Sodium intake and kidney function in the general population: an observational, population-based study

Abstract Background The relationships of sodium intake to kidney function within the population have been poorly investigated and are the objective of the study. Methods This observational, population-based, cross-sectional and longitudinal study targeted 4595 adult participants of the Gubbio study with complete data at baseline exam. Of these participants, 3016 participated in the 15-year follow-up (mortality-corrected response rate 78.4%). Baseline measures included sodium:creatinine ratio in timed overnight urine collection, used as an index of sodium intake, together with serum creatinine, sex, age and other variables. Follow-up measures included serum creatinine and other variables. Estimated glomerular filtration rate (eGFR, mL/min/1.73 m2) was calculated using serum creatinine, sex and age and was taken as an index of kidney function. Results The study cohort was stratified in sex- and age-controlled quintiles of baseline urine sodium:creatinine ratio. A higher quintile associated with higher baseline eGFR (P < 0.001). In multivariable analysis, the odds ratio (OR) of Stage1 kidney function (eGFR ≥90 mL/min/1.73 m2) was 1.98 times higher in Quintile 5 compared with Quintile 1 [95% confidence interval (CI) 1.50–2.59, P < 0.001]. The time from baseline to follow-up was 14.1 ± 2.5 years. Baseline to follow-up, the eGFR change was more negative along quintiles (P < 0.001). In multivariable analysis, the OR in Quintile 5 compared with Quintile 1 was 2.21 for eGFR decline ≥30% (1.18–4.13, P = 0.001) and 1.38 for worsened stage of kidney function (1.05–1.82, P = 0.006). Findings were consistent within subgroups. Conclusions Within the general population, an index of higher sodium intake associated cross-sectionally with higher kidney function but longitudinally with greater kidney function decline.

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P0732DOES KIDNEY FUNCTION INFLUENCE PLASMA ADIPONECTIN CONCENTRATION IN ELDERLY CAUCASIANS?

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0732 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Marcin Adamczak ◽

Sylwia Dudzicz ◽

Jerzy Chudek ◽

Jan Zejda ◽

Tomasz Zdrojewski ◽

...

Keyword(s):

Plasma Concentration ◽

Kidney Function ◽

Multivariate Regression Analysis ◽

Population Based ◽

Cross Sectional Study ◽

Elderly Subjects ◽

Study Cohort ◽

Adiponectin Concentration ◽

Cross Sectional ◽

Plasma Adiponectin

Abstract Background and Aims Adiponectin is a hormone produced almost exclusively by the adipose tissue with vaso-protective activity and mostly metabolized in the kidneys. Glomerular filtration rate (GFR) is declining with age in elderly subjects and therefore it is expected to be followed by accumulation of adiponectin in the circulation. The aim of this study was to assess the plasma concentration of adiponectin in relation to GFR in the older population-based on the PolSenior study cohort. Method The PolSenior study was a multicenter cross-sectional study which assessed the health status of older adults in Poland. In 3913 subjects aged 65 years or above (2041 male and 1872 female, BMI 28.1±5.1 kg/m2, mean age 79±9 years) plasma adiponectin concentration (ELISA; B-Bridge International) was measured. GFR was estimated using a short MDRD formula. All results are presented as means with standard deviations. Results In studied subjects eGFR was 76 ml/min/1.73 m2. eGFR below 60 ml/min/1.73 m2 was observed in 842 (22%) subjects. Plasma concentration of adiponectin was 11.9±6.4 µg/ml. In subjects with eGFR < 60 ml/min/1.73 m2 significantly higher plasma adiponectin concentrations were observed compared to subjects with eGFR ≥ 60 ml/min/1.73 m2 (12.5±6.7 vs. 11.8±6.3 respectively, p=0.01). Plasma adiponectin concentration depends strongly on BMI (R= -0.28; p<0.001) and marginally on the kidney function (R=-0.05; p=0.005). Multivariate regression analysis including plasma adiponectin concentration, BMI, eGFR, occurrence of diabetes mellitus and hypertension, showed that BMI and prevalence of diabetes (b=-0.24, p<0.001, b=-0.11, p<0.0001, respectively) but not eGFR explain variability of plasma adiponectin concentration. Conclusion Plasma adiponectin concentration is only slightly affected by kidney function in elderly Caucasians from the PolSenior study.

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Prevalence and factors associated with fatigue in the Lausanne middle-aged population: a population-based, cross-sectional survey

BMJ Open ◽

10.1136/bmjopen-2018-027070 ◽

2019 ◽

Vol 9 (8) ◽

pp. e027070 ◽

Cited By ~ 6

Author(s):

Coralie Galland-Decker ◽

Pedro Marques-Vidal ◽

Peter Vollenweider

Keyword(s):

General Population ◽

Sleep Disturbances ◽

Handgrip Strength ◽

Multivariable Analysis ◽

Population Based ◽

Bivariate Analysis ◽

P Value ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Factors Associated

ObjectiveTo assess the prevalence and factors associated with fatigue in the general population.DesignPopulation-based, cross-sectional survey performed between May 2014 and April 2017.SettingGeneral population of the city of Lausanne, Switzerland.Participants2848 participants (53.2% women, age range 45–86 years).Primary outcome measurePrevalence of fatigue the previous week, defined as a score of ≥4 using the Fatigue Severity Scale.ResultsThe prevalence of fatigue was 21.9% (95% CI 20.4% to 23.4%) in the total sample. On bivariate analysis, participants with fatigue were younger, had a higher body mass index, a lower handgrip strength and lower ferritin levels. Participants with fatigue were more frequently women, had a lower educational level, presented more frequently with clinical insomnia, diabetes, anaemia, depression and low thyroid stimulating hormone (TSH) values, had a higher consumption of antihistamines, antidepressants and hypnotics, and rated more frequently their health as bad or very bad. Multivariable analysis showed that obesity (OR 1.40 (95% CI 1.03 to 1.91)), insomnia categories (p value for trend <0.001), depression (OR 3.26 (95% CI 2.38 to 4.46)), anaemia (OR 1.70 (95% CI 1.00 to 2.89)) and low self-rated health status (p value for trend <0.001) were positively associated with fatigue, while older age (p value for trend 0.002) was negatively associated with fatigue. Conversely, no association was found for diabetes, TSH levels, antihistamines or hypnotics.ConclusionIn a population-based sample aged 45–86, fatigue was present in one out of five subjects. Regarding clinical factors, sleep disturbances such as insomnia and sleep apnoea should be assessed first, followed by depression. Regarding biological factors, anaemia should be ruled out, while screening for hypothyroidism is not recommended as a first step. Sleep complaints and fatigue in older subjects are not due to ageing and should prompt identification of the underlying cause.

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Clinical and genetic factors associated with mismanagement of dyslipidemia. Multiple cross-sectional analysis

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.382 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

V Chekanova ◽

P Marques-Vidal ◽

N Abolhassani

Keyword(s):

High Risk ◽

Total Cholesterol ◽

Genetic Factors ◽

Multivariable Analysis ◽

Population Based ◽

P Value ◽

Cvd Risk ◽

Cross Sectional ◽

Factors Associated

Abstract Funding Acknowledgements Type of funding sources: None. Aims Identify the clinical and genetic factors associated with poor control of high cholesterol in the Swiss population. Methods Data from three waves [baseline, N = 617; first, N = 844 and second, N = 798 follow-ups] of a population-based, prospective study conducted in Lausanne, Switzerland. Inadequate management of dyslipidemia was assessed according to the most common Swiss guideline. Genetic scores for lipid levels were computed based on the existing literature. Results Prevalence of inadequately managed dyslipidemia was 30%, 31.5% and 17.4% in the baseline, first and second follow-up. On multivariable analysis, participants at high risk of CVD had a lower likelihood of being adequately managed: odds ratio (OR) and (95% confidence interval) for high-risk relative to low-risk: 0.10 (0.06-0.18), 0.11 (0.07-0.17) and 0.15 (0.09-0.27) for the baseline, first and second follow-up (p for trend < 0.001). Use of more potent statins increased the likelihood of adequate management, OR and (95% CI) for third vs. first level: 2.89 (1.76-4.74) and 5.17 (2.51-10.6) in the first and second follow-up (p for trend < 0.001). No differences in total cholesterol, LDL and HDL genetic scores were found between adequately and inadequately managed participants: for the total cholesterol, -3.7 ± 9.6 vs. -2.7 ± 9.4; -3.5 ± 8.9 vs. -3.7 ± 9.5 and -3.8 ± 8.9 vs. -3.3 ± 9.4 in the baseline, first and second follow-up, p = NS. Those findings were replicated when the thresholds for adequate control were relaxed. Conclusion Management of dyslipidemia is suboptimal in Switzerland. Use of newer, more potent statins in high-risk patients could improve this status. The use of genetic scores appears to be of little interest. Multivariate Analysis First FUOR (95% CI) p-value Second FUOR (95% CI) p-value CVD risk Intermediate 0.18 (0.10 - 0.32) <0.001 0.22 (0.09 - 0.55) 0.001 High 0.07 (0.04 - 0.12) <0.001 0.09 (0.04 - 0.2) <0.001 p-value for trend <0.001 <0.001 Swiss vs Non-Swiss 1.34 (0.87 - 2.05) 0.181 0.79 (0.43 - 1.43) 0.428 FH dyslipidemia (yes/no) 1.02 (0.63 - 1.63) 0.948 0.55 (0.29 - 1.03) 0.060 Statins potency First 1 (ref.) 1 (ref.) Second 2.00 (1.22 - 3.27) 0.006 2.59 (1.23 - 5.44) 0.012 Third 2.89 (1.76 - 4.74) <0.001 5.17 (2.51 - 10.6) <0.001 p-value for trend <0.001 <0.001

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Associations between emphysema-like lung on CT and incident airflow limitation: a general population-based cohort study

Thorax ◽

10.1136/thoraxjnl-2017-210842 ◽

2017 ◽

Vol 73 (5) ◽

pp. 486-488 ◽

Cited By ~ 5

Author(s):

Elizabeth C Oelsner ◽

Benjamin M Smith ◽

Eric A Hoffman ◽

Aaron R Folsom ◽

Steven M Kawut ◽

...

Keyword(s):

General Population ◽

Cardiac Ct ◽

Population Based ◽

Airflow Limitation ◽

Smoking History ◽

Lung Function Decline ◽

Upper Limit ◽

Adult Participants ◽

Heavy Smokers

Emphysema on CT is associated with accelerated lung function decline in heavy smokers and patients with COPD; however, in the general population, it is not known whether greater emphysema-like lung on CT is associated with incident COPD. We used data from 2045 adult participants without initial prebronchodilator airflow limitation, classified by FEV1/FVC<0.70, in the Multi-Ethnic Study of Atherosclerosis. Emphysema-like lung on baseline cardiac CT, defined as per cent low attenuation areas<—950HU>upper limit of normal, was associated with increased odds of incident airflow limitation at 5-year follow-up on both prebronchodilator (adjusted OR 2.62, 95% CI 1.47 to 4.67) and postbronchodilator (adjusted OR 4.38, 95% CI 1.63 to 11.74) spirometry, independent of smoking history. These results support investigation into whether emphysema-like lung could be informative for COPD risk stratification.

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Urinary Potassium and Kidney Function Decline in the Population—Observational Study

Nutrients ◽

10.3390/nu13082747 ◽

2021 ◽

Vol 13 (8) ◽

pp. 2747

Author(s):

Massimo Cirillo ◽

Giancarlo Bilancio ◽

Pierpaolo Cavallo ◽

Raffaele Palladino ◽

Enrico Zulli ◽

...

Keyword(s):

Kidney Function ◽

Population Based ◽

Dietary Sodium ◽

Study Cohort ◽

Creatinine Ratio ◽

Time Data ◽

High Potassium ◽

Cross Sectional ◽

Potassium Intake ◽

Urinary Potassium

Background—Some data suggest favorable effects of a high potassium intake on kidney function. The present population-based study investigated cross-sectional and longitudinal relations of urinary potassium with kidney function. Methods—Study cohort included 2027 Gubbio Study examinees (56.9% women) with age ≥ 18 years at exam-1 and with complete data on selected variables at exam-1 (1983–1985), exam-2 (1989–1992), and exam-3 (2001–2007). Urinary potassium as urinary potassium/creatinine ratio was measured in daytime spot samples at exam-1 and in overnight timed collections at exam-2. Estimated glomerular filtration rate (eGFR) was measured at all exams. Covariates in analyses included demographics, anthropometry, blood pressure, drug treatments, diabetes, smoking, alcohol intake, and urinary markers of dietary sodium and protein. Results—In multivariable regression, urinary potassium/creatinine ratio cross-sectionally related to eGFR neither at exam-1 (standardized coefficient and 95%CI = 0.020 and −0.059/0.019) nor at exam-2 (0.024 and −0.013/0.056). Exam-1 urinary potassium/creatinine ratio related to eGFR change from exam-1 to exam-2 (0.051 and 0.018/0.084). Exam-2 urinary potassium/creatinine ratio related to eGFR change from exam-2 to exam-3 (0.048 and 0.005/0.091). Mean of urinary potassium/creatinine ratio at exam-1 and exam-2 related to eGFR change from exam-1 to exam-3 (0.056 and 0.027/0.087) and to incidence of eGFR < 60 mL/min per 1.73 m2 from exam-1 to exam-3 (odds ratio and 95%CI = 0.78 and 0.61/0.98). Conclusion—In the population, urinary potassium did not relate cross-sectionally to eGFR but related to eGFR decline over time. Data support the existence of favorable effects of potassium intake on ageing-associated decline in kidney function.

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Predictors of Outcome for Orofacial Pain in the General Population: a Four-year Follow-up Study

Journal of Dental Research ◽

10.1177/154405910408300911 ◽

2004 ◽

Vol 83 (9) ◽

pp. 712-717 ◽

Cited By ~ 36

Author(s):

T.V. Macfarlane ◽

A.S. Blinkhorn ◽

R.M. Davies ◽

J. Kincey ◽

H.V. Worthington

Keyword(s):

General Population ◽

Orofacial Pain ◽

Population Sample ◽

Participation Rate ◽

Population Based ◽

Predictors Of Outcome ◽

Cross Sectional ◽

The United Kingdom ◽

Population Based Survey

Orofacial pain is often persistent, but it is not clear why it lasts in some patients but not in others. We aimed to describe the natural course of orofacial pain in a general population sample over a four-year period and to identify factors that would predict the persistence of pain. A cross-sectional population-based survey was conducted in the United Kingdom, involving 2504 participants (participation rate 74%), of whom 646 (26%) reported orofacial pain. Overall, 424 (79% adjusted participation rate) of these individuals participated at the four-year follow-up, of whom 229 (54%) reported orofacial pain and 195 (46%) did not report such pain. Persistent orofacial pain was associated with females, older age, psychological distress, widespread body pain, and taking medication for orofacial pain at baseline. These findings may have implications for the identification and treatment of patients with orofacial pain.

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The Association Between Estimated Glomerular Filtration Rate and Hospitalization for Fatigue: A Population-Based Cohort Study

Canadian Journal of Kidney Health and Disease ◽

10.1177/20543581211001224 ◽

2021 ◽

Vol 8 ◽

pp. 205435812110012

Author(s):

Janine F. Farragher ◽

Jianguo Zhang ◽

Tyrone G. Harrison ◽

Pietro Ravani ◽

Meghan J. Elliott ◽

...

Keyword(s):

Cohort Study ◽

Serum Creatinine ◽

Kidney Function ◽

Filtration Rate ◽

Estimated Glomerular Filtration Rate ◽

Population Based ◽

Incidence Of Hospitalization ◽

Creatinine Measurement ◽

Serum Creatinine Measurement

Background: Fatigue is a pervasive symptom among patients with chronic kidney disease (CKD) that is associated with several adverse outcomes, but the incidence of hospitalization for fatigue is unknown. Objective: To explore the association between estimated glomerular filtration rate (eGFR) and incidence of hospitalization for fatigue. Design: Population-based retrospective cohort study using a provincial administrative dataset. Setting: Alberta, Canada. Patients: People above age 18 who had at least 1 outpatient serum creatinine measurement taken in Alberta between January 1, 2009, and December 31, 2016. Measurements: The first outpatient serum creatinine was used to estimate GFR. Hospitalization for fatigue was identified using International Classification of Diseases, Tenth Revision (ICD-10) code R53.x. Methods: Patients were stratified by CKD category based on their index eGFR. We used negative binomial regression to determine if there was an increased incidence of hospitalization for fatigue by declining kidney function (reference eGFR ≥ 60 mL/min/1.73m2). Estimates were stratified by age, and adjusted for age, sex, socioeconomic status, and comorbidity. Results: The study cohort consisted of 2 823 270 adults, with a mean age of 46.1 years and median follow-up duration of 6.0 years; 5 422 hospitalizations for fatigue occurred over 14 703 914 person-years of follow-up. Adjusted rates of hospitalization for fatigue increased with decreasing kidney function, across all age strata. The highest rates were seen in adults on dialysis (adjusted incident rate ratios 24.47, 6.66, and 3.13 for those aged 18 to 64, 65 to 74, and 75+, respectively, compared with eGFR ≥ 60 mL/min/1.73m2). Limitations: Fatigue hospitalization codes have not been validated; reference group limited to adults with at least 1 outpatient serum creatinine measurement; remaining potential for residual confounding. Conclusions: Declining kidney function was associated with increased incidence of hospitalization for fatigue. Further research into ways to address fatigue in the CKD population is warranted. Trial Registration: Not applicable (not a clinical trial).

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Gastroesophageal reflux disease is a risk factor for sputum production in the general population: the Nagahama study

Respiratory Research ◽

10.1186/s12931-020-01601-y ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Chie Morimoto ◽

Hisako Matsumoto ◽

Tadao Nagasaki ◽

Yoshihiro Kanemitsu ◽

Yumi Ishiyama ◽

...

Keyword(s):

Gastroesophageal Reflux Disease ◽

General Population ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Multivariable Analysis ◽

Smoking History ◽

Cross Sectional ◽

Frequency Scale ◽

Sputum Production

Abstract Background Chronic sputum production in the general population is historically associated with clinical indices including male sex and smoking history. However, its relationship with gastroesophageal reflux disease (GERD), which may prove an underlying factor in sputum production, is unclear. We aimed to clarify factors associated with sputum production in the general population in cross-sectional and longitudinal manners. Methods In the Nagahama study, a community-based cohort study, 9804 subjects were recruited between 2008 and 2010 (baseline assessment), 8293 of whom were followed from 2013 to 2015 (follow-up assessment). This study contained a self-completed questionnaire which included medical history, assessment of sputum production, and a frequency scale for symptoms of GERD. A Frequency Scale for Symptoms of Gastroesophageal Reflux Disease score of ≥ 8 was defined as GERD. In addition to the frequency of sputum production at each assessment, frequency of persistent sputum production defined as sputum production at both assessments was examined. Results Frequency of sputum production was 32.0% at baseline and 34.5% at follow-up. Multivariable analysis demonstrated that sputum production at baseline was significantly associated with GERD [odds ratio (OR), 1.92; 95% confidence interval (CI) 1.73–2.13] and post-nasal drip (PND) (OR, 2.40; 95% CI 2.15–2.68), independent of other known factors such as older age, male sex and smoking history. These associations between sputum production and GERD or PND were also observed at follow-up. In longitudinal analysis, 19.4% had persistent sputum production and 12.3% had transient sputum production, i.e., at baseline only. Multivariable analysis for risk of persistence of sputum production revealed that persistent sputum production was associated with GERD and PND, in addition to the known risk factors listed above. The proportion of subjects with GERD at both assessments was highest among subjects with persistent sputum production. Conclusions Cross-sectional and longitudinal analysis demonstrated an association in the general population between sputum production and GERD, as well as PND, independent of known risk factors. The presence of GERD should be assessed in patients complaining of sputum production.

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Glomerular function in relation to fine airborne particulate matter in a representative population sample

Scientific Reports ◽

10.1038/s41598-021-94136-1 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Ying-Mei Feng ◽

Lutgarde Thijs ◽

Zhen-Yu Zhang ◽

Esmée M. Bijnens ◽

Wen-Yi Yang ◽

...

Keyword(s):

Serum Creatinine ◽

Population Sample ◽

Airborne Particulate Matter ◽

Blood Stream ◽

Renal Outcome ◽

Cross Sectional ◽

Cholesterol Ratio ◽

Median Serum ◽

Renal Responses

AbstractFrom 1990 until 2017, global air-pollution related mortality increased by 40%. Few studies addressed the renal responses to ultrafine particulate [≤ 2.5 µm (PM2.5)], including black carbon (BC), which penetrate into the blood stream. In a Flemish population study, glomerular filtration estimated from serum creatinine (eGFR) and the urinary albumin-to-creatinine ratio were measured in 2005–2009 in 820 participants (women, 50.7%; age, 51.1 years) with follow-up of 523 after 4.7 years (median). Serum creatinine, eGFR, chronic kidney disease (eGFR < 60 mL/min/1.73 m2) and microalbuminuria (> 3.5/> 2.5 mg per mmol creatinine in women/men) were correlated in individual participants via their residential address with PM2.5 [median 13.1 (range 0.3–2.9) μg/m3] and BC [1.1 (0.3–18) μg/m3], using mixed models accounting for address clusters. Cross-sectional and longitudinally, no renal outcome was associated with PM2.5 or BC in models adjusted for sex and baseline or time varying covariables, including age, blood pressure, heart rate, body mass index, plasma glucose, the total-to-HDL serum cholesterol ratio, alcohol intake, smoking, physical activity, socioeconomic class, and antihypertensive treatment. The subject-level geocorrelations of eGFR change with to BC and PM2.5 were 0.13 and 0.02, respectively (P ≥ 0.68). In conclusion, in a population with moderate exposure, renal function was unrelated to ultrafine particulate.

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Lymphoproliferative malignancies in patients with neurofibromatosis 1

Orphanet Journal of Rare Diseases ◽

10.1186/s13023-021-01856-8 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Christina Bergqvist ◽

François Hemery ◽

Arnaud Jannic ◽

Salah Ferkal ◽

Pierre Wolkenstein

Keyword(s):

General Population ◽

Medical History ◽

Hodgkin Lymphoma ◽

Incidence Rate ◽

Population Based ◽

Neurofibromatosis 1 ◽

Population Based Study ◽

Non Hodgkin Lymphoma ◽

History Of

AbstractNeurofibromatosis 1 (NF1) is an inherited, autosomal-dominant, tumor predisposition syndrome with a birth incidence as high as 1:2000. A patient with NF1 is four to five times more likely to develop a malignancy as compared to the general population. The number of epidemiologic studies on lymphoproliferative malignancies in patients with NF1 is limited. The aim of this study was to determine the incidence rate of lymphoproliferative malignancies (lymphoma and leukemia) in NF1 patients followed in our referral center for neurofibromatoses. We used the Informatics for Integrated Biology and the Bedside (i2b2) platform to extract information from the hospital’s electronic health records. We performed a keyword search on clinical notes generated between Jan/01/2014 and May/11/2020 for patients aged 18 years or older. A total of 1507 patients with confirmed NF1 patients aged 18 years and above were identified (mean age 39.2 years; 57% women). The total number of person-years in follow-up was 57,736 (men, 24,327 years; women, 33,409 years). Mean length of follow-up was 38.3 years (median, 36 years). A total of 13 patients had a medical history of either lymphoma or leukemia, yielding an overall incidence rate of 22.5 per 100,000 (0.000225, 95% confidence interval (CI) 0.000223–0.000227). This incidence is similar to that of the general population in France (standardized incidence ratio 1.07, 95% CI 0.60–1.79). Four patients had a medical history leukemia and 9 patients had a medical history of lymphoma of which 7 had non-Hodgkin lymphoma, and 2 had Hodgkin lymphoma. Our results show that adults with NF1 do not have an increased tendency to develop lymphoproliferative malignancies, in contrast to the general increased risk of malignancy. While our results are consistent with the recent population-based study in Finland, they are in contrast with the larger population-based study in England whereby NF1 individuals were found to be 3 times more likely to develop both non-Hodgkin lymphoma and lymphocytic leukemia. Large-scale epidemiological studies based on nationwide data sets are thus needed to confirm our findings.

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