presence of diabetes, systolic hypertension (>159 mmHg), hyperuricemia (>6.29 mg/dL), elevated BMI (>24.9 kg/m 2 ) and hypercholesterolemia (>248.3 mg/dL) 26 .…”

Section: Diabetes and Chronic Kidney Disease Complications In Asiamentioning

confidence: 99%

Challenges in achieving optimal glycemic control in type 2 diabetes patients with declining renal function: The Southeast Asia perspective

Chow

Chan

Hwu

et al. 2012

J of Diabetes Invest

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It is well recognised that Asia is at the epicenter of the global type 2 diabetes epidemic. Driven by socioeconomic changes involving industrialization, urbanization and adoption of Western lifestyles, the unprecedented increases in the prevalence of diabetes are particularly evident in Southeast Asia. The impact of diabetes is immense, and despite evidence of the benefit of optimal glucose control in reducing the risk of disease progression and development of macrovascular and microvascular complications, many individuals in this region remain poorly controlled. Chronic kidney disease (CKD) is an increasingly common diabetes-associated complication in Asian patients. Furthermore, Southeast Asia has one of the highest rates of end-stage renal disease (ESRD) in the world. Consequently, CKD in diabetes is associated with considerable morbidity and cardiovascular-related mortality, highlighting the need to screen and assess patients early in the course of the disease. The management of type 2 diabetes patients with declining renal function represents a significant challenge. Many of the older antidiabetic agents, such as metformin and sulfonylureas, are limited in their utility in CKD as a result of contraindications or hypoglycemic episodes. In contrast, dipeptidyl-peptidase IV inhibitors have provided a welcome addition to the therapeutic armamentarium for achieving glycemic control in these special populations. With comparable efficacy to and more favorable pharmacokinetic and side-effect profiles than traditional therapies, agents in this drug class, such as linagliptin, offer a more tailored approach to disease control in type 2 diabetes patients with declining renal function. (J Diabetes Invest

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Risk Factors for Development of Decreased Kidney Function in a Southeast Asian Population

Cited by 192 publications

References 40 publications

Elevated Uric Acid Increases the Risk for Kidney Disease

Elevated Uric Acid Increases the Risk for Kidney Disease

Analysis of Early Kidney Damage in Hospitalized Patients with Chronic Kidney Disease: A Multicenter Study

Challenges in achieving optimal glycemic control in type 2 diabetes patients with declining renal function: The Southeast Asia perspective

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