Association between family members of dialysis patients and chronic kidney disease: a multicenter study in China

Abstract

BackgroundFamily members of patients with end stage renal disease were reported to have an increased prevalence of chronic kidney disease (CKD). However, studies differentiated genetic and non-genetic family members are limited. We sought to investigate the prevalence of CKD among fist-degree relatives and spouses of dialysis patients in China.MethodsSeventeen dialysis facilities from 4 cities of China including 1062 first-degree relatives and 450 spouses of dialysis patients were enrolled. Sex- and age- matched controls were randomly selected from a representative sample of general population in Beijing. CKD was defined as decreased estimated glomerular (eGFR < 60 mL/min/1.73 m2) or albuminuria.ResultsThe prevalence of eGFR less than 60 mL/min/1.73 m2, albuminuria and the overall prevalence of CKD in dialysis spouses were compared with their counterpart controls, which was 3.8% vs. 7.8% (P < 0.01), 16.8% vs. 14.6% (P = 0.29) and 18.4% vs. 19.8% (P = 0.61), respectively. The prevalence of eGFR less than 60 mL/min/1.73 m2, albuminuria and the overall prevalence of CKD in dialysis relatives were also compared with their counterpart controls, which was 1.5% vs. 2.4% (P = 0.12), 14.4% vs. 8.4% (P < 0.01) and 14.6% vs. 10.5% (P < 0.01), respectively. Multivariable Logistic regression analysis indicated that being spouses of dialysis patients is negatively associated with presence of low eGFR, and being relatives of dialysis patients is positively associated with presence of albuminuria.ConclusionsThe association between being family members of dialysis patients and presence of CKD is different between first-degree relatives and spouses. The underlying mechanisms deserve further investigation.

Relatives in silent kidney disease screening (RISKS) study: A Chinese cohort study

“…In comparison with our previous study that screened silent kidney disease in asymptomatic individuals in Hong Kong, the present study reported a significantly higher prevalence of proteinuria (23.1% vs. 3.0%, P < 0.0001), haematuria (25.9% vs. 17.0%, P < 0.0001) and glycosuria (4.4% vs. 1.9%, P = 0.001), respectively . Furthermore, the prevalence of proteinuria (23.1%) in relatives of CKD patients in this study was higher than that from two regional studies in China (Wei et al : 12.9%; Kong et al : 14.4%), and from two population‐based screening programmes in the United States (9.9%) and United Kingdom (9.5%) . However, the proportion of first‐degree relatives with eGFR ≤60 mL/min per 1.73 m 2 was lower (0.5%) than that from two regional studies in China (Wei et al : 7.9%; Kong et al : 1.5%).…”

“…The presence of a first‐degree or second‐degree relative with ESRD was reported to increase the risk of developing ESRD by 3‐ to 5‐fold in Americans . In addition, subsequent studies revealed that a significant proportion of relatives of CKD patients had clinically ‘silent’ kidney diseases, which was manifested as asymptomatic proteinuria and/or microscopic haematuria . The reported prevalence of CKD in relatives of CKD patients ranged from 14% to 30% .…”

“…These findings granted support to the need for screening in these individuals that may carry higher risks of developing CKD compared with the general population. However, the aforementioned studies enrolled mainly relatives of ESRD or dialysis patients . A large‐scale regional study that investigated the prevalence of CKD in first‐degree relatives of CKD patients in China may not be fully representative because more than half of index patients belonged to stage 5 .…”

Association of Relatives of Hemodialysis Patients with Metabolic Syndrome, Albuminuria and Framingham Risk Score

“…The FRS allows for estimation of the individual’s 10-year risk of coronary heart disease by using traditional cardiac risk factors including age, gender, systolic BP, total cholesterol, HDL-C, and smoking status [7]. Previous studies found familial aggregation of traditional CVD risk factors, such as hypertension, diabetes, dyslipidemia, smoking and obesity among family members of CKD or ESRD patients [10], [30], [31], [36], [37]. Genetic traits and the clustering of shared environmental exposures and health behaviors may contribute to higher FRS and atherosclerotic CVD risk.…”

“…Family members of ESRD patients were reported to be at higher risks for development of CKD or ESRD [10]–[16]. In particular, CVD is the leading cause of death in this population [17].…”