Age differences in the relationships between risk factors and loss of kidney function: a general population cohort study

BMC Nephrology

Miho Shimizu¹  Shinji Kitajima¹  Megumi Oshima¹  Takashi Wada¹  Akinori Hara¹  Yasunori Iwata¹  Norihiko Sakai¹  Tadashi Toyama²  Kengo Furuichi³  Kiyoki Kitagawa⁴  Atsushi Hashiba⁵ 

[1] Department of Nephrology and Laboratory Medicine, Kanazawa University, Kanazawa, Japan;Department of Nephrology and Laboratory Medicine, Kanazawa University, Kanazawa, Japan;Innovative Clinical Research Center, Kanazawa University, Kanazawa, Japan;Department of Nephrology, Kanazawa Medical University School of Medicine, Uchinada, Japan;Division of Internal Medicine, National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan;Kanazawa Medical Association, Kanazawa, Japan;

关键词: Aged;    Chronic renal insufficiency;    Glomerular filtration rate;   

DOI  :  10.1186/s12882-020-02121-z

来源: Springer

【 摘 要 】

BackgroundAnnual decline in kidney function is a widely applied surrogate outcome of renal failure. It is important to understand the relationships between known risk factors and the annual decline in estimated glomerular filtration rate (eGFR) according to baseline age; however, these remain unclear.MethodsA community-based retrospective cohort study of adults who underwent annual medical examinations between 1999 and 2013 was conducted. The participants were stratified into different age groups (40–49, 50–59, 60–69, 70–79, and ≥ 80 years) to assess the risk for loss of kidney function. A mixed-effects model was used to estimate the association between risk factors and annual changes in eGFR.ResultsIn total, 51,938 participants were included in the analysis. The age group of ≥80 years included 8127 individuals. The mean annual change in eGFR was − 0.39 (95% confidence interval: − 0.41 to − 0.37) mL/min/1.73 m2 per year. Older age was related to faster loss of kidney function. In the older age group, higher systolic blood pressure, proteinuria, and current smoking were related to faster loss of kidney function (p trend < 0.01, 0.03, and < 0.01, respectively). Conversely, each age group showed similar annual loss of kidney function related to lower hemoglobin levels and diabetes mellitus (p trend 0.47 and 0.17, respectively).ConclusionsHigher systolic blood pressure, proteinuria, and smoking were related to faster loss of kidney function, and a greater effect size was observed in the older participants. More risk assessments for older people are required for personalized care.

【 授权许可】

CC BY