February 17, 2004JAMA
Predictors of New-Onset Kidney Disease in a Community-Based Population
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Discussion
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Implication
Longitudinal cohort study reveals cardiovascular risk factors predict new-onset kidney disease, indicating the value of early filtration monitoring.
Key Points
- To identify clinical and physiological risk factors that predict the development of new-onset kidney disease in a community-based setting.
- Conducted a community-based longitudinal cohort study of 2,585 participants free of baseline kidney disease examined in 1978–1982 and re-evaluated in 1998–2001 (mean follow-up: 18.5 years).
- Defined new-onset kidney disease using the MDRD equation as a glomerular filtration rate (GFR) in the fifth percentile or lower (≤59.25 mL/min/1.73 m² in women, ≤64.25 mL/min/1.73 m² in men).
- Employed stepwise multivariable logistic regression using baseline and 12-year averaged risk factor exposures.
- Over 18.5 years of mean follow-up, 244 participants (9.4%) developed new-onset kidney disease.
- Baseline predictors of new-onset kidney disease included age (OR, 2.36 per 10-year increment; 95% CI, 2.00–2.78), baseline GFR <90 mL/min/1.73 m² (OR, 3.01; 95% CI, 1.98–4.58), BMI (OR, 1.23 per 1 SD; 95% CI, 1.08–1.41), diabetes (OR, 2.60; 95% CI, 1.44–4.70), and smoking (OR, 1.42; 95% CI, 1.06–1.91).
- Long-term averaged risk factor models revealed independent associations for hypertension (OR, 1.57; 95% CI, 1.17–2.12), HDL cholesterol (OR, 0.80 per 1 SD; 95% CI, 0.69–0.92), diabetes (OR, 2.38; 95% CI, 1.45–3.92), and a mildly reduced baseline GFR under 90 mL/min/1.73 m² (OR, 2.95; 95% CI, 1.94–4.49).
Cite This Study
Caroline S. Fox (2004) studied this question.