348. Kidney Function Decline Among HIV-infected Thai Adults: Is Low Vitamin D One of the Factors?

Abstract Background The prevalence of both hypovitaminosis D and Chronic Kidney disease (CKD) are high among Thai HIV-infected adults. Therefore, we examined the association of hypovitaminosis D and kidney function decline among HIV-infected Thai adults. Methods Using data prospectively collected from the HIV-NAT long-term cohort, we selected patients who were on ART, and virologically suppressed for ≥6 months. Baseline was defined as when the patient had a serum 25 OHD measured, with estimated Glomerular filtration rate (eGFR) above 60 mL/minute. Participants with eGFR measured at least twice a year were analyzed in the study. The primary outcome was kidney function impairment assessed as eGFR decline. Generalised estimating equations (GEE) were used to assess associations between the outcome and patient comorbidities and disease-related characteristics, including age, sex, body mass index (BMI) hypertension, gout, diabetes mellitus, co-infections with Hepatitis B or C viruses HIV-viral load and co-variate interactions with vitamin D status defined as normal, insufficient or deficient. Results A total of 435 participants were observed longitudinally through observations over the median follow-up of 24 (IOR 12–48) months. The median age of the participants was 46.6 (IOR 38.06–54.29) years. Median serum 25 OHD was 23.4 (IQR 18.5–29) ng/mL, and 209 (48%) and 126(29%) had insufficient and deficient 25 OH levels, respectively. Median baseline eGFR was 95 (IQR 82.70–104.93) mL/minute/l.73 m2. We found a significant interaction between BMI and vitamin D concentration (P = 0.02). In our multivariate model, the adjusted mean predictions of eGFR change at 24 months for patients with BMI ≥25 kg/m2 and deficient, insufficient and sufficient vitamin D were 89.8 (88.3–91.4), 91.2 (90.1–92.4) and 92.8 (91.3–94.4), respectively. In those with BMI <25 kg/m2 and deficient, insufficient and sufficient Vitamin D the adjusted mean predictions in eGFR change were 92.0 (91.1–93.0), 91.6 (90.9–92.3) and 92.3 (91.3–93.3), respectively. Conclusion HIV-infected Thai adults with high BMI (25 and above) but who are vitamin D deficient had a statistically significant eGFR decline. Further studies in larger populations with multi-ethnic groups are warranted. Disclosures All authors: No reported disclosures.

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MO073ACCELERATION OF KIDNEY FUNCTION DECLINE AFTER INCIDENT HOSPITALIZATION WITH CARDIOVASCULAR DISEASE: THE STOCKHOLM CREATININE MEASUREMENTS (SCREAM) PROJECT

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa140.mo073 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Junichi Ishigami ◽

Marco Trevisan ◽

Lars Lund ◽

Tomas Jernberg ◽

Josef Coresh ◽

...

Keyword(s):

Cardiovascular Disease ◽

Kidney Function ◽

Laboratory Data ◽

Cardiorenal Syndrome ◽

Mixed Effect ◽

Before And After ◽

Lower Egfr ◽

Using Data ◽

Kidney Function Decline ◽

Egfr Decline

Abstract Background and Aims The cardiorenal syndrome refers to a bidirectional relationship between the kidney and the heart. However, epidemiological evidence of cardiovascular disease (CVD) as a risk factor for chronic kidney disease (CKD) progression is actually scarce. We here quantified slopes of kidney function decline before and after the incidence of major CVD. Method We examined the slopes of estimated glomerular filtration rate (eGFR) decline in the 2 years before vs. after an incident hospitalization with heart failure (HF) (n=20,420), coronary heart disease (CHD) (n=18,152), or stroke (n=1,808) using data from a complete laboratory data collection in Stockholm, Sweden between 2006 and 2011. We used mixed-effect models with unstructured residual correlation matrix and stratified by index eGFR (≥60, 30-59, <30 ml/min/1.73m2). Results Overall, patients who had HF were older, and had more comorbidities (e.g., diabetes, hypertension) and lower eGFR compared to those who had CHD or stroke. Incident hospitalization with HF and CHD, but not stroke, was significantly associated with a subsequent accelerated decline in eGFR, with a faster eGFR decline and greater slope change after HF than CHD. In the overall population, the pre-event vs. post-event eGFR slopes (ml/min/1.73m2 per year) were -1.67 (-1.77 to -1.57) vs. -2.76 (-2.82 to -2.71), with a Δslope of -1.09 (-1.16 to -1.02) for HF; -1.09 (-1.20 to -0.98) vs. -1.87 (-1.92 to -1.81), with a Δslope of -0.78 (-0.85 to -0.70) for CHD; and -1.00 (-1.37 to -0.63) vs. -0.99 (-1.19 to -0.78), with a Δslope of 0.02 (-0.24 to 0.27) for stroke (Figure 1A). The accelerated declines in eGFR after HF and CHD were consistent across the spectrum of eGFR, although pre-event eGFR slopes were steeper in lower eGFR (e.g., pre-event eGFR slope for HF -0.64 (-0.76 to -0.53) for eGFR ≥60, -1.43 (-1.57 to -1.30) for eGFR 30-59, and -2.42 (-2.71 to -2.12) for eGFR <30 ml/min/1.73m2) (Figure B-D). Conclusion Incident hospitalization with cardiac diseases (i.e., HF and CHD) was significantly associated with a subsequent acceleration of eGFR decline.

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Vitamin D Status and Kidney Function Decline in HIV-Infected Men: A Longitudinal Study in the Multicenter AIDS Cohort Study

AIDS Research and Human Retroviruses ◽

10.1089/aid.2017.0009 ◽

2017 ◽

Vol 33 (11) ◽

pp. 1140-1148 ◽

Cited By ~ 2

Author(s):

Adrienne Tin ◽

Long Zhang ◽

Michelle M. Estrella ◽

Andy Hoofnagle ◽

Casey M. Rebholz ◽

...

Keyword(s):

Vitamin D ◽

Cohort Study ◽

Longitudinal Study ◽

Kidney Function ◽

Vitamin D Status ◽

Multicenter Aids Cohort Study ◽

Kidney Function Decline

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Is Vitamin D Insufficiency Associated with Mortality of Critically Ill Patients?

Critical Care Research and Practice ◽

10.1155/2013/856747 ◽

2013 ◽

Vol 2013 ◽

pp. 1-9 ◽

Cited By ~ 3

Author(s):

Gulbin Aygencel ◽

Melda Turkoglu ◽

Ayse Fitnat Tuncel ◽

Burcu Arslan Candır ◽

Yelda Deligoz Bildacı ◽

...

Keyword(s):

Vitamin D ◽

Risk Factor ◽

Critically Ill ◽

Critically Ill Patients ◽

Independent Risk Factor ◽

Vitamin D Insufficiency ◽

University Hospital ◽

Median Serum ◽

Vitamin D Levels ◽

Sufficient Vitamin

Objective. To evaluate the vitamin D status of our critically ill patients and its relevance to mortality.Patients and Methods. We performed a prospective observational study in the medical intensive care unit of a university hospital between October 2009 and March 2011. Vitamin D levels were measured and insufficiency was defined as <20 ng/mL.Results. Two hundred and one patients were included in the study. The median age was 66 (56–77) and the majority of patients were male (56%). The median serum level of vitamin D was 14,9 ng/mL and 139 (69%) patients were vitamin D insufficient on admission. While we grouped the ICU patients as vitamin D insufficient and sufficient, vitamin D insufficient patients had more severe acute diseases and worse laboratory values on admission. These patients had more morbidities and were exposed to more invasive therapies during stay. The mortality rate was significantly higher in the vitamin D insufficient group compared to the vitamin D sufficient group (43% versus 26%,P=0,027). However, logistic regression analysis demonstrated that vitamin D insufficiency was not an independent risk factor for mortality.Conclusion. Vitamin D insufficiency is common in our critically ill patients (69%), but it is not an independent risk factor for mortality.

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Impact of sleep disturbances on kidney function decline in the elderly

European Respiratory Journal ◽

10.1183/13993003.01147-2015 ◽

2015 ◽

Vol 47 (3) ◽

pp. 860-868 ◽

Cited By ~ 8

Author(s):

Isabelle Jaussent ◽

Jean-Paul Cristol ◽

Benedicte Stengel ◽

Marie-Laure Ancelin ◽

Anne-Marie Dupuy ◽

...

Keyword(s):

Risk Factors ◽

Glomerular Filtration ◽

Kidney Function ◽

Sleep Disturbances ◽

Total Sleep Time ◽

Sleep Time ◽

Kidney Function Decline ◽

Insomnia Complaints ◽

Egfr Decline

While sleep disturbances are frequent in renal disease patients, no studies have examined prospectively the associations between sleep disturbances and kidney function decline in community-dwelling elderly subjects.Glomerular filtration rates (eGFRs) were estimated at baseline and at 11-year follow-up. A glomerular filtration decline over the follow-up period was defined as a percentage decline greater than or equal to the cut-off value of the highest tertile of kidney function decline (22%) in 1105 subjects. Excessive daytime sleepiness (EDS) and insomnia complaints were self-rated at baseline. Restless legs syndrome (RLS) and its age at onset were assessed at study end-point. An ambulatory polysomnography recording was performed during the follow-up in 277 subjects. Apnoea-hypopnoea index (AHI), periodic limb movements during sleep (PLMS) and total sleep time were analysed.An increased risk of eGFR decline was associated with EDS (OR 1.67, 95% CI 1.18–2.34) and RLS (OR 1.98, 95% CI 1.18–3.30) independently of potential confounders including cardiovascular risk factors. Among insomnia complaints, a borderline association with eGFR decline was found for early morning awakening only. High AHI (≥30 events·h−1) and short total sleep time (<6 h), but not PLMS were linked to eGFR decline in crude associations, but only AHI remained significantly associated after multi-adjustments.EDS, RLS and AHI constitute independent risk factors for kidney glomerular function decline.

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Dietary Patterns Based on Estimated Glomerular Filtration Rate and Kidney Function Decline in the General Population: The Lifelines Cohort Study

Nutrients ◽

10.3390/nu12041099 ◽

2020 ◽

Vol 12 (4) ◽

pp. 1099 ◽

Cited By ~ 2

Author(s):

Qingqing Cai ◽

Louise H. Dekker ◽

Stephan J. L. Bakker ◽

Martin H. de Borst ◽

Gerjan J. Navis

Keyword(s):

Glomerular Filtration Rate ◽

General Population ◽

Glomerular Filtration ◽

Kidney Function ◽

Dietary Patterns ◽

Filtration Rate ◽

Estimated Glomerular Filtration Rate ◽

High Consumption ◽

Kidney Function Decline ◽

Egfr Decline

No specific dietary patterns have been established that are linked with loss of kidney function. We aimed to identify an estimated glomerular filtration rate-based dietary pattern (eGFR-DP) and to evaluate its association with eGFR decline and chronic kidney disease (CKD) incidence in the general population. We included 78,335 participants from the Lifelines cohort in the Northern Netherlands. All participants had an eGFR >60 mL/min/1.73 m2 at baseline and completed a second visit five years later. The eGFR-DP was constructed at baseline using a 110-item food frequency questionnaire by reduced rank regression, stratified by sex. Logistic regression was performed to evaluated the association between the eGFR-DP score and either a ≥20% eGFR decline or incident CKD. Among women, eGFR-DP were characterized by high consumption of egg, cheese, and legumes and low consumption of sweets, white meat, and commercially prepared dishes. In men, eGFR-DP were characterized by high consumption of cheese, bread, milk, fruits, vegetables, and beer and low consumption of white and red meat. A higher eGFR-DP score was associated with a lower risk of a ≥20% eGFR decline (OR 4th vs. 1st quartile, women: 0.79 [95% CI: 0.73–0.87]; men: 0.67 [0.59–0.76]). The association between the eGFR-DP score and CKD incidence was lost upon adjustment for baseline eGFR. Our results provide support for dietary interventions to prevent kidney function decline in the general population.

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Rate of Decline in Kidney Function and Age-of-Onset or Duration of Type 2 Diabetes

10.21203/rs.3.rs-289704/v1 ◽

2021 ◽

Author(s):

Oyunchimeg Buyadaa ◽

Agus Salim ◽

Jedidiah I Morton ◽

Dianna J Magliano ◽

Jonathan E Shaw

Keyword(s):

Type 2 Diabetes ◽

Kidney Function ◽

Estimated Glomerular Filtration Rate ◽

Middle Age ◽

Age Of Onset ◽

Duration Of Diabetes ◽

Rate Of Decline ◽

Kidney Function Decline ◽

Egfr Decline

Abstract The association between rate of kidney function decline and age-of-onset or duration of type 2 diabetes has not been well investigated. We aimed to examine whether rates of estimated glomerular filtration rate (eGFR) decline differ by age-of-onset or duration in people with type 2 diabetes. Using the Action to Control Cardiovascular Risk in Diabetes study dataset rates of eGFR decline were calculated using a joint-longitudinal-survival model and were compared among groups defined by the age-of-onset (0–39, 40–49, 50–59, 60–69 and > 70 years) and 5-year diabetes duration intervals. Changes in renal function were evaluated using median of 6 (interquartile range: 3–10) eGFR measurements per person. eGFR decline was the slowest in those with an age-at-diagnosis of 50 − 59 years or those with duration of diabetes < 5 years. The rates of eGFR decline were significantly greater in those with an age-of-onset < 40 years or those with duration of diabetes > 20 years compared to those diagnosed at 50 − 59 or those with duration of diabetes < 5 years (-1.98 vs -1.61 ml/min/year; -1.82 vs -1.52 ml/min/year; respectively (p < 0.001). Those with youngest age-of-onset or longest duration of type 2 diabetes had more rapid declines in eGFR compared to those diagnosed at middle age or those with shorter duration of diabetes.

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Dietary Magnesium and Kidney Function Decline: The Healthy Aging in Neighborhoods of Diversity across the Life Span Study

American Journal of Nephrology ◽

10.1159/000450861 ◽

2016 ◽

Vol 44 (5) ◽

pp. 381-387 ◽

Cited By ~ 17

Author(s):

Casey M. Rebholz ◽

Adrienne Tin ◽

Yang Liu ◽

Marie Fanelli Kuczmarski ◽

Michele K. Evans ◽

...

Keyword(s):

Kidney Disease ◽

Life Span ◽

Kidney Function ◽

Healthy Aging ◽

Disease Risk ◽

Life Span Study ◽

Magnesium Intake ◽

Dietary Magnesium ◽

Kidney Function Decline ◽

Egfr Decline

Background: Prior studies suggest that certain aspects of the diet related to magnesium intake, such as dietary acid load, protein intake and dietary patterns rich in fruits and vegetables, may impact kidney disease risk. We hypothesized that lower dietary magnesium intake would be prospectively associated with more rapid kidney function decline. Methods: Among participants in the Healthy Aging in Neighborhoods of Diversity across the Life Span study with estimated glomerular filtration rate (eGFR) ≥60 ml/min/1.73 m2 at baseline (2004-2009), dietary magnesium intake was calculated from two 24-hour dietary recalls. Rapid decline was defined as ≥3% eGFR decline per year. Results: Median (25th-75th percentile) dietary magnesium intake was 116 (96-356) mg/1,000 kcal. Among 1,252 participants, those with lower dietary magnesium intake were younger, and were more likely to be African-American men. A total of 177 participants (14.1%) experienced rapid eGFR decline over a median follow-up of 5 years. Lower dietary magnesium intake was significantly associated with a greater odds of rapid eGFR decline (OR for tertile 1 vs. 3: 2.02, 95% CI 1.05-3.86, p value for trend across tertiles = 0.02) in analyses adjusted for sociodemographics (age, sex, race, education level, health insurance status, poverty status), kidney disease risk factors (smoking status, diabetes, hemoglobin A1c, hypertension, body mass index), baseline eGFR and dietary factors (total energy intake; diet quality; dietary intake of fiber, sodium, calcium, potassium and phosphorus). Conclusions: In this urban population, lower dietary magnesium intake was independently associated with greater odds of rapid kidney function decline.

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Associations between urinary cysteine-rich protein 61 excretion and kidney function decline in outpatients with chronic kidney disease: a prospective cohort study in Taiwan

BMJ Open ◽

10.1136/bmjopen-2021-051165 ◽

2021 ◽

Vol 11 (10) ◽

pp. e051165

Author(s):

Chun-Fu Lai ◽

Jian-Jhong Wang ◽

Ya-Chun Tu ◽

Chia-Yu Hsu ◽

Hon-Yen Wu ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Cohort Study ◽

Kidney Disease ◽

Kidney Function ◽

Creatinine Ratio ◽

Discriminative Performance ◽

Cysteine Rich Protein ◽

Kidney Function Decline ◽

Egfr Decline

ObjectivesTo examine whether urinary excretion of cysteine-rich protein 61 (Cyr61), an acknowledged proinflammatory factor in kidney pathologies, increases in chronic kidney disease (CKD) and is associated with subsequent rapid kidney function decline.DesignAn observational cohort study.SettingIn the nephrology outpatient clinics of a tertiary hospital in Taiwan.ParticipantsWe enrolled 138 adult CKD outpatients (n=12, 32, 18, 18, 29 and 29 in stages 1, 2, 3a, 3b, 4 and 5 CKD, respectively) between February and October 2014 and followed them for 1 year. Their mean age was 60.46±13.16 years, and 51 (37%) of them were women.Primary outcome measuresUrinary Cyr61 levels were measured by ELISA. Rapid kidney function decline was defined as an estimated glomerular filtration rate (eGFR) decline rate ≥ 4 mL/min/1.73 m2/year or developing end-stage renal disease during subsequent 3-month or 1-year follow-up period. Models were adjusted for demographic and clinical variables.ResultsThe urine Cyr61-to-creatinine ratio (UCyr61CR) increased significantly in patients with stage 4 or 5 CKD. Multivariable linear regression analysis showed that log(UCyr61CR) was positively correlated with log(urine protein-to-creatinine ratio) (p<0.001) but negatively correlated with baseline eGFR (p<0.001) and hypertension (p=0.007). Complete serum creatinine data during the follow-up were available for 112 patients (81.2%). Among them, multivariable logistic regression identified log(UCyr61CR) was independently associated with rapid kidney function decline (adjusted OR 2.29, 95% CI 1.27 to 4.15) during the subsequent 3 months. UCyr61CR improved the discriminative performance of clinical models to predict 3-month rapid kidney function decline. In contrast, log(UCyr61CR) was not associated with rapid eGFR decline during the entire 1-year follow-up.ConclusionsElevated urinary Cyr61 excretion is associated with rapid short-term kidney function deterioration in patients with CKD. Measuring urinary Cyr61 excretion is clinically valuable for monitoring disease trajectory and may guide treatment planning.

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FC 081ULTRA-PROCESSED FOOD CONSUMPTION AND RISK OF INCIDENT CHRONIC KIDNEY DISEASE: THE LIFELINES COHORT

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab139.001 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Qingqing Cai ◽

Minjie Duan ◽

Louise H Dekker ◽

Stephan Bakker ◽

Martin De Borst ◽

...

Keyword(s):

General Population ◽

Kidney Function ◽

Population Based ◽

Consumption Patterns ◽

Total Food Intake ◽

Incident Chronic Kidney Disease ◽

Obesity Hypertension ◽

Kidney Function Decline ◽

Dietary Strategies ◽

Egfr Decline

Abstract Background and Aims Ultra-processed foods (UPF), that are widespread in Western-style diet, are risk factors for the development of cardiovascular disease, diabetes, obesity, hypertension, and all-cause mortality. The role of UPF in kidney function decline, however, is still unknown. The aim of this study was to investigate the associations of UPF consumption with incident CKD and estimated glomerular filtration rate (eGFR) decline. Additionally, we considered the heterogeneity of UPF by identifying different patterns of UPF consumption. Method The study was performed in a prospective general population-based cohort in the Northern Netherlands. A total of 78 346 participants who were free of CKD at baseline were included in this study. The dietary information was assessed at baseline using a 110-item food frequency questionnaire. The proportion (in weight) of UPF in the total diet was calculated and UPF consumption patterns were identified by principle component analysis (PCA). Multivariable logistic regression analyses were used to evaluated the associations of the proportion of UPF consumption and UPF patterns, respectively, with risk of incident CKD and a ≥20% eGFR decline. Results Average UPF consumption was 37.7% of total food intake in grams. After a mean (SD) follow-up of 7.9±1.1 years, 2 072 participants developed CKD and 7 611 had a ≥20% eGFR decline. The consumption of UPF was independently associated with a higher risk of incident CKD (OR for an absolute increment of 10 % of UPF in the diet 1.07 [95% CI 1.01-1.13], P=0.026) and with a higher risk of ≥20% eGFR decline (OR10% increment 1.07 [95% CI 1.05-1.10], P<0.001). PCA revealed four habitual UPF consumption patterns. The “warm savory snack” pattern was associated with both incident CKD (OR 1.13 [1.04-1.23], P=0.003) and a ≥20% eGFR decline (OR 1.08 [1.05-1.11], P<0.001). The “sweet snack” pattern was associated with eGFR decline (OR 1.06 [1.03-1.09], P<0.001) only, whereas the “Dutch traditional” and the “cold snack” were not associated with CKD or eGFR decline. Conclusion A higher UPF consumption was associated with higher risks of incident CKD and eGFR decline in the general population. Different UPF consumption patterns were identified, with different impact on renal risk. The “warm savory snack” pattern and the “sweet snack” pattern were associated with kidney function decline. Our findings suggest that UPF need to be considered in designing future dietary strategies for CKD prevention.

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Abstract MP34: Acceleration of Kidney Function Decline After Incident Hospitalization With Cardiovascular Disease: The Stockholm Creatinine Measurements (scream) Project

Circulation ◽

10.1161/circ.141.suppl_1.mp34 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Junichi Ishigami ◽

Marco Trevisan ◽

Lars Lund ◽

Tomas Jernberg ◽

Josef Coresh ◽

...

Keyword(s):

Cardiovascular Disease ◽

Kidney Function ◽

Laboratory Data ◽

Cardiorenal Syndrome ◽

Mixed Effect ◽

Before And After ◽

The Individual ◽

Kidney Function Decline ◽

Egfr Decline ◽

Egfr Slope

Background: The cardiorenal syndrome suggests a bidirectional relationship between worsening kidney function and cardiac dysfunction. However, to our knowledge, no studies have quantified changes in slopes of kidney function decline before and after the incidence of major cardiovascular disease (CVD) subtypes. Methods: We compared the individual slopes of estimated glomerular filtration rate (eGFR) decline in the 2 years before vs. after the incident hospitalization with heart failure (HF) (n=20,420), coronary heart disease (CHD) (n=18,152), and stroke (n=1,808) using data from the complete laboratory data collection of Stockholm healthcare (Sweden) between 2006 and 2011. Using mixed effect models with unstructured residual correlation matrix, we examined changes in individual slopes of eGFR decline before and after incident CVD in the overall population, and by index eGFR strata (≥60, 30-59, <30 ml/min/1.73m 2 ). Results: Incident hospitalization with HF and CHD, but not stroke, was significantly associated with a subsequent acceleration of eGFR decline, with a faster eGFR decline and greater slope change after HF than CHD. The pre-event vs. post-event eGFR slope (ml/min/1.73m 2 per year) were -1.67 (-1.77 to -1.57) vs. -2.76 (-2.82 to -2.71), with Δslope of -1.09 (-1.16 to -1.02) for HF; -1.09 (-1.20 to -0.98) vs. -1.87 (-1.92 to -1.81), with Δslope of -0.78 (-0.85 to -0.70) for CHD; and -1.00 (-1.37 to -0.63) vs. -0.99 (-1.19 to -0.78), with , Δslope of 0.02 (-0.24 to 0.27) for stroke ( Figure ). The accelerated eGFR declines after HF and CHD were consistently observed across eGFR strata, with pre-event eGFR slopes steeper in lower eGFR (e.g., pre-event eGFR slope for HF -0.64 (-0.76 to -0.53) for eGFR ≥60, -1.43 (-1.57 to -1.30) for eGFR 30-59, and -2.42 (-2.71 to -2.12) for eGFR <30 ml/min/1.73m 2 ). Conclusions: Incident hospitalization with cardiac diseases (ie, HF and CHD) was significantly associated with a subsequent acceleration of eGFR decline.

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