Abstract
Background: Glomerular Filtration Rate (GFR) is a valid indicator for kidney function, both in healthy and diseased people. Different factors can affect GFR. The purpose of this study is to assess a causal model to show direct and indirect effects of GFR-related factors using structural equation modeling.
Patients and methods : We analyzed data from recruitment phase of Ravansar Non-Communicable Disease cohort study. Data on socio-behavioral, nutritional, cardiovascular, and metabolic risk factors were entered in a conceptual model in order to test direct and indirect effects of the associated factors on GFR, separately in male and female, using the structural equation modeling.
Results : Of 8927 individuals participated in this study, 4212 subjects were male (47.2%) and 4715 subjects were female (52.8%). The obtained standard deviation of GFR was 76.05 (±14.3) per 1.73 . Filtration rate for 11.52%, 72.96% and 15.50% of people were <60, and , respectively. Hypertension in both gender and atherogenic factor in male directly, and in female directly and indirectly had a decreasing effect on GFR. Blood Urea Nitrogen (BUN) and smoking in male and female, directly or indirectly through other variables, was associated with a decrease in GFR. In female, diabetes had a decreasing direct and indirect effect on GFR. Obesity in female was directly associated with increasing and indirectly associated with decreasing filtration.
Conclusion : According to our results, increasing age, hypertension, diabetes, obesity and high blood lipids, and BUN had a decreasing direct and indirect effects on GFR. Although low GFR might have different reasons and it is not a consistent sign of CKD, our findings, in line with other reports, provide more detailed informations about important risk factors of low GFR. Public awareness about such factors can improve public practice of positive health behaviours.