Risk factors for end‐stage renal disease in a community‐based population: 26‐year follow‐up of 25 821 men and women in eastern Finland

Kastarinen, Mika; Juutilainen, Auni; Kastarinen, Helena; Salomaa, Veikko; Karhapää, Pauli; Tuomilehto, Jaakko; Grönhagen‐Riska, Carola; Jousilahti, Pekka; Finne, Patrik

doi:10.1111/j.1365-2796.2009.02197.x

Cited by 56 publications

(35 citation statements)

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“…The loss of association between obesity measures and incident CKDs3-5 after risk factor adjustment suggest that the relation between obesity and CKDS3-S5 may be attributed to the presence of diabetes or hypertension. In 26 year follow-up in Eastern Finland, the independent effect of obesity on ESRD risk seemed to appear only just before the end of study [28]; hence, the lack of independent risk of obesity in our study might be related to the medium duration of follow-up. Interestingly, among men higher WC was associated with a lower risk for incident CKDs3-5 which was marginally significant [0.703(0.476–1.040), P = 0.078]; a similar finding among the male population of Hoorn study was shown,applying change in renal function as the incident CKD rather than using a predefined threshold [9].It could be speculated that lower risk of incident CKD among TLGS population with abdominal adiposity might be attributable to healthier life because of increased awareness among cohort population however, we recently [29] demonstrated that there is increasing trend in the prevalence of general and abdominal obesity among TLGS participants during phase 2 and 3 in both genders.…”

Section: Discussioncontrasting

confidence: 49%

Incidence of Chronic Kidney Disease and Its Risk Factors, Results of Over 10 Year Follow Up in an Iranian Cohort

et al. 2012

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To examine, the predictors of incident chronic kidney disease (CKD) in a community-based cohort of Middle East population, during a mean follow-up of 9.9 years. In a sample of 3313 non-CKD Iranian adults ≥20 years the estimated glomerular filtration rate (eGFR) was calculated at baseline and at three year intervals during three consecutive phases. The eGFR <60 mL/min/1.73 m2 was defined as CKD. Multivariate Logistic regression analysis was used to determine the independent variables associated with incident CKD. The incidence density rates of CKD were 285.3 and 132.6 per 10,000 person-year, among women and men, respectively. Female gender per se was associated with higher risk of CKD, compared with males. Among women, age, eGFR, known diabetes, being single or divorced/widowed, hypertension (marginally significant) and current smoking were independent risk factors for CKD; however the intermediate degree of education and family history of diabetes decreased the risk by 40% (P<0.05). Among male subjects, independent predictors of developing CKD included aging and hypertension (with significantly higher risk than in women, P for interaction<0.05), eGFR, new diagnosed diabetes, high normal blood pressure; abdominal obesity decreased the risk of CKD about 30% which was marginally significant. In the Iranian population,>2% of individuals develops CKD each year. Our findings confirmed that sex- specific risk predictors should be considered in primary prevention for incident CKD.

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Section: Discussioncontrasting

confidence: 49%

Incidence of Chronic Kidney Disease and Its Risk Factors, Results of Over 10 Year Follow Up in an Iranian Cohort

et al. 2012

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“…Furthermore, a mildly reduced GFR (60-90 mL/min/1.73 m 2 ) predicted the progression to kidney disease. Based on a Finnish study, diabetes mellitus, hypertension, obesity, and male gender were independent risk factors for ESRD in the general population [31]. Kronborg et al [32] studied factors that predicted a change in eGFR during a 7-year follow-up.…”

Section: Resultsmentioning

confidence: 99%

Trends in estimated kidney function: the FINRISK surveys

et al. 2012

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We evaluated the temporary trend in estimated glomerular filtration rate (eGFR) of subjects aged from 25 to 74 years between two cross-sectional population surveys in 2002 and in 2007. The mean eGFR across age-groups, the prevalences of eGFR categories, and the prevalence of chronic kidney disease (CKD) stage 3–5 defined by eGFR\60 mL/min/1.73 m2 were defined in sex- and age-specific groups using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) Study equation. The eGFR decreased from year 2002 to 2007 across the age-groups in both genders. The prevalence of CKD stage 3–5 (eGFR\60 mL/min/1.73) increased in women from 1.8 to 3.1% (P=0.017), but not in men. In the combined analysis of both genders, CKD stage 3–5 was markedly more common in 2007 compared to 2002, with odds ratio (OR) 1.59 (95% confidence interval (CI) 1.22–2.08) remaining significant after adjusting the model for age, gender, study area, hypertension, obesity, prior cardiovascular disease, and diabetes mellitus, and being at lowest when only age, gender and waist circumference were included in the model (OR 1.34; 95% CI 1.02–1.76). To conclude, the mean eGFR decreased significantly during 2002–2007 in both sexes, and CKD stage 3–5 increased in women. This trend was concurrent with increases in mean waist circumference and in the prevalence of diabetes mellitus.

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“…Beside gender differences in physiological factors the lower prevalence may also be a function of the correction factor for females in the Cr-based equations. Men are de facto also at higher risk for ESRD compared to women, which is also indirect evidence for a higher burden of the underlying CKD, which finally may progress to ESRD [18]. …”

Section: Discussionmentioning

confidence: 99%

Prevalence and determinants of chronic kidney disease in community-dwelling elderly by various estimating equations

et al. 2012

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BackgroundChronic kidney disease (CKD) represents a global public health problem. Few data exist in the elderly. The objective of the current study is to estimate the prevalence of CKD by means of various established and new equations and to identify the main determinants of CKD in elderly.MethodsThe ActiFE Ulm (Activity and Function in the Elderly in Ulm) study is a population-based cohort study in people of 65 years and older. Kidney function was assessed by means of estimated glomerular filtration rate (eGFR) based on two creatinine- (Cr-; MDRD, CKD-EPI) and one cystatin C - (CysC-) based method. The relationship between various potential risk factors and CKD was quantified using unconditional logistic regression.ResultsA total of 1471 subjects were in the final analysis (mean age 75.6 years, SD 6.56). Overall, prevalence of CKD (eGFR < 60 mL/min/1.73 m2) was 34.3% by MDRD, 33.0% by CKD-EPI, and 14.6% by the CysC-based eGFR. All eGFRs showed statistically significant correlations with C-reactive protein, uric acid, as well as with lipid values. In multivariable analysis age was clearly related to prevalence of CKD and the risks were highest with the CysC-based equation. Females had a higher risk for CKD stages 3–5 with MDRD (OR 1.63; 95% CI: 1.23–2.16) whereas the OR was 1.23 (95% CI 0.92–1.65) with the CKD-Epi and OR = 0.89 (95% CI 0.58–1.34) with the CysC-based equation after multivariable adjustment. Although the cystatin C based definition of CKD resulted in a lower prevalence compared to the creatinine based ones, other measures of renal damage such as albuminuria were more prevalent in those defined by CysC-eGFR.ConclusionsPrevalence of CKD is very variable based on the used estimating equation. More work is needed to evaluate the various estimating equations especially in elderly before we are able to assess the practical consequences of the observed differences.

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Risk factors for end‐stage renal disease in a community‐based population: 26‐year follow‐up of 25 821 men and women in eastern Finland

Cited by 56 publications

References 49 publications

Incidence of Chronic Kidney Disease and Its Risk Factors, Results of Over 10 Year Follow Up in an Iranian Cohort

Incidence of Chronic Kidney Disease and Its Risk Factors, Results of Over 10 Year Follow Up in an Iranian Cohort

Trends in estimated kidney function: the FINRISK surveys

Prevalence and determinants of chronic kidney disease in community-dwelling elderly by various estimating equations

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