Hypertriglyceridemic waist phenotype and risk of chronic kidney disease in community-dwelling adults aged 60 years and older in Tianjin, China: a 7-year cohort study

Abstract Background The hypertriglyceridemic waist (HTGW) phenotype has been proposed to be related to the occurrence and progression of chronic kidney disease (CKD). The ageing trend of the Chinese population continues to intensify, and elderly individuals are at high risk of CKD. The purpose of this study was to investigate the cross-sectional and longitudinal associations between the HTGW phenotype and the risk of CKD by following community-dwelling adults aged 60 years and older in Tianjin, China, for 7 years. Methods This study was an observational cohort study conducted between 2013 and 2019. Of 2050 participants aged 60 years and older who underwent an annual health examination in 2013, 1605 individuals with complete data were enrolled in the cross-sectional analysis. Among them, 1271 individuals were observed until 2019. Detailed follow-up records were available for 816 participants, of whom 600 participants without CKD at baseline were eligible for inclusion in the retrospective analysis. The HTGW phenotype was defined as a waist circumference of 90 cm or more and triglyceride concentrations of 2.0 mmol/L or more in males or a waist circumference of 85 cm or more and triglyceride concentrations of 1.5 mmol/L or more in females. CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m2 and/or proteinuria (urinary albumin-to-creatinine ratio (ACR) ≥ 30 mg/g). Multivariable logistic regression analyses were performed to evaluate the relationship between the HTGW phenotype and CKD. Results In 2013, the prevalence of CKD among older adults was 31.03%, and the prevalence of CKD in the HTGW phenotype group was 37.81%. Over a 7-year observation period, 195 individuals developed CKD, with an incidence rate of 32.50%. Statistically significant associations were observed between the HTGW phenotype and CKD in older adults in both cross-sectional surveys and retrospective analyses, with odds ratios and 95% confidence intervals of 1.38 (95% CI: 1.03–1.86, P = 0.033) and 2.27 (95% CI: 1.30–3.97, P = 0.004), respectively, after adjustment for confounders. Conclusions In this community-based cohort study, the HTGW phenotype was confirmed to be independently associated with an increased risk of prevalent and incident CKD in older adults aged 60 years and above in Tianjin, China.

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Prevalence of Impaired Kidney Function in the German Elderly: Results from the Berlin Aging Study II (BASE-II)

Gerontology ◽

10.1159/000454831 ◽

2017 ◽

Vol 63 (3) ◽

pp. 201-209 ◽

Cited By ~ 4

Author(s):

Maximilian König ◽

Maik Gollasch ◽

Ilja Demuth ◽

Elisabeth Steinhagen-Thiessen

Keyword(s):

Risk Factors ◽

Older Adults ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

The Elderly ◽

Community Dwelling ◽

Structured Interviews ◽

Cross Sectional ◽

Increased Risk ◽

Aging Study

Background: In aging populations with an ever-growing burden of risk factors such as obesity, diabetes, and hypertension, chronic kidney disease (CKD) is on the rise. However, little is known about its exact prevalence among elderly adults, and often albuminuria is not included in the definition of CKD. Moreover, novel equations for the estimated glomerular filtration rate (eGFR) have recently emerged, which have not been applied comprehensively to older adults. Data on CKD awareness among the elderly are sparse. Objectives: To determine the prevalence of CKD among older adults by eGFR and albumin/creatinine ratio (ACR), compare the performance of 6 established and novel eGFR formulas, explore risk factors, and determine the awareness of CKD in a large cohort of community-dwelling elderly from Germany. Methods: A total of 1,628 subjects from the Berlin Aging Study II (BASE-II) were included in this analysis (mean age 68.7 years; 51.2% female). Extensive cross-sectional data on sociodemographics, lifestyle, medication, and diagnoses were inquired during structured interviews and a medical examination, and blood and urine parameters were measured. Results: In all, 77.1% of the subjects had hypertension, 12.4% had diabetes, and 18.3% were obese. The prevalence of CKD strongly depended on the eGFR equations used: 25.4% (full age spectrum [FAS] equation), 24.6% (Berlin Initiative Study), 23.1% (Lund-Malmö revised), 19.3% (Cockcroft-Gault), 16.4% (Chronic Kidney Disease-Epidemiology Collaboration [CKD-EPI]), and 14.7% (Modification of Diet in Renal Disease [MDRD]). Of the subjects with an eGFRFAS <60 mL/min/1.73 m2 and/or an ACR >30 mg/g, only 3.9% were aware of having CKD. Polypharmacy, age, BMI, coronary artery disease, non-HDL cholesterol, and female sex were independently associated with CKD. Conclusions: CKD is prevalent among older adults in Germany, but awareness is low. The FAS equation detects higher rates of CKD than MDRD and CKD-EPI, which are most widely used at present. Also, when CKD is defined based on eGFR and albuminuria, considerably more people are identified than by eGFR alone. Finally, polypharmacy is associated with an increased risk for CKD in the elderly.

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Prevalence of sarcopenia in community-dwelling older adults using the updated EWGSOP2 definition according to kidney function and albuminuria

BMC Geriatrics ◽

10.1186/s12877-020-01700-x ◽

2020 ◽

Vol 20 (S1) ◽

Author(s):

Rafael Moreno-Gonzalez ◽

◽

Xavier Corbella ◽

Francesco Mattace-Raso ◽

Lisanne Tap ◽

...

Keyword(s):

Older Adults ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Kidney Function ◽

Handgrip Strength ◽

Bioelectrical Impedance ◽

Community Dwelling ◽

Cross Sectional ◽

European Working ◽

Community Dwelling Older Adults

Abstract Background Loss of muscle mass and function may be more pronounced in older adults with chronic kidney disease (CKD) and with albuminuria. Thus, we investigated the prevalence of sarcopenia among community-dwelling older adults according to kidney function and grade of albuminuria. We also explored differences in the prevalence of sarcopenia according to three different equations for the estimation of glomerular filtration rate (eGFR). Methods A cross-sectional analysis of 1420 community-dwelling older adults (≥75 years old) included in the SCOPE study, a multicenter prospective cohort study, was conducted. Comprehensive geriatric assessment including short physical performance battery (SPPB), handgrip strength test and bioelectrical impedance analysis (BIA) was performed. Sarcopenia was defined using the updated criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2). eGFR was calculated using Berlin Initiative Study (BIS), Chronic Kidney Disease Epidemiological Collaboration (CKD-EPI) and Full Age Spectrum (FAS) equations, and urinary albumin-to-creatinine ratio (ACR) was collected to categorize CKD according to Kidney Disease Improving Global Outcomes guidelines. Results Median age was 79.5 years (77.0–83.0), 804 (56.6%) were women. Using EWGSOP2 definition, 150 (10.6%) participants met diagnostic criteria for sarcopenia. Moreover, 85 (6%) participants had severe sarcopenia. Sarcopenia was more prevalent in participants with more advanced stages of CKD according to BIS eq. (9.6% in stages 1 and 2 and 13.9% in stages 3a, 3b and 4, p = 0.042), and also according to CKD-EPI (9.8% vs. 14.2%, p = 0.042) and FAS although not reaching statistical signification (9.8% vs. 12.7%, p = 0.119). Thus, differences in prevalence are observed among CKD categories as estimated by different equations. Prevalence of sarcopenia was also higher with increasing albuminuria categories: 9.3% in normoalbuminuric, 13.2% in microalbuminuric and 16.8% in macroalbuminuric participants, (p = 0.019). Conclusions Sarcopenia is common among community-dwelling older adults, especially among those with more advanced CKD categories, with prevalence estimates differing slightly depending on the equation used for the estimation of eGFR; as well as among those with higher albuminuria categories.

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Impact of Sedentary Time on Chronic Kidney Disease and Disability Incidence in Community-Dwelling Japanese Older Adults: A 4-Year Prospective Cohort Study

Journal of Aging and Physical Activity ◽

10.1123/japa.2017-0326 ◽

2019 ◽

Vol 27 (2) ◽

pp. 184-190

Author(s):

Sungchul Lee ◽

Sangyoon Lee ◽

Seongryu Bae ◽

Kazuhiro Harada ◽

Songee Jung ◽

...

Keyword(s):

Older Adults ◽

Chronic Kidney Disease ◽

Cohort Study ◽

Kidney Disease ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Sedentary Time ◽

Community Dwelling ◽

Japanese Older Adults

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Risk Factors for Chronic Kidney Disease in Older Adults with Hyperlipidemia and/or Cardiovascular Diseases in Taipei City, Taiwan: A Community-Based Cross-Sectional Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17238763 ◽

2020 ◽

Vol 17 (23) ◽

pp. 8763

Author(s):

Horng-Jinh Chang ◽

Kuan-Reng Lin ◽

Junn-Liang Chang ◽

Meng-Te Lin

Keyword(s):

Risk Factors ◽

Older Adults ◽

Chronic Kidney Disease ◽

Uric Acid ◽

Cardiovascular Diseases ◽

Kidney Disease ◽

Healthy Population ◽

Health Examination ◽

Cross Sectional ◽

Taipei City

This cross-sectional study aimed to compare risk factors for chronic kidney disease (CKD) in older adults with or without dyslipidemia and/or cardiovascular diseases (CVD) in Taipei City, Taiwan. The data on 2912 participants with hyperlipidemia and/or CVD and 14,002 healthy control participants derived from the Taipei City Elderly Health Examination Database (2010 to 2011) were analyzed. The associations between conventional CKD risk factors and CKD were comparable between participants with and without hyperlipidemia. Participants with high uric acid and BUN had a higher risk of CKD if they also had hyperlipidemia and CVD [odds ratio (OR) in uric acid = 1.572, 95% CI 1.186–2.120, p < 0.05; OR in BUN = 1.271, 95% CI 1.181–1.379, p < 0.05]. The effect was smaller in participants with hyperlipidemia only (OR in uric acid = 1.291, 95% CI 1.110–1.507, p < 0.05; OR in BUN = 1.169, 95% CI 1.122–1.221, p < 0.05). The association between uric acid/BUN and CKD was also observed in the healthy population and participants with CVD only. In conclusion, older adults with hyperlipidemia and CVD are at high of CKD. Physicians should be alert to the potential for CKD in older patients with hyperlipidemia and CVD.

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Relationships between cystatin C- and creatinine-based eGFR in Japanese rural community-dwelling older adults with sarcopenia

10.21203/rs.2.16445/v1 ◽

2019 ◽

Author(s):

Hiroshi Kusunoki ◽

Shotaro Tsuji ◽

Tomoyuki Kusukawa ◽

Yosuke Wada ◽

Kayoko Tamaki ◽

...

Keyword(s):

Older Adults ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Cystatin C ◽

Gait Speed ◽

Multivariate Logistic Regression Analysis ◽

Community Dwelling ◽

Cross Sectional ◽

Community Dwelling Older Adults ◽

Grip Power

Abstract Background Sarcopenia is prevalent in patients with chronic kidney disease (CKD). Sarcopenia is prevalent in patients with chronic kidney disease (CKD). The indices of physical function, such as grip power and gait speed, decreased according to the decline in estimated glomerular filtration rate (eGFR). Methods We examined the relationships between cystatin C-based GFR (eGFRcys), and creatinine-based GFR (eGFRcre), and their ratio (eGFRcys/eGFRcre) and low skeletal muscle mass index (SMI) in community-dwelling older adults in Japan. This cross-sectional study included 286 men aged 73.3±6.2 years and 606 women aged 72.9±5.8 years from a rural area in Hyogo Prefecture, Japan. eGFRcys and eGFRcre were simultaneously measured, whereas low SMI based on the AWGS criteria was evaluated. Results eGFRcys and the eGFRcys/eGFRcre were significantly correlated with grip power and gait speed. The eGFRcys/eGFRcre was also correlated with SMI. In the multivariate logistic regression analysis, when the eGFRcys/eGFRcre was added as a covariate to the basic model, it was significantly associated with low SMI, both in all subjects. Moreover, CKDcys with a low eGFRcys/eGFRcre ratio (<1.0) was associated with a higher risk of low SMI than CKDcys alone. Conclusion In conclusion, CKDcys but not CKDcre is an independent risk factor of low SMI. In patients with CKDcys, lower eGFRcys/eGFRcre may be a practical screening marker of low SMI in community-dwelling older adults.

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Anemia among Chinese patients with chronic kidney disease and its association with quality of life - results from the Chinese cohort study of chronic kidney disease (C-STRIDE)

BMC Nephrology ◽

10.1186/s12882-021-02247-8 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Yan Shen ◽

◽

Jinwei Wang ◽

Jing Yuan ◽

Li Yang ◽

...

Keyword(s):

Quality Of Life ◽

Chronic Kidney Disease ◽

Cohort Study ◽

Kidney Disease ◽

Systematic Investigation ◽

Chinese Patients ◽

Cross Sectional ◽

Five Dimensions ◽

Anemia Treatment

Abstract Background Anemia is one of the common complications in patients with chronic kidney disease (CKD). However, there is no systematic investigation on the prevalence of anemia in CKD patients and its relationship with the quality of life in China. Methods The data for this study comes from baseline data from the Chinese Chronic Kidney Disease Cohort Study (C-STRIDE), which recruited predialysis CKD patients in China. The kidney disease quality of life summary (KDQOL-TM) was used to assess health-related quality of life (HRQoL). Use linear regression model to estimate the relationship between hemoglobin level and quality of life. Results A total of 2921 patients were included in this study. The adjusted prevalence of hemoglobin (Hb) less than 100 g/L was 10.3% (95% confidence interval [CI]: 9.9,11.4%), and showed an increased trend through reduced eGFR levels from 4.0% (95%CI:2.3,5.9%) in the 45-60 ml/min/1.73m2 group to 23.4% (95%CI:20.5,26.2%) in the 15–29 ml/min/1.73m2 group. The prevalence of anti-anemia treatment was 34.0% (95%CI: 28.7,39.3%) and it is shown by reducing eGFR levels from 15.8% (95%CI:0,36.7%) in the 45-60 ml/min/1.73m2 group to 38.2% (95%CI: 30.7,45.2%) in the 15–29 ml/min/1.73m2 group. All five dimensions of the KDQOL scores in patients with CKD decreased as hemoglobin declined. After multivariable adjustments,the degrees of decrease became somewhat blunted. For example, compared with hemoglobin of ≥130 g/L, regression coefficients in the hemoglobin of < 100 g/L were − 0.047(95%CI: − 0.049,-0.045) for Symptoms and Problems(S), − 0.047(95%CI: − 0.049,-0.044) for Effects of the Kidney Disease(E), − 0.207(95%CI: − 0.212,-0.203) for Burden of the Kidney Disease(B), − 0.112(95%CI: − 0.115,-0.109) for SF-12 Physical Functioning (PCS), − 0.295(95%CI: − 0.299, -0.292) for SF-12 Mental Functioning (MCS), respectively. Conclusions In our cross-sectional analysis of patients with CKD in China, prevalence of both anemia and anti-anemia treatment increased with decreased eGFR. In addition, anemia was associated with reduced HRQoL.

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