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Age differences in the relationships between risk factors and loss of kidney function: a general population cohort study.

ABSTRACT: BACKGROUND:Annual decline in kidney function is a widely applied surrogate outcome of renal failure. It is important to understand the relationships between known risk factors and the annual decline in estimated glomerular filtration rate (eGFR) according to baseline age; however, these remain unclear. METHODS:A community-based retrospective cohort study of adults who underwent annual medical examinations between 1999 and 2013 was conducted. The participants were stratified into different age groups (40-49, 50-59, 60-69, 70-79, and???80?years) to assess the risk for loss of kidney function. A mixed-effects model was used to estimate the association between risk factors and annual changes in eGFR. RESULTS:In total, 51,938 participants were included in the analysis. The age group of ?80?years included 8127 individuals. The mean annual change in eGFR was -?0.39 (95% confidence interval: -?0.41 to -?0.37) mL/min/1.73?m2 per year. Older age was related to faster loss of kidney function. In the older age group, higher systolic blood pressure, proteinuria, and current smoking were related to faster loss of kidney function (p trend

SUBMITTER: Toyama T

PROVIDER: S-EPMC7664087 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Age differences in the relationships between risk factors and loss of kidney function: a general population cohort study.

Toyama Tadashi T Kitagawa Kiyoki K Oshima Megumi M Kitajima Shinji S Hara Akinori A Iwata Yasunori Y Sakai Norihiko N Shimizu Miho M Hashiba Atsushi A Furuichi Kengo K Wada Takashi T

BMC nephrology 20201113 1

<h4>Background</h4>Annual decline in kidney function is a widely applied surrogate outcome of renal failure. It is important to understand the relationships between known risk factors and the annual decline in estimated glomerular filtration rate (eGFR) according to baseline age; however, these remain unclear.<h4>Methods</h4>A community-based retrospective cohort study of adults who underwent annual medical examinations between 1999 and 2013 was conducted. The participants were stratified into d ...[more]

PMID: 33187480

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Project description:ObjectiveTo determine the association between baseline kidney function and subsequent all-cause mortality.Design and settingA general population-based cohort study from rural Uganda.ParticipantsPeople aged 18 years and above with measured baseline estimated glomerular filtration rate (eGFR), recruited from survey rounds in 2011-2012 or 2014-2015 and followed up to March 2019.Outcome measureThe primary outcome was all-cause mortality, identified through reports from community health workers and verified by verbal autopsy. The association between baseline eGFR category and mortality was determined using multivariable Cox regression.ResultsOf 5812 participants in both rounds, we included 5678 (97.7%) participants with kidney function and mortality data; the median age was 36 years (IQR 24-50), 60.7% were female, 10.3% were hypertensive, 9.8% were HIV-positive and 1.5% were diabetic. During a median follow-up of 5.0 years (IQR 3.7-6.0) there were 140 deaths. In age-adjusted and sex-adjusted analyses, eGFR <45 mL/min/1.73 m2 at baseline was associated with a 5.97 (95% CI 2.55 to 13.98) increased risk of mortality compared with those with baseline eGFR >90 mL/min/1.73 m2. After inclusion of additional confounders (HIV, body mass index, diabetes, hypertension, alcohol and smoking status) into the model, eGFR <45 mL/min/1.73 m2 at baseline remained strongly associated with mortality (HR 6.12, 95% CI 2.27 to 16.45), although the sample size fell to 3102. Test for trend showed strong evidence (p<0.001) that the rate of mortality increased progressively as the category of baseline kidney function decreased. When very high eGFR was included as a separate category in age-adjusted and sex-adjusted analyses, baseline eGFR ≥120 mL/min/1.73 m2 was associated with increased risk of mortality (HR 2.68, 95% CI 1.47 to 4.87) compared with the reference category of 90-119 mL/min/1.73 m2.ConclusionIn a prospective cohort in rural Uganda we found that impaired baseline kidney function was associated with subsequently increased total mortality. Improved understanding of the determinants of kidney disease and its progression is needed in order to inform interventions for prevention and treatment.

Dataset Information

Age differences in the relationships between risk factors and loss of kidney function: a general population cohort study.

Publications

Age differences in the relationships between risk factors and loss of kidney function: a general population cohort study.

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