scholarly journals Consumption of whole grains, fruit and vegetables is not associated with indices of renal function in the population-based longitudinal Doetinchem study

2017 ◽  
Vol 118 (5) ◽  
pp. 375-382 ◽  
Author(s):  
Gerrie-Cor M. Herber-Gast ◽  
Marijke Boersma ◽  
W. M. Monique Verschuren ◽  
Coen D. A. Stehouwer ◽  
Ron T. Gansevoort ◽  
...  
Keyword(s):  
Renal Function ◽  
Estimated Glomerular Filtration Rate ◽  
Population Based ◽  
Whole Grains ◽  
Fruit And Vegetables ◽  
Food Groups ◽  
Multivariate Models ◽  
Disease Epidemiology ◽  
Annual Decline

AbstractEmerging evidence suggests that diet and renal function are related. Little is known, however, about the association of consumption of whole grains, fruit and vegetables with urinary albumin:creatinine ratio (ACR) and changes in estimated glomerular filtration rate (eGFR). We investigated this in a population-based cohort aged 26–65 years. Data were from 3787 participants from the Doetinchem cohort study, who were examined ≥3 times, 5 years apart. Consumption of food groups was assessed at each round with a validated FFQ. GFR was estimated at each round from routinely measured cystatin C and creatinine using the Chronic Kidney Disease-Epidemiology (CKD-EPI) equation. ACR was measured at the last round. Generalised estimated equation models were performed to examine associations with changes in eGFR. Linear regression was used to examine associations with ACR. Adjustments were made for covariates related to lifestyle, biological factors and diet. Mean baseline eGFR was 104·5 (sd 13·7) and mean annual decline was −0·95 (sd 0·67) ml/min per 1·73 m2 over a 15-year follow-up. A trend was observed towards slightly less annual decline in eGFR among those with higher consumption of whole grains (P=0·06). This association, however, was attenuated and no longer significant in multivariate models (P=0·29). Consumption of fruit and vegetables was not associated with changes in eGFR and urinary ACR. In conclusion, consumption of whole grains, fruit and vegetables is not associated with changes in eGFR and mean ACR. As this was the first longitudinal study into this association in the general population, and as results are only partially in line with related studies, further research is recommended.

scholarly journals The Predictive Value of Creatinine Clearance for Mortality in Patients Undergoing Revascularization

2020 ◽  
Author(s):  
Eilon Ram ◽  
Pazit Beckerman ◽  
Amit Segev ◽  
Nir Shlomo ◽  
Abigail Atlas-Lazar ◽  
...  
Keyword(s):  
Renal Function ◽  
Creatinine Clearance ◽  
Estimated Glomerular Filtration Rate ◽  
Independent Predictor ◽  
Multivariable Analysis ◽  
Current Data ◽  
Disease Epidemiology ◽  
Artery Disease ◽  
Vessel Coronary Artery

Abstract BackgroundRenal function plays a significant role in the prognosis and management of patients with multi-vessel coronary artery disease (CAD) referred for revascularization. Current data lack precise risk stratification using estimated glomerular filtration rate (eGFR) and creatinine clearance. MethodsThis prospective study includes a three-year follow-up of 1112 consecutive patients with multi-vessel CAD enrolled in the 22 hospitals in Israel that perform coronary angiography. ResultsThe Mayo formula yielded the highest mean eGFR (90±26 mL/min per 1.73m2) and chronic kidney disease-epidemiology collaboration (CKD-EPI) the lowest (76±24 mL/min per 1.73m2). Consequently, the Mayo formula classified more patients (56%) as having normal renal function. There was a significant and strong correlation between the values obtained from all five formulas using Cockcroft-Gault as the reference formula: Mayo: r=0.80, p<0.001; CKD-EPI: r=0.87, p<0.001; modification of diet in renal disease (MDRD): r=0.84, p<0.001; inulin clearance-based: r=0.99, p<0.001). Multivariable analysis demonstrated that decreased renal function is an independent predictor of 3-year mortality in all five formulas, with risk increasing by 15-25% for each 10-unit decrease in eGFR. Despite the similarities between the formulas, the ability to predict mortality was highest in the Mayo formula and lowest in MDRD.ConclusionsOur data suggest that the Mayo and CKD-EPI formulas may be superior to other formulas, including the widely used MDRD, in prognosticating mortality in CAD patients.

“Outcome evaluation of fruit and vegetables distribution interventions in schools: A systematic review and meta-analysis”

2021 ◽  
pp. 1-34
Author(s):  
M. R. Ismail ◽  
J. A. Seabrook ◽  
J. A. Gilliland
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Population Based ◽  
Outcome Evaluation ◽  
Fruit And Vegetables ◽  
Post Intervention ◽  
Health Strategy ◽  
Rigorous Study ◽  
Mean Differences

Abstract Objective: Fruit and vegetables (FVs) distribution interventions have been implemented as a public health strategy to increase children’s intake of FVs at school settings. The purpose of this review was to examine whether snack-based FVs distribution interventions can improve school-aged children’s consumption of FVs. Design: Systematic Review and meta-analysis of articles published in English, in a peer-review journals were identified by searching six databases up to August 2020. Standardized Mean Differences (SMDs) and 95% Confidence Interval (CI) were calculated using a random effects model. Heterogeneity was quantified using I2 statistics. Setting: Population-based studies of interventions where the main focus was the effectiveness of distributed FVs as snacks to schoolchildren in North America, Europe and Pacific were included. Results: Forty-seven studies, reporting on 15 different interventions, were identified; 10 studies were included in the meta-analysis. All interventions were effective in increasing children’s consumption of FVs, with only one intervention demonstrating a null effect. Pooled results under all classifications showed effectiveness in improving children’s consumption of FVs, particularly for multi-component interventions at post-intervention (SMD 0.20, CI 0.13, 0.27) and free distribution interventions at follow-up (SMD 0.19, CI 0.12, 0.27). Conclusions: Findings suggest that utilizing FV distribution interventions provide a promising avenue by which children’s consumption can be improved. Nonetheless, our results are based on a limited number of studies, and further studies should be performed to confirm these results. More consistent measurement protocols in terms of rigorous study methodologies, intervention duration, and follow-up evaluation are needed to improve comparability across studies.

scholarly journals Long-term Impact of Crystalloid versus Colloid Solutions on Renal Function and Disability-free Survival after Major Abdominal Surgery

2019 ◽  
Vol 130 (2) ◽  
pp. 227-236 ◽  
Author(s):  
Alexandre Joosten ◽  
Amélie Delaporte ◽  
Julien Mortier ◽  
Brigitte Ickx ◽  
Luc Van Obbergh ◽  
...  
Keyword(s):  
Renal Function ◽  
Abdominal Surgery ◽  
Estimated Glomerular Filtration Rate ◽  
Free Survival ◽  
Crystalloid Solution ◽  
Significant Difference ◽  
Goal Directed Fluid Therapy ◽  
Balanced Crystalloid

Abstract Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background The authors recently demonstrated that administration of balanced hydroxyethyl starch solution as part of intraoperative goal-directed fluid therapy was associated with better short-term outcomes than administration of a balanced crystalloid solution in patients having major open abdominal surgery. In the present study, a 1-yr follow-up of renal and disability outcomes in these patients was performed. Methods All patients enrolled in the earlier study were followed up 1 yr after surgery for renal function and disability using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS). The main outcome measure was the estimated glomerular filtration rate. Other outcomes were serum creatinine, urea, pruritus, and WHODAS score. Groups were compared on a complete-case analysis basis, and modern imputation methods were then used in mixed-model regressions to assess the stability of the findings taking into account the missing data. Results Of the 160 patients enrolled in the original study, follow-up data were obtained for renal function in 129 and for WHODAS score in 114. There were no statistically significant differences in estimated glomerular filtration rate at 1 yr (ml min−1 1.73 m−2): 80 [65 to 92] for crystalloids versus 74 [64 to 94] for colloids; 95% CI [−10 to 7], P = 0.624. However, the WHODAS score (%) was statistically significantly lower in the colloid than in the crystalloid group (2.7 [0 to 12] vs. 7.6 [1.3 to 18]; P = 0.015), and disability-free survival was higher (79% vs. 60%; 95% CI [2 to 39]; P = 0.024). Conclusions In patients undergoing major open abdominal surgery, there was no evidence of a statistically significant difference in long-term renal function between a balanced hydroxyethyl starch and a balanced crystalloid solution used as part of intraoperative goal-directed fluid therapy, although there was only limited power to rule out a clinically significant difference. However, disability-free survival was significantly higher in the colloid than in the crystalloid group.

scholarly journals Metabolic Healthy Obesity is associated with higher incidence of mild decrease estimate glomerular rate in rural Northeast Chinese

2020 ◽  
Author(s):  
Shasha Yu ◽  
Xiaofan Guo ◽  
GuangXiao Li ◽  
Hongmei Yang ◽  
Liqiang Zheng ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Lower Risk ◽  
Blood Test ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Metabolic Phenotype ◽  
Disease Epidemiology ◽  
Close Relationship

Abstract Background Metabolic healthy obesity (MHO), as one phenotype of obesity, seems associate with lower risk of cardiovascular disease. However, MHO has close relationship with higher incidence of metabolic syndrome and diabetes. This study aims to investigate the prevalence of MHO at baseline, changes of obese metabolic phenotype at follow-up and its relationship with incidence of mildly reduced estimated glomerular filtration rate (eGFR) in rural Northeast Chinese. Methods The Chronic Kidney Disease Epidemiology (CKD-EPI) equation was used to calculate eGFR. 4903 participants aged ≥ 35 years with eGFR > 90 ml/min/1.73 m2 at baseline were enrolled and successfully followed up. All participants completed the questionnaires, anthropometric measurements, and blood test during baseline and follow-up. Mild renal dysfunction defined as mildly reduced eGFR between 60–90 ml/min/1.73 m2. Results The prevalence of MHO was 20.04% in baseline (18.97% for women and 21.11% for men) which was secondary to metabolic abnormal obesity (MAO) (24.4%, 27.2% for women and 21.5% for men). 38.4% of women and 38.90% of men experienced phenotype changes during follow-up. The cumulative incidence of mildly reduced eGFR in MHO was 20.1% (17.7% for women and 22.3% for men) which was also secondary to MAO (20.8%, 18.6% for women and 23.5% for men). After adjusted possible confounders, MHO was associated with higher incidence of mildly reduced eGFR among women [OR (95%CI) = 1.64 (1.18, 2.25)] and men [OR (95%CI) = 1.62 (1.24, 2.11)] whereas MAO was related with higher incidence of mildly reduced eGFR among men only [OR (95%CI) = 1.74 (1.32, 2.29)]. Conclusion MHO was associated with higher incidence of mildly reduced eGFR in both gender; however, there was a specific relationship between MAO and mildly reduced eGFR in men only. Therefore, it is necessary to monitoring kidney function among both MHO and MAO subjects.

scholarly journals Renal function of bladder cancer patients after urinary diversion by ileal conduit in Rajavithi Hospital

2021 ◽  
Vol 42 (1) ◽  
pp. 34-39
Author(s):  
Sittichon Suriyawongkul ◽  
◽  
Chawawat Gosrisirikul ◽  
Vorapot Choonhaklai ◽  
Tanet Thaidumrong ◽  
...  
Keyword(s):  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Urinary Tract ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Ileal Conduit ◽  
Upper Urinary Tract ◽  
Egfr Decline

Objectives: Our objectives were to evaluate the long-term renal function after radical cystectomy (RC) and ileal conduit diversion (ICD) and to analyze year-by-year the estimated glomerular filtration rate (eGFR) and morphologic upper urinary tract changes. Materials and Methods: We retrospectively identified 214 patients who had undergone RC and ICD from 2012 to 2018, with regular postoperative follow-up visits. The eGFR was calculated using the Modification of Diet in Renal Disease equation at baseline and during follow-up. A renal function decrease was defined as a greater than 10 mL/min/1.73 m2 reduction in the estimated glomerular filtration rate. Results: The median follow-up period after RC was 24 months (range, 6-60 months). The median eGFR decreased from 64 mL/min/1.73 m2 (range, 9-125 mL/min/1.73 m2) to 61.5 mL/min/1.73 m2 (range, 8-125 mL/min/1.73 m2). A decline in renal function occurred during the first postoperative years (2.74 mL/ min/1.73 m2 and 3.95 mL/min/1.73 m2 in the first and second year, respectively), with a slight decrease in the subsequent years. The strongest predictor of an eGFR decline was CKD stage 1 or 2 (> 60 mL/min/1.73 m2). Urinary obstruction was diagnosed in 6 patients (2.8%). Among the patients who underwent prompt interventional treatment, we did not find any association with the eGFR decline. Conclusion: Patients with urinary ICD have a lifelong risk of chronic kidney disease. Regular monitoring of renal function and the morphologic upper urinary tract will permit early diagnosis and treatment of modifiable factors, avoiding irreversible kidney damage.

scholarly journals P0845INCREASING TOTAL RENAL VOLUME AFTER NEPHRECTOMY FOR RENAL CELL CARCINOMA IS ASSOCIATED WITH RENAL FUNCTION EVOLUTION

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
SAUL PAMPA-SAICO ◽  
M Soledad Pizarro-Sánchez ◽  
Simona Alexandru ◽  
Laura García Puente-Suárez ◽  
María López-Picasso ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Renal Function ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Linear Regression Analysis ◽  
Multivariate Linear Regression Analysis ◽  
Renal Volume

Abstract Background and Aims Renal cell carcinoma is the most common form of kidney cancer. Reduction of renal mass after radical nephrectomy (RN) in these patients, results in compensatory hypertrophy of the contralateral kidney. The capacity of compensation will determine the renal function (RF) evolution. Measuring of total renal volume (TRV) of the remaining kidney pre and post RN can help assess the RF evolution. Aims To determine the correlation between TRV pre and post nephrectomy (a year of follow-up) with RF and the factors that modify. Method A retrospective cohort study was carried out in our institution, in 62 patients who had underwent RN from 2014 to 2018, due to renal cell carcinoma (confirmed by histopathology). The demographic data included age, gender, body mass index (BMI), associated comorbidities, smoking habits were collected. Serum creatinine, estimated glomerular filtration rate (eGFR) and proteinuria were collected in the preoperative period and in the follow-up. The TRV was calculated pre and post (a year of follow-up) RN, using ellipsoid formula equation (computed tomography scan or magnetic resonance imaging). Renal function evolution was assessed by eGFR using the modification of diet in Renal Disease formula. Multivariate linear regression analysis was used to determine the predictor of TRV at 1 year of follow-up. Results The median age at the time of RN was 71 years old (range, 43-86 years). Most of them were men, 69% (43/19). The estimated glomerular filtration rate (FGe) pre and post nephrectomy was 74 (41-102) and 52.1 ml/min/ m2 (22-89) respectively (P=0.013). The TRV pre and post-nephrectomy was 165.3 (102.3-259.7) and 188.3 ml (115.3-271.2) respectively (P=0.001). On multivariate linear regression analysis, controlling for age and sex; the pre-nephrectomy FGe (β = 0.42; P = 0.023) and the pre TRV (β = 1.23; P &lt;0.0001) were positively correlated with the post-nephrectomy TRV, while the FGe at year of follow-up was correlated negatively (β = -1.11; P = 0.024) Conclusion The post nephrectomy TRV was positively correlated with TRV and FGe pre nephrectomy. While with the FGe at one year post nephrectomy was negatively correlated. The increasing TRV pre and post nephrectomy can help to predict renal function at a year of follow-up in this group of patients.

P3784Impact of progressively impaired renal function on major adverse outcomes in European patients with atrial fibrillation: a report from the ESC EORP-AF long-term general registry

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
G Boriani ◽  
M Proietti ◽  
C Laroche ◽  
I Diemberger ◽  
Z Kalarus ◽  
...  
Keyword(s):  
Renal Function ◽  
Renal Dysfunction ◽  
Impaired Renal Function ◽  
Thromboembolic Event ◽  
Estimated Glomerular Filtration Rate ◽  
Adverse Outcomes ◽  
Coronary Syndrome ◽  
Reduced Renal Function

Abstract Background Renal function is an important predictor of major adverse outcomes in the general population. In the setting of atrial fibrillation (AF), renal dysfunction may act both as a risk factor and a proxy of vascular risk factors and comorbidities. Methods We analyzed the association of renal function, as estimated glomerular filtration rate (eGFR) using the CKD-EPI formula, with 1-year outcomes in a “real-world” cohort of European AF patients from the EORP-AF Long-Term General Registry. Results 7725 were available for this analysis. Of these, 1294 (16.7%) had normal renal function (≥90 mL/min/1.73 m2), 3848 (49.8%) mildly reduced renal function (60–89 mL/min/1.73 m2), 2311 (29.9%) moderately reduced renal function (30–59 mL/min/1.73 m2) and 272 (3.5%) severely reduced renal function (<30 mL/min/1.73 m2). CHA2DS2-VASc and HAS-BLED scores values increased across eGFR strata (p<0.0001). Among patients qualifying for oral anticoagulant (OAC) therapy, those with severely impaired renal function were less often prescribed with any OAC (79.8%, p<0.0001), more likely with vitamin K antagonist (62.9%) than non-vitamin K antagonist oral anticoagulants (16.9%) (p<0.0001). At 1-year follow-up the rates of any thromboembolic event (TE)/acute coronary syndrome (ACS)/cardiovascular (CV) death progressively increased with worsening renal function, up to 20.7% in patients with severe dysfunction (p<0.0001). Rates of CV death and all-cause death were higher in severe renal dysfunction (16.9% and 21.3%; p<0.0001). Cox regression analysis (adjusted for known predictors) showed that eGFR <30 mL/min/1.73 m2, compared to normal renal function was associated with an increased risk of all the adverse outcomes (Table). eGFR decrease by 10 mL/min/1.73 m2 was associated with increased risks (Table). Any TE/ACS/CV Death CV Death All-Cause Death mL/min/1.73 m2 HR (95% CI) HR (95% CI) HR (95% CI) eGFR ≥90 (ref.) – – – eGFR 60–89 0.99 (0.67–1.46) 0.81 (0.44–1.51) 0.74 (0.47–1.19) eGFR 30–50 1.12 (0.74–1.69) 1.00 (0.53–1.89) 0.95 (0.59–1.54) eGFR <30 2.47 (1.52–3.99) 2.73 (1.36–5.49) 2.16 (1.25–3.72) eGFR (by 10 mL/min/1.73 m2 decrease) 1.11 (1.05–1.17) 1.18 (1.10–1.27) 1.11 (1.03–1.18) ACS = Acute coronary syndrome; CI = Confidence interval; CV = Cardiovascular; eGFR = estimated Glomerular Filtration Rate; HR = Hazard ratio; TE = Thromboembolic event. Conclusions In AF patients, impaired renal function at baseline is associated with a progressive increase in the risk of major adverse outcomes during follow up. Severe renal dysfunction is an independent predictor of all the adverse outcomes.

Estimated Glomerular Filtration Rate Changes In Patients (Pts) With Chronic Myeloid Leukemia (CML) Treated With Tyrosine Kinase Inhibitors (TKI)

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1488-1488 ◽  
Author(s):  
Musa Yilmaz ◽  
Hagop M. Kantarjian ◽  
Alfonso Quintas-Cardama ◽  
Susan O'Brien ◽  
Jan A. Burger ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Research Funding ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Estimated Gfr ◽  
Free Survival ◽  
Tki Treatment

Abstract Introduction TKI are standard therapy for pts with CML. Although generally safe, they are associated with some adverse events, most of them manageable and transient. Renal dysfunction has been reported anecdotally on pts with CML treated with TKI. We investigated the incidence of acute renal failure (ARF) and chronic renal failure (CRF) among the CML pts treated with TKI, and analyzed possible relationship between treatment duration with TKI and changes in estimated glomerular filtration rate (GFR). Methods Four hundred and seventy-five pts treated with imatinib (255 pts; 49 at 400 mg daily; 206 at 800 mg daily), dasatinib (101 pts) and nilotinib (119 pts) in prospective clinical trials at a single institution were evaluated. Pts were followed routinely with blood chemistries including renal function tests, at least weekly during the first 2-3 months, then every 2-4 weeks for 6-12 months, then every 8-12 weeks. GFR was estimated using the Modification of Diet in Renal Disease (MDRD) equation and recorded from the onset of TKI treatment until last follow up. ARF was defined as an increase in serum creatinine of ≥0.3 mg/dl, and CRF defined as an estimated GFR ≤ 60 ml/min/1.73 m2 persisting for at least 90 days. Results After a median follow-up of 50 months (range, 2 to 138 months), 19 pts (4%) developed ARF. The median time of onset for ARF was 9 days (range 4-84 days). Sixteen of 19 pts (84%) were on imatinib, 2 on nilotinib, and 1 on dasatinib (p=0.006). There was no association between imatinib dose and incidence of ARF (2% with 400mg vs 7% with 800mg) (p=0.174). The median age for pts with ARF was 58 yrs compared to 48 for pts with no ARF (p=0.009). Seventy-nine percent (15 out of 19) of ARF pts and 59% (269 of 456) of pts without ARF were male (p=0.063). During study time, estimated GFR decreased significantly in pts treated with imatinib compared to dasatinib (Figure 1) (p<0.001). Interestingly, in pts treated with nilotinib, we observed significant increase in GFR when we compare baseline GFR to the GFR in all other time points (p<0.05). 442 pts (94%) had no CRF at baseline, and 48 of these pts (11%) developed CRF over the course of TKI treatment. Among them, 39 pts (81%) were on imatinib compared to 19% on other TKIs (5 dasatinib, 4 nilotinib) (p<0.001). There was no association between imatinib dose (400mg and 800mg) and CRF incidence (p=0.591). The median age for pts who developed CRF was 61 yrs compared to 47 for those with no CRF (p=<0.001). Fifty-eight percent (28 out of 48) of CRF pts and 60 % (256 of 427) of pts without CRF were male (p=0.828). Overall CCyR rate was the same (89%) in pts who had ARF and no ARF, and overall MMR rate was 79% in pts with ARF and 83% in pts with no ARF (p=0.401). Overall CCyR rate was 98% in pts who developed CRF over the course of TKI therapy compared to 89% in pts who did not develop CKD (p=0.026). Similarly, overall MMR rate was higher (96%) in pts developed CKD compared to pts who did not have CKD (82%) (p=0.013). Overall survival and transformation free survival was not statistically different when compared pts with ARF vs no ARF and CRF vs no CRF. However, pts with ARF had decreased event free survival (EFS) when compared to no ARF pts (p=0.019). There was no EFS difference in CRF pts (0.966). Conclusion Long-term treatment with imatinib may cause a significant decline in estimated GFR. Interestingly, treatment with nilotinib may cause a slight improvement in GFR. It is important that pts are monitored for renal function during therapy with TKI, with particular attention to those with risk factors for renal dysfunction. Disclosures: Ravandi: Pfizer and Novartis: Honoraria; BMS: Research Funding. Jabbour:Novartis, BMS, Ariad, and Pfizer: Consultancy. Cortes:Ariad, BMS, Novartis, Pfizer and Teva: Research Funding; BMS, Pfizer and Teva. : Consultancy.

Plasma Copeptin and Decline in Renal Function in a Cohort from the Community: The Prospective D.E.S.I.R. Study

2015 ◽  
Vol 42 (2) ◽  
pp. 107-114 ◽  
Author(s):  
Ronan Roussel ◽  
Nadia Matallah ◽  
Nadine Bouby ◽  
Ray El Boustany ◽  
Louis Potier ◽  
...  
Keyword(s):  
Renal Function ◽  
Kidney Disease ◽  
General Population ◽  
Estimated Glomerular Filtration Rate ◽  
Enzyme Inhibitor ◽  
Public Health Problem ◽  
Female Gender ◽  
Ckd Progression ◽  
Community Based

Background/Aims: In recent days, chronic kidney disease (CKD) is becoming an increasing public health problem. Identification of factors contributing to its progression is crucial for designing preventive interventions. Previous studies suggested that chronically high vasopressin is deleterious to the renal function. We evaluated plasma copeptin, a surrogate of vasopressin, as a predictor for renal function decline in a community cohort. Methods: Plasma copeptin was measured at baseline in 1,234 participants from the D.E.S.I.R. study, a prospective cohort from the French general population. All participants were followed for 9 years. Progression towards CKD during follow-up was defined as an estimated glomerular filtration rate (eGFR) below 60 ml/min/1.73 m2 on at least one follow-up visit. We have also considered the criterion ‘Certain Drop in eGFR' proposed by the Kidney Disease Improving Global Outcomes (KDIGO) group. Results: Progression towards CKD was observed in 86 (7.0%) participants. Factors like age, female gender, plasma copeptin and use of angiotensin converting enzyme inhibitor or angiotensin 2 receptor blocker at baseline were positively associated, and eGFR inversely associated with CKD progression during follow-up. The hazard ratio per unit of log10-transformed plasma copeptin was 1.65 (95% CI 1.06-2.54) and p = 0.02. Copeptin was similarly associated with CKD and this was observed when we considered the KDIGO criterion: OR 3.03 (95% CI 1.21-7.57), p = 0.02. Conclusion: The plasma copeptin level was independently and positively associated with progression towards CKD in a community-based cohort. Our results add to the available evidence for a deleterious effect of high vasopressin on renal health not only in selected groups of patients with CKD but also in the general population.

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