scholarly journals Consequences of exposure to prenatal famine on estimated glomerular filtration rate and risk of chronic kidney disease among survivors of the great Ethiopian famine (1983–85): a historical cohort study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Kalkidan Hassen Abate ◽  
Misra Abdulahi ◽  
Fedlu Abdulhay ◽  
Getachew Arage ◽  
Mohammed Mecha ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Logistic Regression ◽  
Glomerular Filtration Rate ◽  
Blood Glucose ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Famine Exposure ◽  
The Mean ◽  
Prenatal Famine

Abstract Background The impact of an adverse prenatal environment such as famine exposure on the development of adulthood non-communicable chronic illnesses, including diabetes and hypertension has been well articulated in the recent past and supported by evidence. However, there exist few longitudinal studies conducted on the long term consequences of prenatal famine exposure on adulthood kidney function. Hence, we set out to examine whether prenatal exposure to the Ethiopian Great Famine (1983–1985) was associated with changes in estimated glomerular filtration rate (eGFR) and the risk of developing chronic kidney disease (CKD) later in adult life. Methods The study was conducted in 219 famine exposed and 222 non exposed cohorts in Raya Kobo district, North Wollo Zone, Northern Ethiopia. Estimated GFR was computed from standardized serum creatinine using the CKD Epidemiology Collaboration (CKD-EPI) equation. The definition of CKD includes those with an eGFR of less than 60 ml/min/1.73 m2 on at least in two occasions of 90 days apart (with or without markers of kidney damage). Linear and logistic regression analyses were employed to examine the independent effect of prenatal famine exposure on eGFR and CKD respectively. Results The mean (SD) serum creatinine of exposed and non-exposed groups were 0.78 (0.2) and 0.75 (0.2) respectively. The mean (SD) eGFR of exposed groups was 107.95 (27.49) while the non-exposed 114.48 (24.81) ml/min. In linear regression, the unadjusted model to examine the association between famine exposure and eGFR resulted in a significant negative beta coefficient (β = − 0.124: 95% CI: − 11.43, − 1.64). Adjusting the exposure for outstanding covariates of kidney health, including systolic blood pressure, fasting blood sugar and blood glucose did not alter the inverse relationship (β = −.114 95% CI: − 10.84, − 1.17). In the unadjusted bivariate logistic regression model, famine exposure resulted in nearly 2.7 times higher odds of developing CKD (OR: 2.68, 95% CI: 1.16, 6.2). The odds remained equivalent after adjusting for systolic blood pressure, fasting blood glucose and body mass index (OR = 2.61: 95% CI: 1.120, 6.09). Conclusion In the study setting, prenatal exposure to the Great Ethiopian Famine was associated with decreased eGFR and higher risk of developing CKD among survivors. These findings may imply that famine in early life may play a significant role in the development of kidney dysfunction in adulthood.

scholarly journals Consequences of exposure to prenatal famine on estimated glomerular filtration rate and risk of chronic kidney disease among survivors of the great Ethiopian famine (1983-85): a historical cohort study

2021 ◽  
Author(s):  
Kalkidan Hassen Abate ◽  
Misra Abdulahi ◽  
Fedlu Abdulhay ◽  
Getachew Arage ◽  
Mohammed Mecha Abafogi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Logistic Regression ◽  
Glomerular Filtration Rate ◽  
Blood Glucose ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Famine Exposure ◽  
The Mean ◽  
Prenatal Famine

Abstract Background: The impact of an adverse prenatal environment such as famine exposure on the development of adulthood non-communicable chronic illnesses, including diabetes and hypertension has been well articulated in the recent past and supported by evidence. However, there exist few longitudinal studies conducted on the long term consequences of prenatal famine exposure on adulthood kidney function. Hence, we set out to examine whether prenatal exposure to the Ethiopian Great Famine (1983–1985) was associated with changes in estimated glomerular filtration rate (eGFR) and the risk of developing chronic kidney disease (CKD) later in adult life.Methods: The study was conducted in 219 famine exposed and 222 non exposed cohorts in Raya Kobo district, North Wollo Zone, Northern Ethiopia. Estimated GFR was computed from standardized serum creatinine using the CKD Epidemiology Collaboration (CKD-EPI) equation. The definition of CKD includes those with an eGFR of less than 60 ml/min/1.73m2 on at least in two occasions of ninety days apart (with or without markers of kidney damage). Linear and logistic regression analyses were employed to examine the independent effect of prenatal famine exposure on eGFR and CKD respectively.Results: The mean (SD) serum creatinine of exposed and non-exposed groups were 0.78 (0.2) and 0.75 (0.2) respectively. The mean (SD) eGFR of exposed groups was 107.95 (27.49) while the non-exposed 114.48 (24.81) ml/min. In linear regression, the unadjusted model to examine the association between famine exposure and eGFR resulted in a significant negative beta coefficient (β = -0.124: 95% CI: -11.43, -1.64). Adjusting the exposure for outstanding covariates of kidney health, including systolic blood pressure, fasting blood sugar and blood glucose did not alter the inverse relationship (β = -.114 95% CI: -10.84, -1.17). In the unadjusted bivariate logistic regression model, famine exposure resulted in nearly 2.7 times higher odds of developing CKD (OR: 2.68, 95% CI: 1.16, 6.2). The odds remained equivalent after adjusting for systolic blood pressure, fasting blood glucose and body mass index (OR= 2.61: 95% CI: 1.120, 6.09).Conclusion: In the study setting, prenatal exposure to the Great Ethiopian Famine was associated with decreased eGFR and higher risk of developing CKD among survivors. These findings may imply that famine in early life may play a significant role in the development of kidney dysfunction in adulthood.

scholarly journals Consequences of Exposure to Prenatal Famine on Estimated Glomerular Filtration Rate and Risk of Chronic Kidney Disease Among Survivors of the Great Ethiopian Famine (1983-85): A Historical Cohort Study

2020 ◽  
Author(s):  
Kalkidan Hassen Abate ◽  
Misra Abdulahi ◽  
Fedlu Abdulhay ◽  
Getachew Aragie ◽  
Mohammed Mecha Abafogi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Blood Glucose ◽  
Kidney Disease ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Famine Exposure ◽  
The Mean ◽  
Prenatal Famine

Abstract Background: The impact of an adverse prenatal environment such as famine exposure on development of adulthood non communicable chronic illnesses, including diabetes and hypertension has been well articulated in the recent past and supported by evidence. However, there exist a limited number of longitudinal studies on long term consequences of prenatal famine on adulthood kidney function. Hence, we set out to examine whether prenatal exposure to the Ethiopian Great Famine (1983–1985) was associated with changes in estimated glomerular filtration rate (GFR) and risk of developing chronic kidney disease (CKD) during adulthood.Methods: The study was conducted in 219 famine exposed and 222 non exposed cohorts in Raya Kobo district, North Wollo Zone, Northern Ethiopia. Estimated GFR was computed using the CKD Epidemiology Collaboration (The CKD-EPI) equation. CKD was defined as eGFR= <60 mL/min per 1.73 m2. Linear and logistic regression analyses were employed to examine the independent effect of prenatal famine exposure on eGFR and CKD respectively.Results: The mean (SD) serum creatinine of exposed and non-exposed groups were 0.78 (0.2) and 0.75 (0.2) respectively. The mean (SD) eGFR of exposed groups was 107.95 (27.49) while the non-exposed 114.48 (24.81) ml/min. In linear regression, unadjusted model to examine the association between famine exposure and eGFR resulted in a significant negative beta coefficient (β = -0.124: 95% CI: -11.43, -1.64). Adjusting the exposure for outstanding covariates of kidney health, including systolic blood pressure, fasting blood sugar and blood glucose did not alter the inverse relationship (β = -.114 95% CI:-10.84, -1.17). In binary unadjusted logit model, famine exposure resulted in nearly 2.7 times increased odds of developing CKD (OR: 2.68, 95% CI: 1.16, 6.2). The odds remained equivalent after adjusting for systolic blood pressure, fasting blood glucose and BMI (OR= 2.61: 95% CI: 1.120, 6.09).Conclusion: prenatal exposure to the Great Ethiopian Famine was associated with decreased eGFR and greater risk of CKD among survivors. These findings may imply that famine in early life may play significant role in the development of kidney dysfunction in adulthood.

Abstract 066: Association Between Nocturnal Blood Pressure Dipping Magnitude And Chronic Kidney Disease Risk Among Patients With Controlled Office Blood Pressure

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
So Mi J Cho ◽  
Hokyou Lee ◽  
Tae-Hyun Yoo ◽  
Jong Hyun Jhee ◽  
Sungha Park ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Lower Risk ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Disease Risk ◽  
Chronic Kidney Disease Risk

Although abnormal diurnal blood pressure (BP) patterns are associated with adverse cardiorenal outcomes, their risks are yet unquantified by BP dipping magnitude. We assessed chronic kidney disease risk across nocturnal BP dipping spectrum among patients with controlled hypertension without prior advanced kidney disease. Ambulatory BP measurements were collected from 995 middle-aged patients with controlled office BP (<140/90 mmHg). The magnitude of dipping was defined as the difference between daytime and nighttime systolic BP divided by daytime systolic BP. Accordingly, patients were categorized as extreme-dipper (≥20%) dipper (10-<20%), non-dipper (0-<10%), or reverse-dipper (<0%). We cross-sectionally analyzed continuous and categorical associations of dipping with albuminuria (urine albumin-to-creatinine ratio ≥30 mg/g) and decreased estimated glomerular filtration rate (<60 ml/min/1.73m 2 ), adjusting for office/ambulatory BP, antihypertensive class, body mass index, total cholesterol, fasting glucose, socioeconomic status, and health behavior. The participants (mean age 60.2 years; 52.9% male) consisted of 13.5% (134 of 995) extreme-dippers, 43.1% (429 of 995) dippers, 34.7% (345 of 995) non-dippers, and 8.7% (87 of 995) reverse-dippers. In reference to dippers, odds ratios (95% confidence interval) for albuminuria were 1.73 (1.04-2.60) in reverse-dippers, 1.67 (1.20-2.32) in non-dippers, and 0.62 (0.38-1.04) in extreme-dippers; this reflects significantly lower risk (0.77, 0.55-0.95) per 10% dipping. Likewise, persons presenting reduced and reverse-directional dipping were at higher risk for decreased estimated glomerular filtration rate: reverse-dippers 2.02 (1.06-3.84); non-dippers 1.98 (1.07-3.08); extreme-dippers 0.69 (0.20-1.17), with lower risk (0.74, 0.22-1.02) per every 10%. In short, monitoring nocturnal BP patterns may identify chronic kidney disease risk otherwise overlooked based on office BP.

scholarly journals Association between neck circumference and the risk of decreased estimated glomerular filtration rate in the general population of China: a cross-sectional study

2020 ◽  
Author(s):  
Jing Xue ◽  
Bing Li ◽  
Jie Wang ◽  
Songyan Yu ◽  
Anping Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Glomerular Filtration Rate ◽  
General Population ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Neck Circumference ◽  
Male Subjects

Abstract Background: The burden of chronic kidney disease is increasing substantially worldwide. Neck circumference (NC), an anthropometric index for upper-body adiposity, has been recognized as an indicator of cardiometabolic diseases. However, the association between NC and renal dysfunction has not been fully disclosed. The aim of this study was to investigate the association between NC and estimated glomerular filtration rate (eGFR) in the general population in China. Methods: A total of 8805 participants (3322 men and 5483 women) were enrolled in this study. Logistic regression analysis was conducted to examine the association between NC and eGFR. The male and female subjects were divided into four groups according to the neck circumference quartiles. The primary outcome was defined as an eGFR ≤ 90 mL/min/1.73 m2.Results: Logistic regression analysis revealed that in both sexes, higher neck circumference was significantly associated with a higher risk of decreased eGFR even after fully adjusting for age; other anthropometric indexes, including body mass index and waist to hip ratio; traditional risk factors for chronic kidney diseases; and sociologic risk factors (Quartile1 as a reference; the odds ratios [95% confidence intervals] were as follows: Quartile 2, 1.26[0.99-1.59]; Quartile 3, 1.40[1.07-1.83]; Quartile 4, 1.71[1.22-2.38] in men; Quartile 2, 1.14[0.95-1.37]; Quartile 3, 1.31[1.03-1.66]; Quartile 4, 1.32[1.04-1.68] in women.) Stratified analyses suggested that the association was significant among subjects with prediabetes and those with normal serum uric acid levels. When the subjects were stratified according to blood pressure or BMI, the association persisted among male subjects with abnormal blood pressure and was strengthened among male subjects who were overweight/obese, while the association disappeared among female subjects. Conclusions: NC is independently associated with the risk of decreased eGFR in the general population in China, indicating that NC could contribute to renal dysfunction risk assessment.

scholarly journals Association between Neck Circumference and the Risk of Decreased Estimated Glomerular Filtration Rate in the General Population of China: A Cross-Sectional Study

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Jing Xue ◽  
Bing Li ◽  
Jie Wang ◽  
Songyan Yu ◽  
Anping Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Glomerular Filtration Rate ◽  
General Population ◽  
Renal Dysfunction ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Male Subjects

Background. The burden of chronic kidney disease is increasing substantially worldwide. Neck circumference (NC), an anthropometric index for upper-body adiposity, has been recognized as an indicator of cardiometabolic diseases. However, the association between NC and renal dysfunction has not been fully disclosed. Objectives. The aim of this study was to investigate the association between NC and estimated glomerular filtration rate (eGFR) in the general population in China. Methods. A total of 8805 participants (3322 men and 5483 women) were enrolled in this study. Logistic regression analysis was conducted to examine the association between NC and eGFR. The male and female subjects were divided into four groups according to the NC quartiles. The primary outcome was defined as an eGFR ≤ 90   mL / min / 1.73   m 2 . Results. Logistic regression analysis revealed that in both sexes, higher NC was significantly associated with a higher risk of decreased eGFR even after fully adjusting for age, other anthropometric indexes, traditional risk factors for chronic kidney diseases, and sociologic risk factors (quartile 1 as a reference; the odds ratios [95% confidence intervals] were as follows: quartile 2, 1.26 [0.99-1.59]; quartile 3, 1.40 [1.07-1.83]; and quartile 4, 1.71 [1.22-2.38], in men; quartile 2, 1.14 [0.95-1.37]; quartile 3, 1.31 [1.03-1.66]; and quartile 4, 1.32 [1.04-1.68], in women). Stratified analyses suggested that the association was significant among subjects with prediabetes or normal serum uric acid levels and those without cardiovascular diseases (CVD). Among subjects with CVD, the association persisted only in males. When the subjects were stratified according to blood pressure or BMI, the association persisted among male subjects with abnormal blood pressure and was strengthened among male subjects who were overweight/obese, while the association disappeared among female subjects. Conclusions. NC is independently associated with the risk of decreased eGFR in the general population in China, indicating that NC could contribute to renal dysfunction risk assessment.

scholarly journals Physical Activity In Renal Disease (PAIRED) and the effect on hypertension: study protocol for a randomized controlled trial

2018 ◽  
Author(s):  
Jeyasundar Radhakrishnan ◽  
MD/ Michelle Graham ◽  
MD Stephanie Thompson ◽  
MMath/PStat Natasha Wiebe ◽  
MD Gabor Gyenes ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Systolic Blood Pressure ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Moderate Intensity ◽  
Home Based

Abstract Background: The prevalence of hypertension among people with chronic kidney disease is high with over 60% of people not attaining recommended targets despite multiple medications. Given the health and economic implications of hypertension, additional strategies are needed. Exercise is an effective strategy for reducing blood pressure in the general population; however, it is not known whether exercise would have a comparable benefit in people with moderate to advanced chronic kidney disease and hypertension. Methods: This is a parallel arm trial of adults with hypertension (systolic blood pressure greater than 130 mmHg) and an estimated glomerular filtration rate of 15-45 ml/min 1.73 m2. A total of 160 participants will be randomized, with stratification for estimated glomerular filtration rate, to a 24-week aerobic-based exercise intervention or enhanced usual care. The primary outcome is the difference in 24-hour ambulatory systolic blood pressure after eight weeks of exercise training. Secondary outcomes at eight and 24 weeks include: other measurements of blood pressure, aortic stiffness (pulse wave velocity), change in the Defined Daily Dose of anti-hypertensives, medication adherence, markers of cardiovascular risk, physical fitness (cardiopulmonary exercise testing), seven day accelerometry, quality of life, and adverse events. The effect of exercise on renal function will be evaluated in an exploratory analysis. The intervention is a thrice-weekly moderate intensity aerobic exercise supplemented with isometric resistance exercise delivered in two phases. Phase 1: supervised, facility-based weekly and home-based sessions (eight weeks). Phase 2: home-based sessions (16 weeks). Discussion: To our knowledge, this study is the first trial designed to provide a precise estimate of the effect of exercise on blood-pressure in people with moderate to severe CKD and hypertension. The findings from this study will address a significant knowledge gap in hypertension management in CKD and inform the design of a larger study on the effect of exercise on CKD progression.

scholarly journals Frequency of Blood Pressure and Estimated Glomerular Filtration Rate Testing in Type 2 Diabetes Mellitus: A Retrospective Study with 43,509 Patients

2018 ◽  
Vol 127 (07) ◽  
pp. 455-460 ◽  
Author(s):  
Karel Kostev ◽  
Alexander Lucas ◽  
Louis Jacob
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
The Mean

Abstract Background The goal of this study was to analyze the frequency of blood pressure (BP) and estimated glomerular filtration rate (eGFR) testing in type 2 diabetes mellitus (T2DM) patients followed in general and diabetological practices in Germany. Methods The study included individuals who had at least two concultations due to T2DM diagnosis (ICD-10: E11) between January and December 2016. Patients were followed in 557 general and diabetological practices. The primary outcome was the frequency of BP and eGFR testing in T2DM patients in 2016. The association between several demographic and clinical variables and the odds of receiving≥2 BP and≥1 eGFR tests in the year 2016 was analyzed using multivariate logistic regression models. Results A total of 43,509 individuals were available for analysis. The mean age of the population was 68.6 years (SD=12.4 years). The mean number of measurements was 2.9 (SD=3.5) for BP and 0.4 (SD=1.1) for eGFR. 52.3% of patients were tested at least twice for BP and 15.3% of them at least once for eGFR in 2016. Older patients, individuals followed in diabetological practices, people receiving antihyperglycemic medications, and those affected by chronic conditions (i. e. hypertension, renal complications, or neuropathy) displayed higher odds of receiving≥2 BP and≥1 eGFR tests, whereas patients with a diabetes duration of>1 year displayed lower odds. Conclusions The frequency of BP and eGFR testing was low in T2DM patients in Germany in 2016. Several demographic and clinical variables were associated with this frequency.

scholarly journals Physical Activity In Renal Disease (PAIRED) and the effect on hypertension: study protocol for a randomized controlled trial

2019 ◽  
Author(s):  
MD Stephanie Thompson ◽  
MMath/PStat Natasha Wiebe ◽  
MD Gabor Gyenes ◽  
MSc Rachelle Davies ◽  
Jeyasundar Radhakrishnan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Systolic Blood Pressure ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Moderate Intensity ◽  
Home Based

Abstract Background: The prevalence of hypertension among people with chronic kidney disease is high with over 60% of people not attaining recommended targets despite multiple medications. Given the health and economic implications of hypertension, additional strategies are needed. Exercise is an effective strategy for reducing blood pressure in the general population; however, it is not known whether exercise would have a comparable benefit in people with moderate to advanced chronic kidney disease and hypertension. Methods: This is a parallel arm trial of adults with hypertension (systolic blood pressure greater than 130 mmHg) and an estimated glomerular filtration rate of 15-45 ml/min 1.73 m2. A total of 160 participants will be randomized, with stratification for estimated glomerular filtration rate, to a 24-week aerobic-based exercise intervention or enhanced usual care. The primary outcome is the difference in 24-hour ambulatory systolic blood pressure after eight weeks of exercise training. Secondary outcomes at eight and 24 weeks include: other measurements of blood pressure, aortic stiffness (pulse wave velocity), change in the Defined Daily Dose of anti-hypertensives, medication adherence, markers of cardiovascular risk, physical fitness (cardiopulmonary exercise testing), seven day accelerometry, quality of life, and adverse events. The effect of exercise on renal function will be evaluated in an exploratory analysis. The intervention is a thrice-weekly moderate intensity aerobic exercise supplemented with isometric resistance exercise delivered in two phases. Phase 1: supervised, facility-based weekly and home-based sessions (eight weeks). Phase 2: home-based sessions (16 weeks). Discussion: To our knowledge, this study is the first trial designed to provide a precise estimate of the effect of exercise on blood-pressure in people with moderate to severe CKD and hypertension. The findings from this study will address a significant knowledge gap in hypertension management in CKD and inform the design of a larger study on the effect of exercise on CKD progression. Trial registration: Registered at ClinicalTrials.gov NCT03551119. Registered on 11 June 2018.

Sign in / Sign up

Export Citation Format

Share Document