Risk factors for chronic kidney disease in a community-based population: a 10-year follow-up study

Abstract

The purpose of this study was to explore risk factors affecting the incidence of chronic kidney disease (CKD) in general population. We conducted a 10-year follow-up study with 123 764 (male: 41 012, female: 82 752) adults aged 40 years and over who received community-based annual examinations. The primary outcome for the analysis was the development of CKD during the follow-up period. Predictors for the development of CKD were obtained by the significant hazard ratios (HR) in Cox regression model by sex. During the follow-up period, 4307 subjects (male: 2048, female: 2259) developed CKD stage I or II, and 19 411 subjects (male: 4257, female: 15 154) developed CKD stage III or higher. The baseline-adjusted predictor of developing CKD included age, glomerular filtration rate, hematuria, hypertension, diabetes, serum lipids, obesity, smoking status, and consumption of alcohol. Treated diabetes in male subjects, and treated hypertension, systolic blood pressure >160 mm Hg and/or diastolic blood pressure >100 mm Hg, diabetes, and treated diabetes in female subjects were associated with more than a doubling of the HR. For the development of CKD stage III or higher, proteinuria of >or= + +, and proteinuria and hematuria were associated with more than a doubling of the HR in male subjects. The prevalence of newly developed CKD over 10 years was 23 718 subjects (19.2%) in adults. This study suggested that not only hypertension and diabetes but also several metabolic abnormalities were independent risk factors for developing CKD.

Cigarette smoking and chronic kidney diseases

“…Of these studies, the largest cohort, which consisted of 123 764 subjects 440 years of age in the residential health system in Japan's Ibaragi prefecture, was reported by Yamagata et al 5 During the 10-year observational period of this study, 4307 subjects had newonset CKD stage 1 or 2 and 19 411 subjects had new-onset CKD stage 3-5. When new-onset CKD stage 1 or 2 was treated as the outcome of interest, multiple logistic regression analyses identified current smoking vs. never smoking as a significant risk factor (hazard ratio, 1.26; 95% confidence interval (CI), 1.14-141 for men; hazard ratio, 1.40; 95% CI, 1.16-169 for women).…”

Overweight, Obesity, and the Development of Stage 3 CKD: The Framingham Heart Study

“…1 CKD is a risk factor for cardiovascular disease (CVD), 2; 3 and this association is partly mediated through the association between CKD and diabetes, hypertension, dyslipidemia, smoking, and obesity. [4][5][6][7] Obesity is a major global health concern, and it precedes the development of many CVD risk factors, including diabetes 9; 10 hypertension, 11; 12 and dyslipidemia. 13; 14 Therefore, obesity may mediate the association with CKD through these risk factors.…”

Blood pressure components and risk for chronic kidney disease in middle-aged Japanese men: The Kansai Healthcare Study

“…[3][4][5][6][7] Some epidemiological studies have focused on which blood pressure (BP) components are superior as predictors of cardiovascular diseases, including systolic BP (SBP), diastolic BP (DBP), pulse pressure (PP) and mean arterial pressure (MAP). [8][9][10][11][12][13][14][15][16][17] However, the BP components that are the most important risks factor for CKD are currently unknown.…”

“…[3][4][5][6][7] BP is also divided into two other components: MAP, which reflects a steady component, and PP, which reflects a pulsatile component. [18][19][20][21] PP is mainly determined by ventricular ejection, arterial stiffness and the timing of the reflected waves, and it increases with advancing age.…”