Estimated renal function and cardiovascular or non-cardiovascular mortality in community population: results from the national health and nutrition examination surveys

Author(s):  
Jieleng Huang ◽  
Xuebiao Wei ◽  
Mei Jiang ◽  
Zedazhong Su ◽  
Zhiwen Yang ◽  
...  

Abstract Background Renal insufficiency is an important risk factor for mortality in various populations. The present study was conducted to determine the optimal equation for the estimation of renal function in predicting adverse events in community population in US. Methods We examined the Cockcroft–Gault, modification of diet in renal disease (MDRD), Mayo Healthy-Chronic Kidney Disease (Mayo), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) derived estimated glomerular filtration rates (eGFR) and the association with cardiovascular or non-cardiovascular mortality among 25,677 participants of US National Health and Nutrition Examination Survey from 2005 to 2014. Results The cardiovascular mortality and non-cardiovascular mortality increased with decrease in renal function. The MDRD derived eGFR exhibited the lowest predictive ability for all-cause mortality in all participants. For cardiovascular mortality, the Cockcroft–Gault derived eGFR exhibited the highest predictive power compared with the MDRD (area under the curve [AUC]: 0.842 vs. 0.764, p < 0.001), Mayo (AUC: 0.842 vs. 0.812, p < 0.001) and CKD-EPI (AUC: 0.842 vs. 0.813, p < 0.001) derived eGFR. For non-cardiovascular mortality, the Cockcroft–Gault derived eGFR exhibited similar superiority in non-cardiovascular mortality. Conclusions The value of the Cockcroft–Gault equation was superior to the other three equations for the prediction of cardiovascular or non-cardiovascular mortality in community population. This equation can serve as a risk-stratification tool for long-term events in community population.

Life ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 904
Author(s):  
Kathleen E. Adair ◽  
Kelly R. Ylitalo ◽  
Jeffrey S. Forsse ◽  
LesLee K. Funderburk ◽  
Rodney G. Bowden

Metabolic syndrome (MetS) is associated with decreased renal function and chronic kidney disease (CKD). To date, no research regarding the sixteen possible constellations resulting in the diagnosis of MetS has been elucidated. The purpose of this study is to report renal function in sixteen metabolic constellations grouped into four metabolic clusters. Individuals (n = 2767; representing 86,652,073 individuals) from the 2013–2018 National Health and Nutrition Examination Surveys who met the criteria for MetS were included. Sixteen possible constellations of three or more risk factors were analyzed for renal function. Four metabolic clusters representing MetS with hyperglycemia (Cluster I), MetS with hypertension (Cluster II), MetS with hyperglycemia and hypertension (Cluster III), or MetS with normoglycemia and normotension (Cluster IV) were assessed for renal function and CKD status. Cluster III had the highest odds of CKD (OR = 2.57, 95% CL = 1.79, 3.68). Clusters II and III had the lowest renal function and were not different from one another (87.82 and 87.28 mL/min/1.73 m2, p = 0.71). The constellation with the lowest renal function consisted of hypertension, high triglycerides, and a large waist circumference (82.86 mL/min/1.73 m2), whereas the constellation with the highest renal function consisted of hyperglycemia, low HDL, and a large waist circumference (107.46 mL/min/1.73 m2). The sixteen constellations of MetS do not have the same effects on renal function. More research is needed to understand the relationship between the various iterations of MetS and renal function.


2019 ◽  
Vol 3 (s1) ◽  
pp. 126-126
Author(s):  
Magda Shaheen ◽  
Erfun Sadeghi ◽  
Senait Teklehaimanot

OBJECTIVES/SPECIFIC AIMS: The aim of the study is to examine the relation between dental fluorosis, serum and water levels of fluoride and Chronic Kidney Disease (CKD) among children. A link between dental fluorosis, fluoride level and CKD can be an indicator of the blind danger of fluoride toxicity that poses a great threat to the human health. METHODS/STUDY POPULATION: Dental fluorosis, serum and water levels of fluoride and CKD were examined in children 6-19 years old, using data from the National Health and Nutrition Examination Survey1999-2012 and 2013-2016. We used multiple logistic regression to adjust for the confounders (demographics, insurance, dental visit, and co-morbidity) to assess the relation between dental fluorosis, serum and water levels of fluoride and CKD. STATA 14.0 was used to analyze the data (sample design and weight). P < 0.05 is statistically significant. RESULTS/ANTICIPATED RESULTS: The prevalence of CKD was 13.9% and dental fluorosis was 34.3%. In the multivariate model, plasma fluoride level was independently associated with CKD (Adjusted Odds Ratio (AOR) = 1.68, 95% Confidence Interval (CI) = 1.06-2.68, p = 0.029) but not with dental fluorosis (AOR = 1.4, 95% CI = 0.87-2.2, p = 0.17) or water fluoride level (AOR = 0.91, 95% CI = 0.59-1.396, p = 0.659). DISCUSSION/SIGNIFICANCE OF IMPACT: Results indicated that serum fluoride level is independently associated with CKD but dental fluorosis and water fluoride level were not related to CKD. Increase awareness and screening for fluorosis in children are needed for early detection and prevention of organ damage. Prospective studies related to fluorosis and tissue damage are needed.


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