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NDT Advance Access published online on April 9, 2008
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfn148
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Predictors of change in estimated GFR: a population-based 7-year follow-up from the Tromsø study

Jens Kronborg1,5, Marit Solbu1,3, Inger Njølstad2, Ingrid Toft1,3, Bjørn O. Eriksen3,4 and Trond Jenssen1,6

1 Institutes of Clinical 2 Community Medicine, University of Tromsø 3 Department of Nephrology 4 Clinical Research Center, University Hospital of North Norway, Tromsø 5 Department of Internal Medicine, Innlandet Hospital Trust, Lillehammer 6 Department of Nephrology, Rikshospitalet University Hospital, Oslo, Norway

Correspondence and offprint requests to: Jens Kronborg, Department of Internal Medicine, Innlandet Hospital Trust, Olav Aukrustsvej 6 N-2618, Lillehammer, Norway. E-mail: kronborg{at}broadpark.no, kronborg{at}sykehuset-innlandet.no



  Abstract

Background. Chronic kidney disease is associated with increased cardiovascular mortality, and even mild impairment of renal function is a cardiovascular risk factor. Several studies have investigated the risk factors for the development of end-stage renal disease, but little is known about predictors of change in renal function in the general population.

Methods. The present study included 2249 men and 2192 women without signs of kidney disease at baseline who were followed for 7 years from 1994 to 1995 in the Tromsø Study. Estimated glomerular filtration rate (eGFR) was calculated from the Modification of Diet in Renal Disease study equation. Gender-specific multiple linear regression analyses were used to assess predictors of change in eGFR ({Delta}GFR).

Results. Change in eGFR, measured in ml/min/1.73 m2/year, was associated with systolic blood pressure (SBP) [β-value for a 10-mmHg increase in SBP, men = –0.14, 95% confidence interval (CI) = –0.18 to –0.09; women = –0.07, 95% CI = –0.11 to –0.03] and fibrinogen [β-value for 1 SD increase in fibrinogen, men (1 SD: 0.85 g/L) = –0.12, 95% CI –0.20 to –0.03; women (1 SD: 0.80) = –0.11, 95% CI –0.20 to –0.02]. High alcohol consumption in men and high physical activity in women predicted an increase in eGFR. Higher albumin/creatinine ratio was associated with a decline in eGFR in men only.

Conclusions. Some risk factors for change in GFR seem to be gender specific but both high SBP and high levels of fibrinogen contribute to a more rapid decline in GFR for both men and women.

Keywords: cardiovascular risk factors; gender differences; general population; prospective study; renal function

Received for publication: 9.10.07
Accepted in revised form: 25. 2.08


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