NDT Advance Access published online on November 26, 2007
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfm790
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Predictors of New-Onset Decline in Kidney Function in a General Middle-European Population
1 3rd Medical Department (Division of Nephrology, Diabetes and Hypertension), Donauspital, Sozialmedizinsches Zentrum Ost der Stadt Wien, Langobardenstrasse 122, A-1220, Vienna, Austria 2 Department of Health Prevention, Neutorgasse 15, A-1010, Vienna, Austria 3 Department of Statistics and Decision Support, University of Vienna, Universitätsstrasse 5, A-1090, Vienna, Austria 4 Department of Urology and Andrology, Donauspital, Sozialmedizinisches Zentrum Ost der Stadt Wien, Langobardenstrasse 122, A-1220, Vienna, Austria 5 Department of Nephrology, Krankenhaus der Elisabethinen, Fadingerstrasse 1, A-4010 Linz, Linz, Austria and, Medical University Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
Correspondence and offprint requests to: Rudolf P. Obermayr, 3rd Medical Department, Donauspital, Sozialmedizinisches Zentrum Ost der Stadt Wien, Langobardenstrasse 122, A-1220 Vienna, Austria (EU). Tel: +43-1-28802-5402; Fax: +43-1-28802-5480; E-mail: rudolf.obermayr{at}gmail.com
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Abstract |
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Background. Limited epidemiological data are available on predictors of new-onset kidney disease.
Methods. In this longitudinal cohort study, 17 375 apparently healthy volunteers of the general Viennese population (46.4% women, age range 20–84 years, men 20–89 years) performed a baseline examination at some time within the study period (1990–2005) and completed a median of two follow-up examinations [interquartile range (IQR) 1 to 4]; the median follow-up period was 7 years (IQR 4 to 11). The outcome of interest was the development of kidney disease, defined as a decrease of the glomerular filtration rate (GFR) <60 ml/min/1.73 m2 at the follow-up examinations [calculated by the abbreviated modification of diet in renal disease (MDRD) equation]. Logistic generalized estimating equations were used to analyse the relationship between the covariates and the outcome variable.
Results. The following parameters [odds ratios (OR) with 95% confidence intervals] predicted new-onset kidney disease: Age (increase by 5 years), OR = 1.36 (1.34–1.40); National Kidney Foundation-chronic kidney disease (NKF-CKD) stage 1 with proteinuria (+), OR = 1.39 (1.10–1.75); NKF-CKD stage 1 with proteinuria (
++), OR = 2.07 (1.11–3.87); NKF-CKD stage 2 with proteinuria (+), OR = 2.71 (2.10–3.51); NKF-CKD stage 2 with proteinuria (++), OR = 3.80 (2.29–6.31); body mass index, OR = 1.04 (1.02–1.06); current-smoker, OR = 1.20 (1.01–1.43); performing no sports, OR = 1.57 (1.27–1.95); uric acid (increase by 2 mg/dl), OR = 1.69 (1.59–1.80); HDL-cholesterol (decrease by 10 mg/dl), OR = 1.12 (1.07–1.17); hypertension stage 1, OR = 1.35 (1.08–1.67); hypertension stage 2, OR = 2.01 (1.62–2.51); diabetes mellitus, OR = 1.44 (1.07–1.93).
Conclusions. Cardiovascular risk factors as well as NKF-CKD stages 1 and 2 and proteinuria, the more the higher and an entirely novel finding, performing no sports, predicted new-onset kidney disease.
Keywords: Caucasian middle-European population; epidemiology; estimated glomerular filtration rate; new-onset kidney disease; predictors
Received for publication: 14. 7.07
Accepted in revised form: 10.10.07
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