Screening of a Population at Risk of Chronic Kidney Disease: Analysis of Factors Associated with Low eGFR and Microalbuminuria

Ležaić, Višnja; Dimković, Nada; Peković, Gordana Peruničić; Bukvić, Danica; Bajcetic, Sanja; Bontić, Ana; Zec, Nadezda; Pavlović, Jelena; Marinković, Jelena; Đukanović, Ljubica

doi:10.3109/0886022x.2011.615969

Cited by 7 publications

(9 citation statements)

References 35 publications

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“…In agreement with the results of this study, a number of studies have reported that cigarette smoking is associated with higher eGFR [22]–[24], while others have found the reverse [25], [41].…”

Section: Discussionsupporting

confidence: 92%

“…Research into the associations between later life influences and kidney function have shown conflicting results for body mass index (BMI) [16]–[20] and smoking [21]–[25], and a positive association for current SES [26]–[28]. The Newcastle Thousand Families birth cohort [29]–[30] provided a unique opportunity to analyse longitudinal data and investigate the effects of both early and later life influences on kidney function at age 63–64 years.…”

Section: Introductionmentioning

confidence: 99%

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Early Life Influences Kidney Function at Age 63–64 Years, but So Does Adult Body Size: Results from the Newcastle Thousand Families Birth Cohort

2013

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BackgroundIt is suggested that impaired fetal growth can affect kidney development, resulting in fewer glomeruli being formed and reduced kidney function later in life. The aim of this study was to investigate early life variables in relation to adult kidney function, and compare these to the influence of later life variables.MethodsDetailed information was collected prospectively regarding 1,142 babies, born in 1947 in Newcastle upon Tyne. At the age of 63–64 years, 335 participants had serum creatinine successfully measured and completed a lifestyle questionnaire. These measurements were used to calculate their estimated glomerular filtration rate (eGFR).ResultsBody mass index (BMI) and being female were significantly negatively associated with eGFR. Birth weight was significantly positively associated with eGFR. In sex-specific analyses, BMI and cigarette smoking remained significant for males (n = 154), with a near significant association for birth weight, whereas none of the variables remained significant for females (n = 181).ConclusionsThe findings suggest that sex, size at birth and BMI may be important variables influencing adult kidney function. However, as only a small amount of variance in eGFR was explained by these variables, additional longitudinal studies would be beneficial for assessing lifecourse influences on kidney function.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Early Life Influences Kidney Function at Age 63–64 Years, but So Does Adult Body Size: Results from the Newcastle Thousand Families Birth Cohort

2013

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“…While the bias introduced is negligible in many patients it cannot be ruled out that some where misclassified. It was recently shown however, that dipstick screening of microalbuminuria could be used in a population at risk of chronic kidney disease [35]. 5) We obtained no information on blood glucose or HbA1c.…”

Section: Discussionmentioning

confidence: 94%

Microalbuminuria indicates long-term vascular risk in patients after acute stroke undergoing in-patient rehabilitation

et al. 2012

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BackgroundPatients in neurologic in-patient rehabilitation are at risk of cardio- and cerebrovascular events. Microalbuminuria (MAU) is frequent and an important risk predictor but has not been validated in in-patient rehabilitation. We therefore aimed to examine MAU as an indicator of risk and predictor of vascular events in a prospective study.MethodsThe INSIGHT (INvestigation of patients with ischemic Stroke In neuroloGic reHabiliTation) registry is the first to provide large scale data on 1,167 patients with acute stroke (< 3 months) that survived the initial phase of high risk and were undergoing neurologic in-patient rehabilitation. MAU was determined by dipstick-testing and correlated to baseline clinical variables (stroke-origin, functional impairment, co-morbidity, ankle-brachial-index, intima-media-thickeness) as well as vascular events after one year of follow-up. Comparisons were made with the χ2 or Mann–Whitney-U Test. Relative risks (RR) with 95% confidence intervals (CI) were estimated using log-binominal models. To evaluate the association between MAU and new vascular events as well as mortality, we calculated hazard ratios (HR) using Cox proportional hazard regression.ResultsA substantial proportion of patients was MAU positive at baseline (33.1%). Upon univariate analysis these patients were about 4 years older (69 vs. 65 years; p < 0.0001), had a slightly higher body mass index (27.8 vs. 27.1 kg/m2; p = 0.03) and increased waist circumference (79.5 vs. 50.4% for women [p < 0.0001] and 46.8 vs. 43.2% for men [p = 0.04]) and twice as often had diabetes mellitus (41.8 vs. 20.1%; p < 0.0001). Patients with MAU had a similar NIH stroke scale score (median 3 vs. 3; p = 0.379) but had lower values on the Barthel Index (median 75 vs. 90; p < 0.001). They had higher rates of atrial fibrillation (RR 1.38; 95% CI 1.09-1.75), coronary artery disease (RR 1.54; 95% CI 1.18-2.00), heart failure (RR 1.70; 95% CI 1.10-2.60) symptomatic peripheral artery disease (RR 2.30; 95% CI 1.40-3.80) and atherosclerotic stroke etiology (53.7 vs. 35.4%; p < 0.0001). MAU was associated with an increased intima-media-thickness, decreased ankle-brachial-index and polyvascular disease (RR 1.56; 95%CI 1.31-1.99). The event rate after a median follow-up of 13 months was 6.7% for fatal or nonfatal stroke, 4.7% for death, and 10.9% for combined vascular events (stroke, MI, vascular death). The presence of MAU was predictive for vascular events during the following year (HR for total mortality 2.2; 95% CI 1.3-3.7; HR for cardiovascular events 2.3; 95% 1.2 - 4.4).ConclusionsINSIGHT demonstrated a significant association between MAU and polyvascular disease and further supports previous findings that MAU predicts cardio-/cerebrovascular events in patients recovering from ischemic stroke. This biomarker may also be used in patients during neurologic in-patient rehabilitation, opening a window of opportunity for early intervention in this patient group at increased risk for recurrent events.

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“…The most effective method is apparently to evaluate various clinical factors such as those suggested by the Kidney Heath Check: blood pressure, eGFR and urinalysis [7]. Other studies combine eGFR evaluation with microalbuminuria and/or proteinuria [11,12,13,14]. However, there is some debate whether these full tests are economically viable on a large scale [7,9,15].…”

Section: Discussionmentioning

confidence: 99%

A Cross-Sectional Study on the Use of Urinalysis for Screening Early-Stage Renal Insufficiency

Xue

Zhang

Teng

et al. 2016

Nephron

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Background/Aims: Proteinuria and hematuria detected by routine urinalysis can indicate impaired renal function. This study evaluated the effect of routine urinalysis in screening out patients with estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m² at an early stage and investigated its associated factors. Methods: Healthy adults who underwent physical examination between September 2008 and September 2013 were enrolled in the study (n = 43,516). Urine was analyzed for protein, and red and white blood cells. Ten milliliter blood samples were collected for serum creatinine, urea, albumin and other parameters for the estimation of eGFR and renal function. Results: Abnormal routine urinalysis was found in 7.1% and eGFR <60 ml/min/1.73 m² was found in 0.9% of subjects. Age and gender were similar in the overall and abnormal urinalysis populations (43 vs. 43 years and 36.7 vs. 38.2% females, respectively), but the eGFR <60 ml/min/1.73 m² group were older (64 years, p < 0.001) with increased females (46.4%, p = 0.002). Sensitivity for predicting eGFR <60 ml/min/1.73 m² was 0.110 and specificity was 0.928. Univariate and multivariate analyses in 6,318 subjects with more detailed clinical data suggested significant associations of sex (OR 0.058, 95% CI 0.030-0.113), age (OR 1.045, 95% CI 1.027-1.064), and high density lipoprotein (HDL) (OR 0.158, 95% CI 0.043-0.587) with eGFR <60 ml/min/1.73 m². Conclusion: Routine urinalysis showed a poor performance in the screening for early-stage renal insufficiency. In future, other screening methods should be considered. Age, gender and HDL were associated with eGFR <60 ml/min/1.73 m².

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Screening of a Population at Risk of Chronic Kidney Disease: Analysis of Factors Associated with Low eGFR and Microalbuminuria

Cited by 7 publications

References 35 publications

Early Life Influences Kidney Function at Age 63–64 Years, but So Does Adult Body Size: Results from the Newcastle Thousand Families Birth Cohort

Early Life Influences Kidney Function at Age 63–64 Years, but So Does Adult Body Size: Results from the Newcastle Thousand Families Birth Cohort

Microalbuminuria indicates long-term vascular risk in patients after acute stroke undergoing in-patient rehabilitation

A Cross-Sectional Study on the Use of Urinalysis for Screening Early-Stage Renal Insufficiency

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