Prevalence and Predictors of Renal Disease in a National Representative Sample of the Romanian Adult Population: Data from the SEPHAR IV Survey

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Chronic kidney disease and hypertension (n=883). Intervention: Serum uric acid (SUR) > 6.9 mg/dL vs. Serum uric acid (SUR) ≤ 6.9 mg/dL. Primary outcome: Prevalence of chronic kidney disease (defined as eGFR < 60 mL/min/1.73 m2 and one or more markers of kidney damage) (OR 6.61, 95% CI 2.063, 10.83, p=0.004).

Q: What does this research mean for the field?

Serum uric acid levels exceeding 6.9 mg/dL are an independent predictor of chronic kidney disease in adults, with CKD prevalence being more than ten-fold higher among hypertensives than normotensives. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Călin Pop; Oana Gheorghe‐Fronea; Ioana Antonia Branea; Lucian Itu; Roxana Darabont; Irinel Parepa; Theodora Benedek; Maria Dorobanţu

doi:10.3390/diagnostics12123199

December 16, 2022DiagnosticsOpen Access

Prevalence and Predictors of Renal Disease in a National Representative Sample of the Romanian Adult Population: Data from the SEPHAR IV Survey

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Key result

Serum uric acid > 6.9 mg/dL was an independent predictor of chronic kidney disease (OR 6.61, 95% CI 2.063-10.83, p=0.004) in Romanian adults, with CKD prevalence reaching 4.49% in hypertensives.

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Why the study?

Chronic kidney disease correlates with hypertension, prompting investigation into the prevalence and predictors of CKD in a representative sample of the Romanian adult population.

What is the prevalence of chronic kidney disease and is elevated serum uric acid (>6.9 mg/dL) an independent predictor of chronic kidney disease in a nationally representative sample of Romanian adults?

Key Points

To evaluate the prevalence and independent predictors of chronic kidney disease in a representative sample of the Romanian adult population.
Analyzed data from 883 adult participants who completed renal laboratory testing within the Romanian SEPHAR IV survey (sample of 1470 enrolled subjects).
Calculated estimated glomerular filtration rate (eGFR) using the CKD-EPI equation, defining chronic kidney disease (CKD) as an eGFR < 60 mL/min/1.73 m2.
Identified independent predictors using multivariable logistic regression adjusted for age, sex, and diabetes mellitus status.
Chronic kidney disease was identified in 2.15% (19/883) of participants, with a prevalence of 4.49% (17/379) among hypertensive adults compared with 0.39% (2/504) in normotensive adults, while 89.47% (17/19) of individuals with CKD had hypertension.
Participants with CKD were older (71.94 ± 7.4 vs. 50.3 ± 16.21 years, p < 0.0001) and had higher serum uric acid levels (7.44 ± 1.51 vs. 5.26 ± 1.57 mg/dL).
After adjusting for age, sex, and diabetic status, serum uric acid > 6.9 mg/dL was an independent predictor of CKD (OR: 6.61; 95% CI: 2.063, 10.83; p = 0.004).

Study Design

Type

Cross-Sectional (n=883)

Multicenter

Yes

Structured PICO

What is the prevalence of chronic kidney disease and is elevated serum uric acid (>6.9 mg/dL) an independent predictor of chronic kidney disease in a nationally representative sample of Romanian adults?

P

Population

883 Romanian adults (mean age 60.9 years, 59.23% female) from the nationally representative SEPHAR IV survey who completed renal laboratory evaluations across two study visits within a four-day interval.

E

Exposure

Exposure to hyperuricemia defined as serum uric acid (SUR) > 6.9 mg/dL, and hypertension (SBP ≥140 mmHg and/or DBP ≥90 mmHg at two visits or antihypertensive treatment).

C

Comparator

Normouricemia (SUR ≤ 6.9 mg/dL) and normotensive status.

O

Outcome

Prevalence and independent predictors of chronic kidney disease (CKD), defined as 2021 CKD-EPI eGFR < 60 mL/min/1.73 m2 and/or markers of kidney damage (e.g., albuminuria ACR > 30 mg/g or AER > 30 mg/24 h).surrogate

Main Result

Odds Ratio: 6.61 (95% CI 2.063–10.83)

p-value: p=0.004

Limitations

Single measurement of corresponding variables, which could impact the SUR and CKD definitions
Limited sample of participants with complete renal data (883 out of 1470 enrolled)
Cross-sectional design that limited the interpretation of determinants and causal relationships
Single measurement of corresponding variables (which could impact the SUR and CKD definitions)
Limited sample of those with complete renal data (883 out of 1470 enrolled)

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Implication

In a nationally representative Romanian adult cohort, CKD prevalence was more than tenfold higher in hypertensive than normotensive adults (4.49% vs 0.39%), and serum uric acid > 6.9 mg/dL was identified as a strong independent predictor of CKD.

Abstract

Background: The prevalence of chronic kidney disease (CKD) correlates with the prevalence of hypertension (HT). We studied the prevalence and predictors of CKD in a representative sample of the Romanian adult population. Methods: A sample of 1470 subjects were enrolled in the SEPHAR IV (Study for the Evaluation of Prevalence of Hypertension and Cardiovascular Risk) survey. All subjects were evaluated for blood pressure (BP) and extensive evaluations of target organ damage, blood, and urine samples were undertaken. Results: A total of 883 subjects were included in the statistical analysis. Those experiencing CKD with an eGFR < 60 mL/min/1.73 m2 were older at 71.94 ± 7.4 years (n = 19, 2.15%) compared with those without renal impairment at 50.3 ± 16.21 years (n = 864, 97.85%), p < 0.0001. The prevalence of CKD among hypertensives (379 from 883) was 4.49% (17/379), while 17 out of 19 subjects with CKD had HT (89.47%). After adjusting for age, sex, and diabetic status, only serum uric acid (SUR) > 6.9 mg/dL (OR: 6.61; 95% CI: 2.063, 10.83; p = 0.004) was an independent risk factor and a predictor of CKD. Conclusions: The prevalence of CKD in hypertensive Romanian adults was more than ten times higher than in the normotensive population. Levels of SUR > 6.9 mg/dL were predictors of CKD.

Discussion

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Cite This Study

Pop et al. (2022) conducted a cross-sectional in Chronic kidney disease and hypertension (n=883). Serum uric acid (SUR) > 6.9 mg/dL vs. Serum uric acid (SUR) ≤ 6.9 mg/dL was evaluated on Prevalence of chronic kidney disease (defined as eGFR < 60 mL/min/1.73 m2 and one or more markers of kidney damage) (OR 6.61, 95% CI 2.063, 10.83, p=0.004). Serum uric acid > 6.9 mg/dL was an independent predictor of chronic kidney disease (OR 6.61, 95% CI 2.063-10.83, p=0.004) in Romanian adults, with CKD prevalence reaching 4.49% in hypertensives.

synapsesocial.com/papers/6a75d7b087be37a05b1625f8 https://doi.org/10.3390/diagnostics12123199

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Prevalence and Predictors of Renal Disease in a National Representative Sample of the Romanian Adult Population: Data from the SEPHAR IV Survey

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Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Prevalence and Predictors of Renal Disease in a National Representative Sample of the Romanian Adult Population: Data from the SEPHAR IV Survey

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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