Association of Lipid Accumulation Product With Chronic Kidney Disease in Chinese Community Adults: A Report From the REACTION Study

Abstract Background: Limited studies regarding the relationship between lipid accumulation product (LAP), a novel surrogate marker of visceral adiposity, and declined estimated glomerular filtration rate (eGFR) have yielded conflicting findings, and no report has demonstrated the relationship of LAP with chronic kidney disease (CKD), defined by lower eGFR and/or the presence of albuminuria. This study aimed to estimate the possible association between LAP and CKD in Chinese community adults. Method: This cross‐sectional study, drawn from the REACTION study, included 7072 participants aged ≥40 years in Luzhou city, Sichuan Province. LAP was determined based on a combination of waist circumference (WC) and fasting triglycerides (TG). CKD was defined as eGFR <60mL/min/1.73m² and/or presence of albuminuria [urinary albumin‐creatinine ratio (ACR) ≥30mg/g]. A multiple logistic regression model was performed to evaluate the possible association between LAP and CKD in Chinese community adults. Results: Participants with CKD had significantly higher LAP, age, WC, weight, body mass index, systolic blood pressure, diastolic blood pressure, pulse pressure (PP), TG, total cholesterol (TC), fasting blood glucose, 2 h postload blood glucose, glycated hemoglobin A1C, serum creatinine, urinary ACR, prevalence of obesity, type 2 diabetes mellitus, hypertension, myocardial infarction, coronary heart disease, peripheral arterial disease, cardiovascular disease (CVD), users of hypoglycemic drugs, and lower high density lipoprotein cholesterol, eGFR, and users of drinking (P<0.01 or P<0.05). Multiple logistic regression analysis demonstrated that LAP quartiles were positively associated with an increased risk of prevalent CKD (Q2: odds rate [OR]: 1.083, 95% confidence intervals [CI] 0.850-1.381; Q3: OR: 0.961, 95% CI 0.741-1.247; Q4: OR: 1.497, 95% CI 1.139-1.966, P for trend = 0.004) even after adjustment for potential confounding factors. Stratified analysis revealed that the associations of LAP quartiles with increased risk of prevalent CKD also occurred in people who were older, women, overweight, with hypertension, normal glucose tolerance, normal PP, low-density lipoprotein cholesterol < 3.4 mmol/L, without CVD events, no smoking and drinking. Conclusions: These findings suggest that LAP is significantly associated with increased risk of prevalent CKD in Chinese community adults, and may inform both public health recommendations and clinical practice.

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Abstract 211: Variation of NEDD4L is Associated with Hypertension in Chinese Hans Chronic Kidney Disease Patients

Hypertension ◽

10.1161/hyp.62.suppl_1.a211 ◽

2013 ◽

Vol 62 (suppl_1) ◽

Author(s):

Cheng Wang ◽

Jun Zhang ◽

Cuicui Li ◽

Wenyu Gong ◽

Tanqi Lou

Keyword(s):

Blood Pressure ◽

Chronic Kidney Disease ◽

Logistic Regression ◽

Kidney Disease ◽

Blood Pressure Monitoring ◽

Multivariate Logistic Regression Analysis ◽

Multivariate Logistic Regression ◽

Functional Studies ◽

Chi Squared ◽

The Relationship

Background: Neural precursor cell expressed developmentally down-regulated 4-like (NEDD4L) is a candidate gene for hypertension, and carriers of an intact NEDD4L C2-domain,encoded by the NEDD4L rs4149601 (G/A) GG genotype, together with the C-allele of the NEDD4L rs2288774 (C/T) polymorphism have been found be associated with hypertension both in African Americans and whites. However, there is no data on the relationship between polymorphism of NEDD4L rs4149601 and rs2288774 and hypertension in Chinese chronic kidney disease (CKD) patients. The purpose of the current study was to investigate the relationship between the variation of NEDD4L rs4149601, rs2288774 and hypertension in CKD patients. Methods: A total of 546 Chines Hans CKD patients were enrolled in our study. The SNPs were genotyped using PCR-based techniques. All patients underwent ambulatory blood pressure monitoring, and clinical data were also collected. Multivariate logistic regression analysis was used to identify the relationship between polymorphisms and hypertension. Results: 506 patients carried GG/GA genotype and 30 carried AA genotype. Rs4149601 AA genotype carriers had significantly higher rate of hypertension (68.3% vs 46.2%, P = 0.022) than GG/GA genotype carriers by Chi-squared test. AA genotype carriers also had a higher day-time and bedtime systolic blood pressure (142±16 vs 135±23, P=0.036; 137±18 vs 127±13, P=0.022, respectively) when compared with GG/GA genotype carriers. AA genotype [OR= 3.08, 95% CI (1.06-9.80)], lowever eGFR [OR=0.98, 95% CI (0.97-0.99)], older age [OR=1.03, 95% CI (1.01-1.05)] were independently associated with hypertension in CKD patients by multivariate logistic regression. However, No difference was found in blood pressure with rs2288774 TT/TC/CC genotypes, and no difference was found in the incidence of hypertension among patients with three genotypes. Conclusions: Our results suggested 4149601AA genotype of NEDD4L may be associated with hypertension in CKD patients, and further genetic and functional studies are required to understand its role in the manifestation of hypertension in Chinese CKD patients.

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The Effects of Cardiometabolic Factors on the Association Between Serum Uric Acid and Chronic Kidney Disease in Chinese Middle-aged and Older Population: a Mediation Analysis

10.21203/rs.3.rs-439404/v1 ◽

2021 ◽

Author(s):

Lu Xu ◽

Hang Sun ◽

Lili Liu ◽

Siyan Zhan ◽

Shengfeng Wang ◽

...

Keyword(s):

Blood Pressure ◽

Chronic Kidney Disease ◽

Uric Acid ◽

Blood Glucose ◽

Kidney Disease ◽

Linear Regression ◽

Serum Uric Acid ◽

Dose Response ◽

Mediation Analysis ◽

Density Lipoprotein

Abstract Background: To explore whether dyslipidemia, hyperglycemia or hypertension has mediating effect on the association between serum uric acid (SUA) and the development of chronic kidney disease (CKD).Methods: We conducted a mediation analysis to explore the potential mediating effects of systolic blood pressure (SBP), diastolic blood pressure (DBP), blood glucose, triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) on the association between SUA and estimated glomerular filtration rate (eGFR). The data were obtained from China Health and Retirement Longitudinal Study (CHARLS), covering 5 762 individuals. Results: SUA had a negative dose-response total effect on eGFR (β -3.11, 95% CI -3.40 to -2.82, P-value<0.001). The linear regression between SUA and seven potential mediators indicated that blood glucose (β 0.80, 95% CI 0.18 to 1.42, P-value=0.012), TG (β 10.01, 95% CI 8.22 to 11.79, P-value<0.001), TC (β 2.64, 95% CI 1.83 to 3.45, P-value<0.001), HDL-C (β -0.27, 95% CI -0.52 to -0.02, P-value=0.034) and LDL-C (β 1.15, 95% CI 0.49 to 1.80, P-value=0.001) all had significant dose-response association with SUA, but SBP and DBP showed no significant association with SUA. In terms of the association between potential mediators and eGFR, only TG did not have significant linear association with eGFR (β 0.00, 95% CI 0.00 to 0.01, P-value=0.117). The linear regression showed that SUA was directly associated with eGFR (P-value<0.001).Conclusions: This study supported that the association between SUA and the risk of CKD was not mediated by hypertension, hyperglycemia or dyslipidemia.

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The Effects of Cardiometabolic Factors on the Association Between Serum Uric Acid and Chronic Kidney Disease in Chinese Middle-Aged and Older Population: A Mediation Analysis

Frontiers in Endocrinology ◽

10.3389/fendo.2021.702138 ◽

2021 ◽

Vol 12 ◽

Author(s):

Lu Xu ◽

Hang Sun ◽

Lili Liu ◽

Siyan Zhan ◽

Shengfeng Wang ◽

...

Keyword(s):

Blood Pressure ◽

Chronic Kidney Disease ◽

Uric Acid ◽

Blood Glucose ◽

Kidney Disease ◽

Linear Regression ◽

Serum Uric Acid ◽

Dose Response ◽

Mediation Analysis ◽

Density Lipoprotein

IntroductionTo explore whether dyslipidemia, hyperglycemia or hypertension has mediating effect on the association between serum uric acid (SUA) and the development of chronic kidney disease (CKD).MethodsWe conducted a mediation analysis to explore the potential mediating effects of systolic blood pressure (SBP), diastolic blood pressure (DBP), blood glucose, triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) on the association between SUA and estimated glomerular filtration rate (eGFR). The data were obtained from China Health and Retirement Longitudinal Study (CHARLS), covering 5,762 individuals.ResultsSUA had a negative dose-response total effect on eGFR (β -3.11, 95% CI -3.40 to -2.82, P-value<0.001). The linear regression between SUA and seven potential mediators indicated that blood glucose (β 0.80, 95% CI 0.18 to 1.42, P-value=0.012), TG (β 10.01, 95% CI 8.22 to 11.79, P-value<0.001), TC (β 2.64, 95% CI 1.83 to 3.45, P-value<0.001), HDL-C (β -0.27, 95% CI -0.52 to -0.02, P-value=0.034) and LDL-C (β 1.15, 95% CI 0.49 to 1.80, P-value=0.001) all had significant dose-response association with SUA, but SBP and DBP showed no significant association with SUA. In terms of the association between potential mediators and eGFR, only TG (β 0.003, 95% CI -0.001 to 0.01, P-value=0.117) and HDL-C (β 0.01, 95% CI -0.02 to 0.04, P-value=0.444) did not have significant linear association with eGFR. The linear regression showed that SUA was directly associated with eGFR (P-value<0.001).ConclusionsThis study supported that the association between SUA and the risk of CKD was not mediated by hypertension, hyperglycemia or dyslipidemia.

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DEVELOPMENT OF ARTERIAL HYPOTENSION IN PREMATURE INFANTS WITH EARLY ONSET BACTERIAL INFECTIONS: TOOLS OF CLINICAL PREDICATION

Wiadomości Lekarskie ◽

10.36740/wlek201905222 ◽

2019 ◽

Vol 72 (5) ◽

pp. 1068-1073

Author(s):

Valeriy Pokhylko ◽

Olena Kovalova ◽

Yuliia Cherniavska ◽

Svitlana Tsvirenko ◽

Yuliia Klymchuk

Keyword(s):

Blood Pressure ◽

Logistic Regression ◽

Blood Glucose ◽

Diagnostic Criteria ◽

Premature Infants ◽

Early Onset ◽

Bacterial Infections ◽

Prognostic Model ◽

Multiple Logistic Regression ◽

Premature Babies

Introduction: The safe thresholds of blood pressure in preterm neonates are still unclear. The aim of our study was to substantiate the diagnostic criteria for the syndrome of arterial hypotension (AH) and indications for the appointment of hemodynamic support in premature infants with early onset bacterial infections. Materials and methods: A prospective cohort study was conducted. 2 experimental groups were formed –premature babies with early onset bacterial infections and AH (n = 58), and control group (n = 62), premature babies without AH. The subjects of the study were a number of risk factors. Simple and multiple logistic regression analyses were used. Results: In premature infants with AH, compared with those without AH, there are significantly lower values of stroke index of left ventricle (SILV), index of resistance (IR) of the middle cerebral artery, pH, significantly higher level of urea in serum and a higher proportion of children with hypoglycemia. Multiple logistic regression analysis was used to develop a clinical prognostic model for the AH-syndrome. Only prognostic model, which included SILV, blood pH and blood glucose, had high prognostic characteristics and the largest area under the ROC curve. Conclusions: The following diagnostic criteria can be used for the appointment of medical support for hemodynamics: the digital value of the level of mean blood pressure, expressed in mmHg, is less than the gestational age in weeks, and at least one of the following indicators –pH is less than 7.2, blood glucose level is less than 2.8 mmol/l, SILV is less than the normal ranges.

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Rate of uncontrolled blood pressure and its associated factors in patients with predialysis chronic kidney disease in Bali, Indonesia

Journal of Health Research ◽

10.1108/jhr-09-2019-0203 ◽

2020 ◽

Vol 34 (6) ◽

pp. 535-545

Author(s):

Ni Wayan Kesari Dharmapatni ◽

Aurawamon Sriyuktasuth ◽

Kanaungnit Pongthavornkamol

Keyword(s):

Blood Pressure ◽

Chronic Kidney Disease ◽

Logistic Regression ◽

Kidney Disease ◽

Associated Factors ◽

Univariate Analysis ◽

Multiple Logistic Regression ◽

Care Providers ◽

Uncontrolled Blood Pressure ◽

Content Type

PurposeHypertension is a key determinant for the development and progression of chronic kidney disease (CKD). The purpose of this study is to assess the rate of uncontrolled blood pressure (BP) and identify its associated factors in patients with predialysis CKD in Bali, Indonesia.Design/methodology/approachA cross-sectional study was conducted among 165 patients who attended the nephrology clinic in a central public hospital in Bali. Data were obtained by measuring BP at threshold 130/80 mmHg, as well as collected through standardized questionnaires. Univariate analysis was done using Chi-square test, and multivariate analyses were carried out using multiple logistic regression.FindingsA total of 165 patients (111 males and 54 females) with predialysis CKD participated in this study. About 64% of the participants had uncontrolled BP. In multiple logistic regression, all selected variables significantly explained 63.2% of the variance in uncontrolled BP. However, low physical activity (odds ratio [OR] = 24.287, 95% confidence interval [CI]: 3.114–189.445), unhealthy dietary pattern (OR = 10.153, 95% CI: 2.770–37.210), as well as perceived moderate stress (OR = 4.365, 95% CI: 1.024-18.609) and high stress (OR = 10.978, 95% CI: 2.602–46.312) were significantly associated with uncontrolled BP.Research limitations/implicationsThe study findings provide evidence for health care providers to improve BP control among patients with predialysis CKD.Originality/valueControlling BP among patients with predialysis CKD was poor. Lifestyle modification and stress management are keys to improving BP control.

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Visceral adiposity index is closely associated with albuminuria in the Chinese population with prediabetes: results from the REACTION study

10.21203/rs.3.rs-28851/v1 ◽

2020 ◽

Author(s):

Jie Wang ◽

Binruo Zhu ◽

Xinye Jin ◽

Kang Chen ◽

Wenhua Yan ◽

...

Keyword(s):

Blood Pressure ◽

Logistic Regression ◽

Chinese Population ◽

Multiple Logistic Regression Analysis ◽

Visceral Obesity ◽

Visceral Adiposity ◽

Visceral Adiposity Index ◽

Multiple Logistic Regression ◽

Adiposity Index ◽

Increased Risk

Abstract Background Visceral obesity is a major health issue and a risk factor for atherogenic state. It has been reported to be a crucial link between albuminuria and cardiovascular diseases (CVD). However, there is limited available data on the relationship between visceral obesity and albuminuria. Therefore, we aimed to explore the association between visceral obesity and albuminuria in the Chinses population with prediabetes. Methods This cross-sectional study included 24871 prediabetic participants aged over 40 years from seven centers across China. Visceral adiposity index (VAI), which has been confirmed as a simple and reliable indicator of visceral adiposity distribution and dysfunction, is determined based on the measurements of anthropometric indices and lipid parameters. Increased albuminuria was defined as urinary albumin-creatinine ratio (UACR)≥30 mg/g, indicating kidney damage. Propensity score matching was used to reduce the bias and multiple logistic regression model was performed to evaluate the association between visceral obesity and albuminuria in the population with prediabetes. Results Participants with increased UACR had increased VAI, age, blood pressure, triglycerides, poor glycemic control, and decreased estimated glomerular filtration rate (eGFR). The prevalence of CVD was higher in the increased UACR group. Multiple logistic regression analysis showed that VAI quartiles was positively associated with increased risk of albuminuria (Q2: odds rate (OR):1.10, 95% confidence intervals [CI]: 0.96-1.25; Q3: OR:1.16, 95%CI 1.01-1.32; Q4: OR:1.26, 95%CI 1.10-1.44, P for trend=0.001). Stratified analysis revealed that the association of VAI level with increased albuminuria risk was also observed in people who were young, women, overweight or obese, with poor control of blood pressure, and eGFR≥ 90 mL/min per 1.73 m 2 . Conclusions Visceral obesity assessed by VAI was significantly associated with increased albuminuria in the Chinese population with prediabetes.

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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

10.21203/rs.3.rs-72125/v2 ◽

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.

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The relationship between leukocyte level and hypertension in elderly patients with hyperuricemia.

10.21203/rs.3.rs-31127/v1 ◽

2020 ◽

Author(s):

Lijin Shen ◽

Wei Zhao ◽

Mingzhen Li ◽

Bei Sun ◽

Zhichao Zhou ◽

...

Keyword(s):

Logistic Regression ◽

Risk Factor ◽

Elderly Patients ◽

Independent Risk Factor ◽

Serum Uric Acid Level ◽

Control Group ◽

Multiple Logistic Regression ◽

Cross Sectional ◽

Increased Risk ◽

The Relationship

Abstract Background : This study was to evaluate the change of leukocyte level caused by hyperuricemia and explore the relationship between leukocyte level and hypertension in elderly patients with hyperuricemia. Methods: A cross-sectional study of serum uric acid level was conducted in 1352 elderly people over 65 years old . The study samples were divided into three categories according to the tertiles of leukocyte: Tertile 1, leukocyte≤5.2 × 10 9 /L; Tertile 2, leukocyte=5.3~6.3 × 10 9 /L; and Tertile 3, leukocyte≥6.4 × 10 9 /L. Multiple logistic regression models were used for modeling relationships between leukocyte, hyperuricemia and hypertension. In vitro, human vascular endothelial cells (HUVECs) were treated by different concentrations of UA (0, 4, 8, 16 mg/dl) for 24 h, then cells were collected. Some cytokines were measured. Reactive oxygen species (ROS) were analyzed with a fluorescence microscope. Results: The levels of leukocyte were higher in elderly patients with hyperuricemia than without hyperuricemia( P <0.01). In multiple logistic regression, hyperuricemia was an independent risk factor of leukocyte in Tertile 3 (OR=1.657, 95%CI: 1.180～2.328, P =0.004). The prevalences of hypertension were higher in elderly patients with hyperuricemia than without hyperuricemia (77.0% vs 63.5%, χ 2 =11.447, P =0.001). In multiple logistic regression (Model 1), hyperuricemia was an independent risk factor of hypertension (OR=1.536, 95%CI: 1.026～2.302, P =0.037). Leukocyte in Tertile 3 was an independent risk factor of hypertension in Model 2 (OR= 1.333, 95%CI: 1.031~1.724, P =0.028). Expression levels of IL-1β, iNOS and TNF-α were obviously higher in the 8mg/dl UA group and 16mg/dl UA group than that in the control group ( P <0.05). Expression level of eNOS was obviously lower in the 8mg/dl UA group and 16mg/dl UA group than that in the control group ( P <0.05). The production of ROS in the 8mg/dl UA group and in the 16mg/dl UA group were obviously higher than that in the control group ( P <0.05). Conclusion: The present study demonstrated that hyperuricemia was associated with an increased risk for hypertension. The chronic inflammation caused by hyperuricemia maybe one of important pathogenesis of incident hypertension in patients with hyperuricemia.

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Association between Hyperuricemia and Metabolic Syndrome: An Epidemiological Study of a Labor Force Population in Taiwan

BioMed Research International ◽

10.1155/2015/369179 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 12

Author(s):

Cheng-Yu Wei ◽

Chia-Cheng Sun ◽

James Cheng-Chung Wei ◽

Hsu-Chih Tai ◽

Chien-An Sun ◽

...

Keyword(s):

Metabolic Syndrome ◽

Logistic Regression ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Multiple Logistic Regression Analysis ◽

Density Lipoprotein ◽

Cross Sectional Study ◽

Multiple Logistic Regression ◽

Cross Sectional ◽

The Relationship

The increasing prevalence of metabolic syndrome (MetS) has become an important issue worldwide. Metabolic comorbidities of hypertension, obesity, and hyperlipidemia are shown as important risk factors for incident gout. The purpose of this study was to investigate the relationship between hyperuricemia and MetS. This is a cross-sectional study. The effective sample included 21,544 individuals who received worker health examinations at a local teaching hospital in Changhua County from 2008~2012. We used multiple logistic regression analysis to investigate the influences of hyperuricemia on MetS. The results showed that individuals with MetS had significantly higher blood pressure, fasting plasma glucose, triglycerides, waist circumference, and high-density lipoprotein cholesterol than those without MetS(P<0.001). Multiple logistic regression analysis revealed hyperuricemia to be an important factor of MetS. The risk of developing MetS is higher with high levels of serum uric acid (SUA) and the odds ratio (OR) of having MetS is 4.98 times higher for Tertile 3 than for Tertile 1 (95% CI = 4.16–5.97) and 4 times higher for Quartile 4 than for Quartile 1 (95% CI = 3.59–4.46). In conclusion, males are more likely to develop MetS than females, and the risk of having MetS increases with age and SUA concentration.

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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

Nutrition Journal ◽

10.1186/s12937-021-00675-8 ◽

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.

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