scholarly journals Polymorphisms inPPARGenes (PPARD,PPARG, andPPARGC1A) and the Risk of Chronic Kidney Disease in Japanese: Cross-Sectional Data from the J-MICC Study

PPAR Research ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Asahi Hishida ◽  
Kenji Wakai ◽  
Mariko Naito ◽  
Takashi Tamura ◽  
Sayo Kawai ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Risk Estimation ◽  
Cross Sectional ◽  
Increased Risk ◽  
Invader Assay ◽  
Study Population ◽  
Stage Renal Disease ◽  
End Stage ◽  
Study Participants

Chronic kidney disease (CKD) is well known as a strong risk factor for both end stage renal disease and cardiovascular disease. To clarify the association of polymorphisms in thePPARgenes (PPARD,PPARG, andPPARGC1A) with the risk of CKD in Japanese, we examined this association among the Japanese subjects using the cross-sectional data of J-MICC (Japan Multi-Institutional Collaborative Cohort) Study. The subjects for this analysis were 3,285 men and women, aged 35–69 years, selected from J-MICC Study participants; genotyping was conducted by multiplex polymerase chain reaction-based Invader assay. The prevalence of CKD was determined for CKD stages 3–5 (defined as eGFR < 60 ml/min/1.73 m2). Participants with CKD accounted for 17.3% of the study population. When those withPPARDT-842CT/Twere defined as reference, those withPPARDT-842CT/CandC/Cdemonstrated the OR for CKD of 1.26 (95%CI 1.04–1.53) and 1.31 (95%CI 0.83–2.06), respectively. There were no significant associations between the polymorphisms in otherPPARgenes and the risk of CKD. The present study found a significantly increased risk of CKD in those with theCallele ofPPARDT-842C, which may suggest the possibility of personalized risk estimation of this life-limiting disease in the near future.

Abstract 145: Rates of Transfusion and Progression to End-Stage Renal Disease in Chronic Kidney Disease Patients Undergoing Transradial Versus Transfemoral Cardiac Catheterization - An Analysis from the VA CART Program

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Amit N Vora ◽  
Maggie A Stanislawski ◽  
John S Rumsfeld ◽  
Thomas M Maddox ◽  
Mladen Vidovich ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cardiac Catheterization ◽  
High Risk Population ◽  
Post Procedure ◽  
Increased Risk ◽  
Significant Difference ◽  
Independent Association ◽  
Stage Renal Disease ◽  
End Stage

Background: Patients with chronic kidney disease (CKD) are at increased risk of bleeding and transfusion after cardiac catheterization. Whether rates of these complications or progression to new dialysis are increased in this high-risk population undergoing transradial (TR) access compared to transfemoral (TF) access is unknown. Methods: From the Veterans Affairs Clinical Assessment, Reporting, and Tracking (CART) Program between 10/2007-09/2012 we identified 40,160 CKD patients undergoing cardiac catheterization with baseline glomerular filtration rate (GFR) ≤ 60 ml/min. We used multivariable Cox modeling to determine the independent association between TR access and post-procedure transfusion as well as progression to new dialysis using TF as the reference. Results: Overall, 3,828 (9.5%) of CKD patients underwent TR access and tended to be slightly younger but overall had similar rates of CKD severity compared with TF patients (GFR 45-60 ml/min: 77.0% vs. 77.0%; GFR 30-44 ml/min: 19.7% vs. 19.3%; GFR 15-29 ml/min: 3.3% vs. 3.7%, p=0.35). TR patients had longer fluoroscopy times (8.1 vs 6.9 minutes, p=<0.0001) but decreased contrast use (90.0 vs 100.0 ml, p=<0.0001). Among the 31,692 patients with a full year of follow-up, 42 (1.7%) of TR patients and 545 (1.9%) of TF patients progressed to new dialysis within 1 year (p=0.64). However, only 33 (0.9%) of TR patients compared with 570 TF patients (1.6%) needed post-procedure blood transfusion (p=0.0006). After multivariable adjustment, there was no significant difference in progression to ESRD between TR and TF patients but TR was associated with a significant decrease in transfusion (Figure). Conclusion: Among CKD patients undergoing cardiac catheterization in the VA health system, TR access is associated with a decreased risk for post-procedure transfusion compared with TF access. There was no significant difference between the two approaches with respect to progression to ESRD. These data suggest that TR is a reasonable option for patients with any level of CKD undergoing cardiac catheterization.

scholarly journals High Unawareness of Chronic Kidney Disease in Germany

2021 ◽  
Vol 18 (22) ◽  
pp. 11752
Author(s):  
Susanne Stolpe ◽  
Bernd Kowall ◽  
Christian Scholz ◽  
Andreas Stang ◽  
Cornelia Blume
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cardiovascular Comorbidities ◽  
Increased Risk ◽  
Binomial Regression ◽  
Ckd Stage ◽  
Stage Renal Disease ◽  
End Stage ◽  
Prevalence Ratios

Chronic kidney disease (CKD) is associated with an increased risk for cardiovascular events, hospitalizations, end stage renal disease and mortality. Main risk factors for CKD are diabetes, hypertension, and older age. Although CKD prevalence is about 10%, awareness for CKD is generally low in patients and physicians, hindering early diagnosis and treatment. We analyzed baseline data of 3305 participants with CKD Stages 1–4 from German cohorts and registries collected in 2010. Prevalence of CKD unawareness and prevalence ratios (PR) (each with 95%-confidence intervals) were estimated in categories of age, sex, CKD stages, BMI, hypertension, diabetes and other relevant comorbidities. We used a log-binomial regression model to estimate the PR for CKD unawareness for females compared to males adjusting for CKD stage and CKD risk factors. CKD unawareness was high, reaching 71% (68–73%) in CKD 3a, 49% (45–54%) in CKD 3b and still 30% (24–36%) in CKD4. Prevalence of hypertension, diabetes or cardiovascular comorbidities was not associated with lower CKD unawareness. Independent of CKD stage and other risk factors unawareness was higher in female patients (PR = 1.06 (1.01; 1.10)). Even in patients with CKD related comorbidities, CKD unawareness was high. Female sex was strongly associated with CKD unawareness. Guideline oriented treatment of patients at higher risk for CKD could increase CKD awareness. Patient–physician communication about CKD might be amendable.

scholarly journals Taking Sleeping Pills and the Risk of Chronic Kidney Disease: A Nationwide Population-Based Retrospective Cohort Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Chen-Yi Liao ◽  
Chi-Hsiang Chung ◽  
Kuo-Cheng Lu ◽  
Cheng-Yi Cheng ◽  
Sung-Sen Yang ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Sleeping Pills ◽  
Potential Association ◽  
Increased Risk ◽  
Stage Renal Disease ◽  
End Stage

Background: Sleeping disorder has been associated with chronic kidney disease (CKD); however, the correlation between sleeping pills use and CKD has not been investigated in-depth yet. This study elucidated the potential association of sleeping pill use with the risk of CKD and CKD progression to end-stage renal disease (ESRD) requiring dialysis.Methods: This study was based on a population-based cohort that included 209,755 sleeping pill users among 989,753 individuals. After applying the exclusion criteria, 186,654 sleeping pill users and 373,308 nonusers were enrolled to monitor the occurrence of CKD. Using a cumulative daily dose, we analyzed the types of sleeping pills related to the risk of CKD and ESRD. Propensity score matching and analysis using Cox proportional hazards regression were performed with adjustments for sex, age, and comorbidities.Results: Sleeping pill use was related to increased CKD risk after adjusting for underlying comorbidities (adjusted hazard ratio [aHR] = 1.806, 95% confidence interval [CI]: 1.617–2.105, p &lt; 0.001). With the exception of hyperlipidemia, most comorbidities correlated with an increased risk of CKD. Persistent use of sleeping pills after CKD diagnosis increased the risk of concurrent ESRD (aHR = 7.542; 95% CI: 4.267–10.156; p &lt; 0.001). After the subgroup analysis for sleeping pill use, brotizolam (p = 0.046), chlordiazepoxide (p &lt; 0.001), clonazepam (p &lt; 0.001), diazepam (p &lt; 0.001), dormicum (p &lt; 0.001), estazolam (p &lt; 0.001), fludiazepam (p &lt; 0.001), flunitrazepam (p &lt; 0.001), nitrazepam (p &lt; 0.001), trazodone (p &lt; 0.001), zolpidem (p &lt; 0.001), and zopiclone (p &lt; 0.001) were found to have significant correlation with increased CKD risk.Conclusion: Sleeping pill use was related to an increased risk of CKD and ESRD. Further studies are necessary to corroborate these findings.

scholarly journals Magnesium in Chronic Kidney Disease: Should We Care?

2018 ◽  
Vol 45 (1-3) ◽  
pp. 173-178 ◽  
Author(s):  
Esther R. van de Wal-Visscher ◽  
Jeroen P. Kooman ◽  
Frank M. van der Sande
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
The Body ◽  
Cardiac Conduction ◽  
Increased Risk ◽  
Total Body ◽  
Stage Renal Disease ◽  
End Stage

Background: Magnesium (Mg) is an essential cation for multiple processes in the body. The kidney plays a major role in regulating the Mg balance. In a healthy individual, total-body Mg content is kept constant by interactions among intestine, bones and the kidneys. Summary: In case of chronic kidney disease (CKD), renal regulatory mechanisms may be insufficient to balance intestinal Mg absorption. Usually Mg remains normal; however, when glomerular filtration rate declines, changes in serum Mg are observed. Patients with end-stage renal disease on dialysis are largely dependent on the dialysate Mg concentration for maintaining serum Mg and Mg homeostasis. A low Mg is associated with several complications such as hypertension, and vascular calcification, and also associated with an increased risk for both cardiovascular disease (CVD) and non-CVD mortality. Severe hypermagnesaemia is known to cause cardiac conduction defects, neuromuscular effects and muscle weakness; a slightly elevated Mg has been suggested to be beneficial in patients with end-stage renal disease. Key Messages: The role of both low and high Mg, in general, but especially in relation to CKD and dialysis patients is discussed.

Soluble urokinase-type plasminogen activator receptor and incident end-stage renal disease in Chinese patients with chronic kidney disease

2018 ◽  
Vol 35 (3) ◽  
pp. 465-470 ◽  
Author(s):  
Li Lv ◽  
Fang Wang ◽  
Liang Wu ◽  
Jin-Wei Wang ◽  
Zhao Cui ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Type Plasminogen Activator ◽  
Urokinase Type Plasminogen Activator ◽  
Increased Risk ◽  
Plasminogen Activator Receptor ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background Soluble urokinase-type plasminogen activator receptor (suPAR), a marker of immune activation, was shown to be associated with outcomes and kidney disease among various patient populations. The prognostic role of circulating suPAR levels in patients with chronic kidney disease (CKD) needs to be investigated in a cohort with large sample size of renal diseases. Methods We measured serum suPAR concentration in 2391 CKD patients in the multicenter Chinese Cohort Study of Chronic Kidney Disease, and investigated the association of serum suPAR with the prespecified endpoint event, end-stage renal disease (ESRD), using Cox proportional hazards regression model. Results Altogether, 407 ESRD events occurred during the median follow-up of 54.8 (interquartile range: 47.5–62.2) months. The higher levels of serum suPAR were independently associated with increased risk of incident ESRD after adjusting for potential confounders including the baseline estimated glomerular filtration rate categories, with the hazard ratios (HRs) of 1.53 [95% confidence intervals (CIs) 1.10–2.12] for the top tertile (≥3904 pg/mL) compared with the bottom tertile (&lt;2532 pg/mL). When stratified by the etiologies of CKD, among patients with glomerulonephritis (GN), serum suPAR levels were also independently associated with the higher risk of ESRD, with an HR of 1.61 (95% CI 1.03–2.53) in the top tertile compared with the bottom tertile. Conclusions Circulating suPAR level was independently associated with an increased risk of progression to ESRD in Chinese CKD patients, especially in those with an etiology of GN.

scholarly journals Obesity and risk of end-stage renal disease in patients with chronic kidney disease: a cohort study

2018 ◽  
Vol 108 (5) ◽  
pp. 1145-1153 ◽  
Author(s):  
Ting-Yun Lin ◽  
Jia-Sin Liu ◽  
Szu-Chun Hung
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
The Body ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Impact

ABSTRACT Background Obesity is a risk factor for de novo chronic kidney disease (CKD) in the general population. Obesity has been increasingly prevalent in patients with CKD and may lead to further progression of pre-existing CKD. However, whether obesity is associated with the development of end-stage renal disease (ESRD) in patients with CKD is not well understood. Objective We investigated the impact of obesity on ESRD (needing chronic dialysis treatment or pre-emptive renal transplantation) or all-cause mortality in patients with moderate to advanced CKD. Design A total of 322 patients with stages 3–5 CKD who were not yet on dialysis were prospectively followed for a median of 4.9 y. Obesity was defined by body mass index (BMI, in kg/m2) ≥30 or body fat percentage (BF%) >25% in men and >35% in women. BF% was assessed with the use of the Body Composition Monitor, a multifrequency bioimpedance spectroscopy device. Results In total, 100 participants progressed to ESRD and 39 participants died. Obesity, whether defined by BMI or BF%, was not associated with a significantly increased risk of ESRD in Cox proportional hazards models that adjusted for age, sex, diabetes mellitus, cardiovascular disease, estimated glomerular filtration rate, urine protein:creatinine ratio, high-sensitivity C-reactive protein, and use of renin-angiotensin-aldosterone system inhibitors or statins, accounting for the competing risk for mortality (subdistribution HR: 1.15; 95% CI: 0.62, 2.14 for BMI-defined obesity and subdistribution HR: 0.84, 95% CI: 0.54, 1.29 for BF%-defined obesity, respectively). Results were similar when BMI and BF% were analyzed as continuous or time-dependent variables. Whereas higher BMI was protective, higher BF% appeared to be associated with increased all-cause mortality. Conclusions Obesity did not confer an increased risk of ESRD in patients with moderate to advanced CKD. This trial was registered at http://www.clinicaltrials.gov as NCT03285074.

scholarly journals Harmonizing Formula Prescription Patterns for Chronic Kidney Disease: A Population-Based Cross-Sectional Study

2020 ◽  
Author(s):  
Hung-Lung Lin ◽  
Ming-Yen Lin ◽  
Cheng-Hsun Tasi ◽  
Yi-Hsiu Wang ◽  
Chung-Jen Chen ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Patient Characteristics ◽  
Target Population ◽  
Population Based ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background Harmonizing formulas have been demonstrated to be associated with reduced risk of end-stage renal disease in patients with chronic kidney disease (CKD). However, the target population and indications of harmonizing formulas in CKD remain unknown. Methods We conducted a population-based cross-sectional study to explore factors associated with harmonizing formulas prescription. Patients who had been prescribed harmonizing formulas after CKD diagnosis were defined as the using harmonizing formulas group. Disease diagnoses for harmonizing formula prescriptions and patient characteristics related to the prescriptions were collected. Results In total, 24,971 patients were enrolled in this analysis, and 5,237 (21%) patients were prescribed harmonizing formulas after CKD diagnosis. The three most frequent systematic diseases and related health problems for which harmonizing formula prescriptions were issued in CKD were symptoms, signs, and ill-defined conditions (24.5%), diseases of the digestive system, (20.67%), and diseases of the musculoskeletal system (12.9%). Higher likelihoods of harmonizing formula prescriptions were associated with young age (adjusted odds ratio: 0.98, 95% confidence interval: 0.97–0.98), female sex (1.79, 1.68–1.91), no diabetes (1.20, 1.06–1.35), no hypertension (1.38, 1.26–1.50), no cerebrovascular disease (1.34, 1.14–1.56), less disease severity (0.86, 0.83–0.89), using nonsteroidal anti-inflammatory drugs (NSAIDs) (1.65, 1.54–1.78), and using analgesic drugs other than NSAIDs (1.46, 1.35–1.59). Conclusions Harmonizing formulas are commonly used for treating symptoms of the digestive and musculoskeletal systems in CKD cases. Further research on harmonizing formula effectiveness with regard to particular characteristics of CKD patients is warranted.

scholarly journals FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KEPATUHAN PEMBATASAN CAIRAN PASIEN GAGAL GINJAL TERMINAL YANG MENJALANI HEMODIALISIS DI SATU RUMAH SAKIT SWASTA DI INDONESIA BARAT [FACTORS ASSOCIATED WITH ADHERENCE TO FLUID RESTRICTION TOWARDS PATIENTS WITH END STAGE RENAL DISEASE UNDERGOING HEMODIALYSIS IN A PRIVATE HOSPITAL, WEST INDONESIA]

2020 ◽  
Vol 8 (1) ◽  
pp. 56
Author(s):  
Eva Chris Veronica Gultom ◽  
I Made Kariasa ◽  
Masfuri Masfuri
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Fluid Restriction ◽  
Cross Sectional ◽  
Self Compassion ◽  
Fluid Adherence ◽  
Stage Renal Disease ◽  
End Stage

<p><em>End Stage Renal Disease is the final stage of the Chronic Kidney Disease (CKD) with a Glomerular Filtration Rate (GFR) value of less than 15 ml / min / 1.73m². End Stage Renal Disease can be treated with hemodialysis therapy </em>(<em>National Kidney Foundation</em>, <em>2015</em>; <em>Thomas, 2014</em>).<em> The hemodialysis provides fluid resctrictions for patients who undergo. There are many factors that make fluid restrictions adherence difficult to do. (Chironda&amp;Bhengu, 2015). The biggest and dominant factor is psychological factor, which is self compassion. </em><em>Self compassion is the attitude of giving compassion to oursel</em><em>ves</em><em>, so that when a patient undergoing hemodialysis in difficult conditions is able to assume the situation is the same as other people, and does not punish themselves and have motivation in undergoing a therapeutic regimen.</em><em> </em><em>The purpose of this study was to identify </em><em>factors</em><em> </em><em>that have corelation to </em><em>fluid adherence in end stage renal disease patients undergoing hemodialysis. This study used a cross sectional method, with 89 end stage renal disease patients who underwent hemodialysis three times a week</em><em> </em><em>and who were selected using a purposive sampling technique. The results showed that the majority of patients had high self compassion (69.7%). The corelation of self compassion with fluid adherence was not significant (p=0,076), other factors affecting fluid adherence were age (p=0.033), gender (p= 0,937), marital status (p = 0.473), working status ( p = 0,885), level of education (p= 0,126), length of undergoing hemodialysis (p = 0,425), and social support (p =0,206) The results of multivariate analysis showed that the most dominant facto</em><em>r</em><em>s related to fluid restriction adherence was age. This research is expected to be a reference for nurses in developing nursing studies in end stage renal disease patients undergoing hemodialysis</em><em></em></p><p><strong>BAHASA INDONESIA ABSTRAK: </strong>Gagal ginjal terminal merupakan tahap akhir dari kondisi <em>Chronic Kidney Disease</em> (CKD) dengan nilai <em>Glomerulus Filtrasi Rate</em> (GFR) kurang dari 15 ml/menit/1,73m². Gagal ginjal terminal dapat ditangani dengan terapi hemodialisis. Adanya hemodialisis ini memberikan pembatasan cairan pada pasien yang menjalaninya. Kepatuhan pembatasan cairan pada sebagian pasien sulit untuk dilakukan dengan alasan banyak faktor, yakni usia, jenis kelamin, tingkat pendidikan, status bekerja, lama menjalani hemodialisis, status menikah, dan dukungan sosial. Faktor yang terbesar dan dominan adalah faktor psikologis, yakni <em>self compassion.</em> <em>Self compassion</em> merupakan sikap memberikan belas kasih kepada diri sendiri, sehingga ketika seorang pasien yang menjalani hemodialisis dalam kondisi sulit mampu menganggap situasinya adalah sama dengan orang lain, dan tidak menghukum diri sendiri serta memiliki motivasi dalam menjalani regimen terapi. Tujuan penelitian ini adalah untuk mengidentifikasi faktor-faktor yang berhubungan dengan kepatuhan pembatasan cairan pasien gagal ginjal terminal yang menjalani hemodialisis. Penelitian ini menggunakan metode <em>cross sectional, </em>sebanyak 89 pasien pasien gagal ginjal terminal yang menjalani hemodialisis dalam tiga kali seminggu yang dipilih menggunakan teknik <em>purposive sampling. </em>Hasil penelitian menunjukkan bahwa mayoritas pasien memiliki <em>self compassion</em> tinggi (69,7%). Hubungan <em>self compassion</em> dengan kepatuhan pembatasan cairan tidak signifikan (p=0,076), faktor lain yang mempengaruhi kepatuhan pembatasan cairan adalah adalah usia (p=0,033), jenis kelamin (p=0,937), status menikah (p=0,473), status bekerja<em> </em>(p=0,885), tingkat pendidikan (p=0,126), lama menjalani hemodialisis (p=0,425), dan dukungan sosial (p=0,206). Hasil analisis multivariat menunjukkan faktor yang paling dominan berhubungan dengan kepatuhan pembatasan cairan adalah usia. Penelitian ini diharapkan dapat menjadikan acuan bagi perawat dalam mengembangkan pengkajian keperawatan pada pasien gagal ginjal terminal yang menjalani hemodialisis.</p>

scholarly journals Depression among Chronic Kidney Diseases Patients Receiving Hemodialysis

2020 ◽  
Vol 3 (2) ◽  
pp. 73-79
Author(s):  
Shanti Khadka ◽  
Rita Adhikari ◽  
Tarun Paudel
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Diseases ◽  
Cross Sectional ◽  
Prevalence Of Depression ◽  
Depression Level ◽  
Western Regional ◽  
Stage Renal Disease ◽  
End Stage

Background: Chronic Kidney Disease (CKD) is a progressive irreversible loss of renal function over a period of months or years. When kidney disease progresses, it may eventually lead to kidney failure, which requires dialysis or a kidney transplant to maintains life. Hemodialysis is used for patients who require short term dialysis (days to weeks) and for patients with advanced CKD and End Stage renal Disease (ESRD) who require long term or permanent renal replacement therapy. Hemodialysis significantly and adversely affects the lives of patients, both physically and psychologically. Depression is the most common psychological condition among patients with ESRD. Depression in dialysis patients not only effect mortality, but increased rate of hospitalizations and dialysis withdrawal is also very common. Methods: A descriptive cross sectional research design was carried out to identify the depression level of chronic kidney disease patients receiving Hemodialysis in Western Regional Hospital, Pokhara using Beck Depression Inventory among forty six patients. Results: The study findings revealed that majority of the patients (84.8%) has various degree of depression i.e. mild (21.7%), moderate (30.8%) and severe (32.6%). Only fifteen percent of patient has no depression. There was no statistical association between the level of depression and socio-demographic variables. It can be concluded that the prevalence of depression is high among patients receiving Hemodialysis. Conclusion: The prevalence of depression is high among patients receiving Hemodialysis. It is effective to provide mental health services to the CKD patients receiving Hemodialysis which help them better psychologically adaptation to their disease and improve their quality of life.  

Abstract P019: Association Between Hypertension and Kidney Function Trajectory: The Atherosclerosis Risk in Communities Study

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Casey M Rebholz ◽  
Yuan Chen ◽  
Kunihiro Matsushita ◽  
Josef Coresh ◽  
Morgan E Grams
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Function ◽  
Hypertension Status ◽  
Atherosclerosis Risk In Communities ◽  
Stage Renal Disease ◽  
End Stage ◽  
Study Participants ◽  
Kidney Function Decline

Introduction: Cardiovascular disease, including hypertension, increases the risk of kidney disease progression. The relationship between hypertension and change in kidney function has not been fully elucidated. We hypothesized that hypertension is associated with faster kidney function decline. Methods: Hypertension status was assessed among Atherosclerosis Risk in Communities (ARIC) Study participants at baseline (1987-89) and defined as systolic blood pressure ≥140, diastolic blood pressure ≥90, or anti-hypertensive medication use in the last two weeks. Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) estimated glomerular filtration rate (eGFR) was calculated using creatinine measured at baseline and follow-up study visits (1990-92; 1996-98; 2011-13) and an eGFR value of 15 mL/min/1.73 m 2 was imputed for incident end-stage renal disease cases. Results: After excluding those with missing baseline measurements of blood pressure, missing serum creatinine, and prevalent end-stage renal disease, there were 15,622 study participants. Baseline mean age was 55 years, 55% were female, 26% were black, and 35% had hypertension. Mean annual eGFR decline was 1.98 mL/min/1.73 m 2 per year among those with hypertension and 1.54 mL/min/1.73 m 2 per year among those without hypertension, after adjusting for demographic characteristics and co-morbidities (Figure, p<0.001). Participants with hypertension at baseline were more likely to develop chronic kidney disease than those without hypertension. Over 25 years, for those with hypertension and those without hypertension, respectively, the probability of developing chronic kidney disease stage 3A (eGFR <60 mL/min/1.73 m 2 ) was 55.3% and 44.5%, stage 3B (eGFR <45 mL/min/1.73 m 2 ) was 24.3% and 19.1%, stage 4 (eGFR <30 mL/min/1.73 m 2 ) was 9.2% and 7.7%, and stage 5 (eGFR <15 mL/min/1.73 m 2 ) was 3.9% and 3.5%. Conclusion: Hypertension status was associated with faster kidney function decline. Absolute risk increase was greater for earlier kidney disease stages.

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