scholarly journals Increased Risk of Chronic Kidney Disease in Rheumatoid Arthritis Associated with Cardiovascular Complications – A National Population-Based Cohort Study

PLoS ONE ◽  
2015 ◽  
Vol 10 (9) ◽  
pp. e0136508 ◽  
Author(s):  
Hsien-Yi Chiu ◽  
Hui-Ling Huang ◽  
Chien-Hsun Li ◽  
Hung-An Chen ◽  
Chia-Lun Yeh ◽  
...  
Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1517
Author(s):  
Juyeon Lee ◽  
Kook-Hwan Oh ◽  
Sue-Kyung Park

We investigated the association between dietary micronutrient intakes and the risk of chronic kidney disease (CKD) in the Ansan-Ansung study of the Korean Genome and Epidemiologic Study (KoGES), a population-based prospective cohort study. Of 9079 cohort participants with a baseline estimate glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m2 and a urine albumin to creatinine ratio (UACR) <300 mg/g and who were not diagnosed with CKD, we ascertained 1392 new CKD cases over 12 year follow-up periods. The risk of CKD according to dietary micronutrient intakes was presented using hazard ratios (HRs) and 95% confidence intervals (95% CIs) in a full multivariable Cox proportional hazard models, adjusted for multiple micronutrients and important clinico-epidemiological risk factors. Low dietary intakes of phosphorus (<400 mg/day), vitamin B2 (<0.7 mg/day) and high dietary intake of vitamin B6 (≥1.6 mg/day) and C (≥100 mg/day) were associated with an increased risk of CKD stage 3B and over, compared with the intake at recommended levels (HR = 6.78 [95%CI = 2.18–21.11]; HR = 2.90 [95%CI = 1.01–8.33]; HR = 2.71 [95%CI = 1.26–5.81]; HR = 1.83 [95%CI = 1.00–3.33], respectively). In the restricted population, excluding new CKD cases defined within 2 years, an additional association with low folate levels (<100 µg/day) in higher risk of CKD stage 3B and over was observed (HR = 6.72 [95%CI = 1.40–32.16]). None of the micronutrients showed a significant association with the risk of developing CKD stage 3A. Adequate intake of micronutrients may lower the risk of CKD stage 3B and over, suggesting that dietary guidelines are needed in the general population to prevent CKD.


BMJ Open ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. e019661 ◽  
Author(s):  
Yu-Feng Wei ◽  
Jung-Yueh Chen ◽  
Ho-Shen Lee ◽  
Jiun-Ting Wu ◽  
Chi-Kuei Hsu ◽  
...  

ObjectiveOur population-based research aimed to clarify the association between chronic kidney disease (CKD) and mortality risk in patients with lung cancer.DesignRetrospective cohort studySettingNational health insurance research database in TaiwanParticipantsAll (n=1 37 077) Taiwanese residents who were diagnosed with lung cancer between 1997 and 2012 were identified. Eligible patients with baseline CKD (n=2269) were matched with controls (1:4, n=9076) without renal disease according to age, sex and the index day of lung cancer diagnosis.MethodsThe cumulative incidence of death was calculated by the Kaplan-Meier method, and the risk determinants were explored by the Cox proportional hazards model.ResultsMortality occurred in 1866 (82.24%) and 7135 (78.61%) patients with and without CKD, respectively (P=0.0001). The cumulative incidences of mortality in patients with and without chronic renal disease were 72.8% vs 61.6% at 1 year, 82.0% vs 76.6% at 2 years and 88.9% vs 87.2% at 5 years, respectively. After adjusting for multiple confounding factors including age and comorbidities, Cox regression analysis revealed that CKD was associated with an increased risk of mortality (adjusted HR 1.38; 95% CI 1.29 to 1.47). Stratified analysis further showed that the association was consistent across patient subgroups.ConclusionComorbidity associated with CKD is a risk factor for mortality in patients with lung cancer.


Neurology ◽  
2022 ◽  
pp. 10.1212/WNL.0000000000013205
Author(s):  
Dearbhla M. Kelly ◽  
Sarah T. Pendlebury ◽  
peter M. rothwell

Objective:Individuals with chronic kidney disease (CKD) appear to be at increased risk of cognitive impairment, with both vascular and neurodegenerative mechanisms postulated. To explore the vascular hypothesis, we studied the association between CKD and dementia before and after transient ischaemic attack (TIA) and stroke.Methods:In a prospective, population-based cohort study of TIA and stroke (Oxford Vascular Study; 2002-2012), pre-event and new post-event dementia were ascertained through direct patient assessment and follow-up for 5 years, supplemented by review of hospital/primary care records. Associations between pre-event dementia and CKD (defined as an estimated glomerular filtration rate [eGFR] < 60 ml/min/1.73m2) were examined using logistic regression, and between post-event dementia and CKD using Cox and competing risk regression models, adjusted for age, sex, education, stroke severity, prior stroke, white matter disease, diabetes mellitus, and dysphasia.Results:Among 2305 TIA/stroke patients (median [IQR] age, 77 [67-84] years, 1133 [49%] male, 688 [30%] TIA), 1174 (50.9%) had CKD. CKD was associated with both pre-event (odds ratio [OR], 2.04 [95% CI, 1.52–2.72]; P<0.001) and post-event dementia (hazard ratio [HR], 2.01 [95% CI, 1.65–2.44]; P<0.001), but these associations attenuated after adjustment for covariates (OR=0.92 [0.65-1.31]; p=0.65 and HR=1.09 [0.85-1.39]; p=0.50). The results were similar when a competing risk model was used (subdistribution HR [SHR] =1.74 [1.43-2.12; p<0.001, attenuating to 1.01 [0.78-1.33]; p=0.92 with adjustment). CKD was more strongly associated with late (>1 year) post-event dementia (SHR=2.32, 1.70-3.17; p<0.001), particularly after TIA and minor stroke (SHR=3.08, 2.05-4.64; p<0.001), but not significantly so after adjustment (SHR=1.53, 0.90-2.60; p=0.12).Conclusions:In patients with TIA and stroke, CKD was not independently associated with either pre- or post-event dementia, suggesting that renal-specific mechanisms are unlikely to play an important role in aetiology.


PLoS ONE ◽  
2017 ◽  
Vol 12 (10) ◽  
pp. e0180446 ◽  
Author(s):  
Hsien-Yi Chiu ◽  
Wen-Yen Huang ◽  
Chung-Han Ho ◽  
Jhi-Joung Wang ◽  
Sung-Jan Lin ◽  
...  

PLoS ONE ◽  
2017 ◽  
Vol 12 (8) ◽  
pp. e0183192 ◽  
Author(s):  
Cheng-Ping Shih ◽  
Hung-Che Lin ◽  
Chi-Hsiang Chung ◽  
Po-Jen Hsiao ◽  
Chih-Hung Wang ◽  
...  

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1253.2-1254
Author(s):  
T. Formánek ◽  
K. Mladá ◽  
M. Husakova

Background:Cohort studies using nationwide health registers have shown an increased risk for affective and anxiety disorders in people with ankylosing spondylitis (AS) and rheumatoid arthritis (RA) (1-3). Moreover, a nationwide cohort study demonstrated an increased risk for mental disorders in people with rheumatic diseases (4).Objectives:We aimed to investigate the risk for psychiatric hospitalization following a hospitalization for rheumatic disease.Methods:Using data from the Czech nationwide register of all-cause hospitalizations, we obtained 4 971 individuals hospitalized (index hospitalization) between 2004 and 2012 for rheumatic diseases - RA, spondyloarthritis (including AS, psoriatic arthritis and undifferentiated spondyloarthritis), systemic lupus erythematosus and systemic sclerodermia, with no history of psychiatric and rheuma-related hospitalization in the previous 10 years from the index hospitalization. On these individuals, we randomly matched (on age, gender and year of index hospitalization) controls that were hospitalized in the same time period for a non-rheumatic disease and have no history of psychiatric and rheumatic hospitalization in the last 10 years from their index hospitalization, in the ratio of 1:5. We employed conditional logistic regression for assessing the risk for psychiatric hospitalization in the subsequent 3 years from the index hospitalization. To strengthen our results, we repeated the matching step 100 times and run the analysis on each resulting dataset separately, and pooled the results. The findings are expressed as odds ratios (OR) with 95% confidence intervals (95% CI).Results:We identified an elevated risk for psychiatric (OR = 1.34, 95% CI = 1; 1.78) and for affective disorders (OR = 2.19, 95% CI = 1.17; 4.1) in people hospitalized for rheumatic diseases. We did not find a statistically significant association with organic, psychotic and anxiety disorders.Conclusion:There is an increased risk for experiencing a psychiatric disorder in the period of 3 years after a rheuma-related hospitalization.References:[1]Shen C-C, Hu L-Y, Yang AC, Kuo BI-T, Chiang Y-Y, Tsai S-J. Risk of Psychiatric Disorders following Ankylosing Spondylitis: A Nationwide Population-based Retrospective Cohort Study. The Journal of Rheumatology. 2016;43(3).[2]Park J-S, Jang H-D, Hong J-Y, Park Y-S, Han K, Suh S-W, et al. Impact of ankylosing spondylitis on depression: a nationwide cohort study. Scientific Reports. 2019;9(1):6736.[3]Hsu C-C, Chen S-C, Liu C-J, Lu T, Shen C-C, Hu Y-W, et al. Rheumatoid Arthritis and the Risk of Bipolar Disorder: A Nationwide Population-Based Study. PLOS ONE. 2014;9(9).[4]Sundquist K, Li X, Hemminki K, Sundquist J. Subsequent Risk of Hospitalization for Neuropsychiatric Disorders in Patients With Rheumatic Diseases: A Nationwide Study From Sweden. Archives of General Psychiatry. 2008;65(5):501-7.Acknowledgments:Supported by the project (Ministry of Health Czech Republic) for conceptual development of research organization 00023728 (Institute of Rheumatology).Disclosure of Interests:Tomáš Formánek: None declared, Karolina Mladá: None declared, Marketa Husakova Speakers bureau: Novartis


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