Impact of Age and Overt Proteinuria on Outcomes of Stage 3 to 5 Chronic Kidney Disease in a Referred Cohort

Obi, Yoshitsugu; Kimura, Tomonori; Nagasawa, Yasuyuki; Yamamoto, Ryohei; Yasuda, Keiko; Sasaki, Koichi; Kitamura, Harumi; Imai, Enyu; Rakugi, Hiromi; Isaka, Yoshitaka; Hayashi, Terumasa

doi:10.2215/cjn.08061109

Cited by 56 publications

(45 citation statements)

References 49 publications

(36 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several investigators demonstrated that proteinuria was strongly associated with introduction to RRT [2,29], however, our analysis failed to determine a role of proteinuria. This might be due to heterogeneity of underlying renal diseases, because other data were based on population study, in that the prevalence of diabetic nephropathy was less.…”

Section: Variablescontrasting

confidence: 55%

See 1 more Smart Citation

Entity of Stage 4 CKD over 75 Years Old is Different from that of Less than 75 Years of Age: Characteristics of Elderly Patients with Stage 4 CKD

T¹

2014

J Nephrol Ther

View full text Add to dashboard Cite

IntroductionThe proportion of older people in the general population is steadily increasing and the fastest growing segment of that population during the past decade is older than 75 years. With this increases in prevalence of elderly people, proportion of prevalent chronic kidney disease (CKD) increased in parallel [1,2]. In spite of these situations, the appropriate treatment of older patients with CKD remains unclear. Moreover, there are a lot of unresolved problems in real world [3]. For example, are there any differences in underlying renal diseases in CKD patients <75 and >75 years?; what are the age-related risk factors for progression to end-stage renal disease (ESRD) and incidence of cardiovascular disease (CVD) [4,5]; is a chance of more cohesive multidisciplinary team approach to CKD producing catastrophic results in elderly CKD patients [6]. Previous reported cross sectional cohort studies failed to reveal what factors are more important for progression to ESRD and for occurrence of CVD in these populations [7]. Besides, it still remains uncertain whether the effects of multidisciplinary care are beneficial or not. Two studies correlated multidisciplinary care with modest improvements in survival [8], but another study showed no differences in kidney function or mortality between patients who received multidisciplinary, intensive care and those who did not [6].Therefore, in the present study, the longitudinal follow-up of elderly patients with stage 4 CKD was carried out in a single center in order to evaluate the characteristics and the prognosis of stage 4 CKD patients >75 years in comparison with those between 74 and 65 years and outcome of late nephrology referral in these patients. Subjects and MethodsThis was a prospective, observational, single-center cohort study. This study was conducted in accordance with the Declaration of Helsinki. Approval for the study was obtained from the Saitama Medical University Ethics Committee, and written informed consent was obtained from each participant.Patients were recruited from specialist renal clinics at Kidney Abstract Background: Although age had a strong effect on the risk of development to end-stage renal disease (ESRD), it is reported that stage 4 CKD patients aged >75 years were less likely to subsequently commence renal replacement therapy (RRT) than those aged <75 years. In the present study, the longitudinal follow-up of elderly patients with stage 4 CKD was carried out in a single center in order to evaluate the prognosis of the patients >75 years in comparison with those between 74 and 65 years and to characterize patients with stage 4 CKD older than 75 years.

show abstract

Section: Variablescontrasting

confidence: 55%

“…With this increases in prevalence of elderly people, proportion of prevalent chronic kidney disease (CKD) increased in parallel [1,2]. In spite of these situations, the appropriate treatment of older patients with CKD remains unclear.…”

mentioning

confidence: 99%

Entity of Stage 4 CKD over 75 Years Old is Different from that of Less than 75 Years of Age: Characteristics of Elderly Patients with Stage 4 CKD

T¹

2014

J Nephrol Ther

View full text Add to dashboard Cite

show abstract

“…During the observation period, 5337 subjects (44.8%) died and 245 subjects developed ESRD. Because many reports suggest that CKD patients die before ESRD onset, 16,17 especially among older patients, 18 this study might have underestimated the effect of smoking on CKD because ESRD was the study outcome. The relationship between smoking and CKD onset and progression in hypertensive patients has not been established, and further studies are required.…”

Section: Smoking and Ckd In Patients With Htmentioning

confidence: 98%

Cigarette smoking and chronic kidney diseases

et al. 2011

Self Cite

View full text Add to dashboard Cite

Observational studies have suggested that different chronic kidney diseases (CKDs) have differing relationships to smoking, but no randomized controlled trial has been conducted to examine this topic. In this article, we review available evidence concerning the relationship between smoking and each type of CKD in the general population as well as in patients with diabetes mellitus (DM), hypertension (HT), primary glomerulonephritis and kidney transplants. There is good evidence of a relationship between smoking and CKD in patients with IgA nephropathy and kidney transplant recipients, but not in patients with DM or HT. Interestingly, it has been reported that the effect of smoking on CKD progression varies depending on the CKD stage. This variation might indicate a cumulative effect of smoking, possibly through oxidative stress. A better understanding of the relationship between smoking and CKD would be useful for nephrologists.

show abstract

“…[1][2][3] Originally, CKD was defined by proteinuria and glomerular filtration rates (GFRs). 4 Similar to CVD, modifiable lifestyle factors, such as smoking, 5,6 alcohol, 7 sleep 8 and exercise, 9 contribute to CKD.…”

Section: Introductionmentioning

confidence: 99%

The association of alcohol and smoking with CKD in a Japanese nationwide cross-sectional survey

et al. 2017

Self Cite

View full text Add to dashboard Cite

Chronic kidney disease (CKD) is characterized by a reduced glomerular filtration rate (GFR) and proteinuria. Modifiable lifestyle factors such as smoking and alcohol contribute to CKD. Recent cohort studies have shown that moderate alcohol consumption attenuates the decline of the GFR and smoking has been previously shown to be associated with CKD. However, the association of smoking and alcohol consumption on CKD is not entirely clear. To examine whether there is evidence to assume that smoking is an effective modifier of the association between CKD and alcohol consumption, we conducted a cross-sectional study of a population of people who presented for a health checkup under a program that targets the insured population aged ≧ 40 years using data from the Specific Health Check and Guidance in Japan between April 2008 and March 2009. Of the 506 807 participants aged ⩾ 40 years, 292 013 (57.6%) were included in the present analysis. Outcomes were kidney dysfunction, as an eGFR of o60 ml/min/1.73 m 2 , and proteinuria. In nonsmokers, drinking a small amount was associated with a lower prevalence of proteinuria, but in smokers, the association between alcohol and proteinuria was not observed. The analysis regarding eGFR o60 ml/min/1.73 m 2 revealed that in both smokers and nonsmokers, alcohol consumption was inversely associated with the risk of CKD. Mild to moderate alcohol consumption might be associated with a lower risk of CKD (proteinuria and eGFR), especially among nonsmokers, because smoking might have modified the potential benefits of alcohol to prevent CKD.

show abstract

Impact of Age and Overt Proteinuria on Outcomes of Stage 3 to 5 Chronic Kidney Disease in a Referred Cohort

Cited by 56 publications

References 49 publications

Entity of Stage 4 CKD over 75 Years Old is Different from that of Less than 75 Years of Age: Characteristics of Elderly Patients with Stage 4 CKD

Entity of Stage 4 CKD over 75 Years Old is Different from that of Less than 75 Years of Age: Characteristics of Elderly Patients with Stage 4 CKD

Cigarette smoking and chronic kidney diseases

The association of alcohol and smoking with CKD in a Japanese nationwide cross-sectional survey

Contact Info

Product

Resources

About