The association between urbanization and reduced renal function: findings from the China Health and Nutrition Survey

BMC Nephrology

Research Article

Yosuke Inoue¹  Amanda L. Thompson²  Amy H. Herring³  Annie Green Howard³  Michelle A. Mendez⁴  Penny Gordon-Larsen⁴ 

[1] Carolina Population Center, The University of North Carolina at Chapel Hill, 27516, Chapel Hill, NC, USA;Carolina Population Center, The University of North Carolina at Chapel Hill, 27516, Chapel Hill, NC, USA;Department of Anthropology, The University of North Carolina at Chapel Hill, 27599, Chapel Hill, NC, USA;Department of Nutrition, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, 27599, Chapel Hill, NC, USA;Carolina Population Center, The University of North Carolina at Chapel Hill, 27516, Chapel Hill, NC, USA;Department of Biostatistics, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, 27599, Chapel Hill, NC, USA;Carolina Population Center, The University of North Carolina at Chapel Hill, 27516, Chapel Hill, NC, USA;Department of Nutrition, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, 27599, Chapel Hill, NC, USA;

关键词: Glomerular filtration rate;    Creatinine;    Renal insufficiency;    China;    Urbanization;   

DOI  :  10.1186/s12882-017-0577-7

 received in 2016-12-31, accepted in 2017-05-08,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundWhile chronic kidney disease (CKD) is a growing public health concern in low- and middle-income countries, such as China, few studies have investigated the association between urbanization and the occurrence of CKD in those countries.MethodsWe investigated the association between urbanization and estimated glomerular filtration rate (eGFR), an important CKD risk marker. Data came from the China Health and Nutrition Survey wave 2009, in which we collected fasting serum, individual and household data along with community level urbanization data, which was used to derive a study-specific urbanization measure, in 218 communities across nine provinces. A total of 3644 men and 4154 women participants aged 18 years or older were included in the analysis. Reduced renal function was defined as eGFR of less than 60 mL/min/1.73 m2 measured using serum creatinine concentration (mg/dL).ResultsAfter adjusting for socio-demographic (e.g., age, education and household income), a sex-stratified multilevel logistic model revealed that living in a more urbanized community was associated with higher odds of reduced eGFR (odds ratio [OR] = 1.38 per one-standard deviation [SD] increase in the CHNS specific urbanization index, 95% confidence interval [CI] = 1.11–1.73 for men; OR = 1.35, 95% CI = 1.11–1.62 for women). After adjusting for behavioral variables (i.e., alcohol consumption, smoking, physical activity and diet), as well as obesity and cardiometabolic risk factors, the association was attenuated in men (OR = 1.25, 95% CI = 0.98–1.59), but remained statistically significant in women (OR = 1.24, 95% CI = 1.01–1.52).ConclusionOur findings suggest that living in an urban environment is linked with higher odds of reduced renal function independently of behavioral and cardiometabolic risk factors, which have been shown to increase along with urbanization.

【 授权许可】

CC BY   
© The Author(s). 2017