Patients who develop AKI during a hospitalization are at substantial risk for the development of CKD by 1 year following hospitalization and timing of AKI recovery is a strong predictor, even for the mildest forms of AKI.
To characterize demographic and regional variation in kidney stone prevalence in the U.S. we studied two nationwide cross-sectional surveys that included data on self-reported, physician-diagnosed kidney stones, supplementing published data on hospitalizations for stones. The larger study, Cancer Prevention Study II (CPS II), included 1,185,124 men and women, age > or = 30, recruited nationally in 1982, and provides state-specific prevalence estimates. The National Health and Nutrition Examination Survey (NHANES II) was a national probability sample of 25,286 U.S. adults interviewed between 1976 and 1980. Kidney stone prevalence increased with age until age 70, then declined and was higher in men than women and in whites than blacks. Prevalence among Hispanic and Asian men was intermediate between that of whites and blacks. There was a strong, statistically significant regional variability in stone prevalence among U.S. whites. The age-adjusted prevalence increased from north to south, and from west to east. The contrast in state-specific prevalence was greatest between men in North Carolina (prevalence = 14.9; 95% confidence interval = 14.2 to 15.7) and North Dakota (5.6; 4.7 to 6.4), and between women in South Carolina (6.4; 5.8 to 6.9) and South Dakota (2.4; 1.9 to 2.9). The marked variations in kidney stone prevalence by age, gender, race, and geographic location may provide clues to their etiology and prevention.
Abstract. The factors associated with proteinuria were examined in a large multiracial Asian population participating in a screening program aimed at the early detection of renal disease. Of 213,873 adults who participated, 189,117 with complete data were included. Malay race, increasing age, both extremes of body mass index (BMI), self-reported family history of kidney disease (FKD), and higher systolic and diastolic BP measurements (even at levels classified as being within the normal range) were independently associated with dipstickpositive proteinuria. The odds ratios (OR) for proteinuria increased progressively with age. There was a J-shaped relationship between BMI and proteinuria (OR of 1.3, 1.00, 1.3, 1.6, and 2.5 for BMI of Յ18.00, 23.00 to 24.99, 25.00 to 27.49, 27.50 to 29.99, and Ն30.00 kg/m 2 , respectively, compared with BMI of 18.01 to 22.99 kg/m 2 ). OR for proteinuria according to systolic and diastolic BP were significantly increased beginning at levels of 110 and 90 mmHg, respectively. In addition, the Malay race was associated with a significantly higher OR for proteinuria, compared with the Chinese race (OR of 1.3). Finally, FKD was significantly associated with proteinuria (OR of 1.7), whereas a family history of diabetes mellitus and a family history of hypertension were not. When family histories were analyzed by clustering, isolated FKD remained a significant determinant of proteinuria and the magnitude of the effect was not significantly different from that observed in the presence of a coexisting family history of diabetes mellitus or hypertension. This is the first study to evaluate factors associated with proteinuria in an Asian population. The epidemiologic study of renal disease in this population suggests that risk factors for renal disease might differ significantly among racial groups.
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