Risk factors and their interaction on chronic kidney disease: A multi-centre case control study in Taiwan

BMC Nephrology

Yuh-Feng Lin⁹  Hung-Yi Chiou³  Yu-Mei Hsueh³  Mei-Yi Wu⁵  Yung-Ho Hsu⁵  Ming-Cheng Wang^1,10  Shang-Jyh Hwang²  Chih-Wei Yang^1,11  Yu Yang¹  Chien-Te Lee⁶  Ying-Chin Ko⁷  Fung-Chang Sung⁷  Jin-Shuen Chen⁹  Yu-Lung Chiu⁴  Hsin-Yi Yang⁴  Ching-Huang Lai⁴  Kuo-Cheng Lu^1,12  Chia-Chao Wu⁹  SenYeong Kao⁴  Chin Lin⁸  Sui-Lung Su⁴ 

[1] The Division of Nephrology, Changhua Christian Hospital, Changhua, Taiwan;Division of Nephrology, Department of Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan;School of Public Health, Taipei Medical University, No. 250, Wuxing St., Xinyi District, Taipei 110, Taiwan;School of Public Health, National Defense Medical Center, Taipei, Taiwan;Division of Nephrology, Department of Medicine, Shuang Ho Hospital, Graduate Institute of Clinical Medicine, Taipei Medical University, No. 250, Wuxing St., Xinyi District, Taipei 110, Taiwan;Division of Nephrology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung Medical University, Kaohsiung, Taiwan;School of Public Health, Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan;Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan;Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan;Department of internal Medicine, Cheng Kung University Medicial Center, Tainan, Taiwan;School of Medicine, Chang Gung University, Taoyuan, Taiwan;Division of Nephrology, Department of Medicine, Cardinal Tien Hospital, School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan

关键词: Interaction;    Hyperlipidaemia;    Anaemia;    Hypertension;    Chronic kidney disease;   

Others  :  1220061
DOI  :  10.1186/s12882-015-0065-x

 received in 2014-10-14, accepted in 2015-05-19,  发布年份 2015

【 摘 要 】

Background

Chronic kidney disease (CKD) is highly prevalent in Taiwan. More than two-thirds of end-stage renal disease is associated with diabetes mellitus (DM) or hypertension (HTN). Therefore, the formulation of a special preventative policy of CKD in these patients is essential. This study surveyed 14 traditional risk factors and identified their effects on CKD in patients with HTN/DM and compared these with their effects in the general population.

Methods

This study included 5328 cases and 5135 controls in the CKD/HTN/DM outpatient and health centres of 10 hospitals from 2008 to 2010. Fourteen common effect factors were surveyed (four demographic, five disease and five lifestyle), and their effects on CKD were tested. Significance tests were adjusted by the Bonferroni method. Results of the stratified analyses in the variables were presented with significant heterogeneity between patients with different comorbidities.

Results

Male, ageing, low income, hyperuricemia and lack of exercise habits were risk factors for CKD, and their effects in people with different comorbidities were identical. Anaemia was a risk factor, and there was an additive effect between anaemia and HTN on CKD. Patients with anaemia had a higher risk when associated with HTN [odds ratio (OR) = 6.75, 95 % confidence limit (95 % CI) 4.76–9.68] but had a smaller effect in people without HTN (OR 2.83, 95 % CI 2.16–3.67). The association between hyperlipidaemia-related factors and CKD was also moderated by HTN. It was a significant risk factor in people without HTN (OR = 1.67, 95 % CI 1.38–2.01) but not in patients with HTN (OR =1.03, 95 % CI 0.89–1.19). Hepatitis B, hepatitis C, betel nut chewing, smoking, alcohol intake and groundwater use were not associated with CKD in multivariate analysis.

Conclusions

We considered that patients with HTN and anaemia were a high CKD risk population. Physicians with anaemic patients in outpatient clinics need to recognise that patients who also have HTN might be latent CKD cases.

【 授权许可】

   
2015 Su et al.

【 图 表 】

Fig. 1.

Fig. 2.

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