scholarly journals Changes in renal risk factors versus renal function outcome during follow-up in a population-based cohort study

2010 ◽  
Vol 25 (6) ◽  
pp. 1846-1853 ◽  
Author(s):  
N. Halbesma ◽  
D. F. Jansen ◽  
R. P. Stolk ◽  
P. E. De Jong ◽  
R. T. Gansevoort ◽  
...  
BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Emerald G. Heiland ◽  
Anna-Karin Welmer ◽  
Grégoria Kalpouzos ◽  
Anna Laveskog ◽  
Rui Wang ◽  
...  

Abstract Background The purpose of this study was to examine the associations between combined and individual cerebral small vessel disease (cSVD) markers on future walking speed over 9 years; and to explore whether these associations varied by the presence of cardiovascular risk factors (CRFs). Methods This population-based cohort study included 331 adults, aged ≥60 years, without limitation in walking speed (≥0.8 m/s). At baseline, cSVD markers, including white matter hyperintensities (WMH), lacunes, and perivascular spaces (PVS), were assessed on magnetic resonance imaging. The modifiable CRFs (physical inactivity, heavy alcohol consumption, smoking, hypertension, high total cholesterol, diabetes, and overweight/obese) were combined into a score. The association between baseline cSVD markers and the decline in walking speed was examined using linear mixed-effects models, whereas Cox proportional hazards models were used to estimate the association with walking speed limitation (defined as < 0.8 m/s) over the follow-up. Results Over the follow-up period, 76 (23.0%) persons developed walking speed limitation. Participants in the highest tertile of the combined cSVD marker score had a hazard ratio (HR) of 3.78 (95% confidence interval [CI] 1.70-8.45) for walking speed limitation compared with people in the lowest score tertile, even after adjusting for socio-demographics, CRFs, cognitive function, and chronic conditions. When investigating the cSVD markers individually, having the highest burden of WMH was associated with a significantly faster decline in walking speed (β coefficient − 0.020; 95% CI -0.035-0.004) and a greater HR of walking speed limitation (HR 2.78; 95% CI 1.31-5.89) compared with having the lowest WMH burden. Similar results were obtained for the highest tertile of PVS (HR 2.13; 95% CI 1.04-4.36). Lacunes were associated with walking speed limitation, but only in men. Having ≥4 CRFs and high WMH volume simultaneously, showed a greater risk of walking speed limitation compared with having ≥4 CRFs and low WMH burden. CRFs did not modify the associations between lacunes or PVS and walking speed. Conclusions Combined cSVD markers strongly predict walking speed limitation in healthy older adults, independent of cognitive function, with WMH and PVS being the strongest contributors. Improving cardiovascular health may help to mitigate the negative effects of WMH on future walking speed.


2020 ◽  
Author(s):  
Hui-Xian Xiang ◽  
Ying Xiang ◽  
Jun Fei ◽  
Zheng Xu ◽  
Ling Zheng ◽  
...  

Abstract Introduction: Increasing evidence indicate that coronavirus disease 2019 (COVID-19) is companied by renal dysfunction. However, the association of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2)-induced renal dysfunction with prognosis remains unclear.Materials and methods: This prospective case-cohort study analyzed 154 COVID-19 patients from the Second People’s Hospital of Fuyang City in Anhui Province. Clinical and demographic information were collected. Renal function was evaluated and its prognosis was followed up. Results: Of 154 hospitalized patients with COVID-19, 125 were common and 29 were severe patients. On admission, 16 (10.4%) patients were with renal dysfunction. Serum creatinine and cystatin C were increased, eGFR was decreased in severe patients compared with those in common patients. Renal dysfunction was more common in severe patients. By multivariate logistic regression, male, higher age and hypertension were three importantly independent risk factors of renal dysfunction in COVID-19 patients. Follow-up study found that at least one renal function marker of 3.33% patients remained abnormal in two weeks after discharge. Conclusion: Male elderly COVID-19 patients with hypertension elevates the risk of renal dysfunction. SARS-CoV-2-induced renal dysfunction are not fully recovered in two weeks after discharge.


2010 ◽  
Vol 128 (7) ◽  
pp. 1652-1658 ◽  
Author(s):  
Mariam Abdullahi Adamu ◽  
Melanie Nicole Weck ◽  
Dietrich Rothenbacher ◽  
Hermann Brenner

Author(s):  
Stéphanie Baggio ◽  
Marlène Sapin ◽  
Yasser Khazaal ◽  
Joseph Studer ◽  
Hans Wolff ◽  
...  

Research into comorbidity of alcohol and cannabis use disorders has resulted in inconsistent findings, especially among simultaneous users, who used alcohol and cannabis together on a single occasion. This study investigated the association of alcohol and cannabis use disorders among simultaneous users using a network perspective, which considers direct relationships between symptoms. We used a subset of simultaneous alcohol and cannabis users driven from the representative population-based sample of young Swiss men cohort study on substance use risk factors (C-SURF) (n = 1559 at baseline and n = 991 at follow-up). Self-reported symptoms of alcohol and cannabis use disorders were collected. Network analyses included network estimation, visualization, and community detection tests. Alcohol and cannabis use symptoms were separated in two distinct clusters, with few paths between them (eleven positive edges at baseline, three at follow-up). Withdrawal symptoms were likely to connect the two disorders at baseline, but not at follow-up. Alcohol and cannabis use disorders appeared as separate disorders among simultaneous users. Our findings mitigated previous findings on the detrimental association between alcohol and cannabis use. Future studies should incorporate network analyses as a means to study comorbidity in other community and clinical samples to confirm our preliminary findings.


Kidney360 ◽  
2020 ◽  
Vol 1 (7) ◽  
pp. 640-647 ◽  
Author(s):  
Allison C. Ouellette ◽  
Elizabeth K. Darling ◽  
Branavan Sivapathasundaram ◽  
Glenda Babe ◽  
Richard Perez ◽  
...  

BackgroundThere are limited data at a population level on the burden, risk factors, and long-term outcomes of neonatal renal vein thrombosis (nRVT). We conducted a population-based cohort study to understand the epidemiology and outcomes of nRVT over a 25-year period in Ontario.MethodsUsing linked administrative health databases, all hospitalized neonates ≤28 days born in Ontario between 1992 and 2016 with nRVT were identified. The primary outcome was to calculate the incidence of nRVT and trend over time in Ontario. We also determined the risk factors associated with nRVT as well as the risk of long-term outcomes after nRVT, including CKD, ESKD, all-cause mortality, and hypertension (HTN) compared with the healthy neonatal population without nRVT.ResultsThe annual incidence rate of nRVT was 2.6 per 100,000 live births (n=85). Presence of respiratory distress syndrome (OR, 8.01; 95% CI, 4.90 to 13.1), congenital heart disease (OR, 9.1; 95% CI, 5.05 to 16.4), central venous catheterization (OR, 3.9; 95% CI, 1.89 to 7.93), maternal preeclampsia (OR, 2.8; 95% CI, 1.6 to 4.79), and maternal diabetes (OR, 2.36; 95% CI, 1.36 to 4.07) conferred the highest risk for nRVT. Over a median follow-up of 15 years and after adjusting for confounders, neonates with nRVT versus the comparator cohort had a 15.5-fold risk of CKD, HTN, or death (n=49 [58%] versus n=90,050 [3%]; 95% CI, 11.7 to 20.6); 12.3-fold increased risk of CKD or death (n=39 [46%] versus n=32,016 [1%]; 95% CI, 8.9 to 16.8); and a 15.7-fold increased risk of HTN (n=33 [39%] versus n=64,458 [2%]; 95% CI, 11.1 to 21.1). None of the nRVT cohort developed ESKD. The median time to composite outcome of CKD, HTN, or death was 11.1 years.ConclusionsPatients with a history of nRVT remain at higher risk than the general population for long-term morbidity or mortality, indicating the need for long-term follow-up.


BMJ ◽  
2019 ◽  
pp. l2323 ◽  
Author(s):  
Alexander Mok ◽  
Kay-Tee Khaw ◽  
Robert Luben ◽  
Nick Wareham ◽  
Soren Brage

AbstractObjectiveTo assess the prospective associations of baseline and long term trajectories of physical activity on mortality from all causes, cardiovascular disease, and cancer.DesignPopulation based cohort study.SettingAdults from the general population in the UK.Participants14 599 men and women (aged 40 to 79) from the European Prospective Investigation into Cancer and Nutrition-Norfolk cohort, assessed at baseline (1993 to 1997) up to 2004 for lifestyle and other risk factors; then followed to 2016 for mortality (median of 12.5 years of follow-up, after the last exposure assessment).Main exposurePhysical activity energy expenditure (PAEE) derived from questionnaires, calibrated against combined movement and heart rate monitoring.Main outcome measuresMortality from all causes, cardiovascular disease, and cancer. Multivariable proportional hazards regression models were adjusted for age, sex, sociodemographics, and changes in medical history, overall diet quality, body mass index, blood pressure, triglycerides, and cholesterol levels.ResultsDuring 171 277 person years of follow-up, 3148 deaths occurred. Long term increases in PAEE were inversely associated with mortality, independent of baseline PAEE. For each 1 kJ/kg/day per year increase in PAEE (equivalent to a trajectory of being inactive at baseline and gradually, over five years, meeting the World Health Organization minimum physical activity guidelines of 150 minutes/week of moderate-intensity physical activity), hazard ratios were: 0.76 (95% confidence interval 0.71 to 0.82) for all cause mortality, 0.71 (0.62 to 0.82) for cardiovascular disease mortality, and 0.89 (0.79 to 0.99) for cancer mortality, adjusted for baseline PAEE, and established risk factors. Similar results were observed when analyses were stratified by medical history of cardiovascular disease and cancer. Joint analyses with baseline and trajectories of physical activity show that, compared with consistently inactive individuals, those with increasing physical activity trajectories over time experienced lower risks of mortality from all causes, with hazard ratios of 0.76 (0.65 to 0.88), 0.62 (0.53 to 0.72), and 0.58 (0.43 to 0.78) at low, medium, and high baseline physical activity, respectively. At the population level, meeting and maintaining at least the minimum physical activity recommendations would potentially prevent 46% of deaths associated with physical inactivity.ConclusionsMiddle aged and older adults, including those with cardiovascular disease and cancer, can gain substantial longevity benefits by becoming more physically active, irrespective of past physical activity levels and established risk factors. Considerable population health impacts can be attained with consistent engagement in physical activity during mid to late life.


Rheumatology ◽  
2021 ◽  
Author(s):  
Johannes Nossent ◽  
Warren Raymond ◽  
Helen Isobel Keen ◽  
David Preen ◽  
Charles Inderjeeth

Abstract Objectives With sparse data available, we investigated mortality and risk factors in adults with IgAV. Methods Observational population-based cohort study using state-wide linked longitudinal health data for hospitalised adults with IgAV (n = 267) and matched comparators (n = 1080) between 1980-2015. Charlson comorbidity index (CCI) and serious infections (SI) were recorded over an extensive lookback period prior to diagnosis. Date and causes of death were extracted from WA Death Registry. Mortality rate (deaths/1000 person-years) ratios (MRR) and hazard ratio (HR) for survival were assessed. Results During 9.9 (±9.8) years lookback patients with IgAV accrued higher CCI scores (2.60 vs1.50 p &lt; 0.001) and had higher risk of SI (OR 8.4, p &lt; 0.001), not fully explained by CCI scores. During 19 years follow-up, the rate of death in Patients with IgAV (n = 137) was higher than in comparators (n = 397) (MRR 2.06, CI 1.70-2.50, p &lt; 0.01) and the general population (SMRR 5.64, CI 4.25, 7.53, p &lt; 0.001). Survival in IgAV was reduced at five (72.7 vs. 89.7%) and twenty years (45.2% vs. 65.6%) (both p &lt; 0.05). CCI (HR1.88, CI:1.25 - 2.73, p = 0.001), renal failure (HR 1.48, CI: 1.04 - 2.22, p = 0.03) and prior SI (HR 1.48, CI:1.01 – 2.16, p = 0.04) were independent risk factors. Death from infections (5.8 vs 1.8%, p = 0.02) was significantly more frequent in patients with IgAV. Conclusions Premorbid comorbidity accrual appears increased in hospitalized patients with IgAV and predicts premature death. As comorbidity does not fully explain the increased risk of premorbid infections or the increased mortality due to infections in IgAV, prospective studies are needed.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Heesun Lee ◽  
Kyungdo Han ◽  
Jun-Bean Park ◽  
In-Chang Hwang ◽  
Yeonyee E. Yoon ◽  
...  

Abstract Although hypertrophic cardiomyopathy (HCM), the most common inherited cardiomyopathy, has mortality rate as low as general population, previous studies have focused on identifying high-risk of sudden cardiac death. Thus, long-term systemic impact of HCM is still unclear. We sought to investigate the association between HCM and end-stage renal disease (ESRD). This was a nationwide population-based cohort study using the National Health Insurance Service database. We investigated incident ESRD during follow-up in 10,300 adult patients with HCM (age 62.1 years, male 67.3%) and 51,500 age-, sex-matched controls. During follow-up (median 2.8 years), ESRD developed in 197 subjects; 111 (1.08%) in the HCM, and 86 (0.17%) in the non-HCM (incidence rate 4.14 vs. 0.60 per 1,000 person-years, p < 0.001). In the HCM, the incidence rate for ESRD gradually increased with age, but an initial peak and subsequent plateau in age-specific risk were observed. HCM was a significant predictor for ESRD (unadjusted HR 6.90, 95% CI 5.21–9.15, p < 0.001), as comparable to hypertension and diabetes mellitus. Furthermore, after adjusting for all variables showing the association in univariate analysis, HCM itself remained a robust predictor of ESRD development (adjusted HR 3.93, 95% CI 2.82–5.46, p < 0.001). The consistent associations between HCM and ESRD were shown in almost all subgroups other than smokers and subjects with a history of stroke. Conclusively, HCM increased the risk of ESRD, regardless of known prognosticators. It provides new insight into worsening renal function in HCM, and active surveillance for renal function should be considered.


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