| Titre : | Predictors of new-onset kidney disease in a community-based population. (2004) |
| Auteurs : | Caroline-S FOX ; CULLETON (Bruce) : CAN. University of Calgary Foothills Hospital. Calgary. AB. ; Martin-G LARSON ; Eric-P LEIP ; Daniel LEVY ; Peter-Wf WILSON ; Boston University School of Medicine. Boston. MA. USA ; National Heart Lung and Blood Institute's Framingham Heart Study. Framingham. MA. USA ; National Institutes of Health. National Heart Lung and Blood Institute. Bethesda. MD. USA |
| Type de document : | Article |
| Dans : | JAMA - Journal of the american medical association (vol. 291, n° 7, 2004) |
| Pagination : | 844-850 |
| Langues: | Anglais |
| Mots-clés : | Rein [pathologie] ; Communauté ; Homme ; Incidence ; Epidémiologie ; Appareil circulatoire [pathologie] ; Association ; Appareil urinaire [pathologie] |
| Résumé : | [BDSP. Notice produite par INIST-CNRS Y3R0xno0. Diffusion soumise à autorisation]. Context : Kidney disease is associated with an increased risk for the development of cardiovascular disease and end-stage renal disease ; however, risk factors for kidney disease have not been well studied. Objective : To identify predictors of the development of new-onset kidney disease. Design, Setting, and Participants : A community-based, longitudinal cohort study of 2585 participants who attended both a baseline examination in 1978-1982 and a follow-up examination in 1998-2001, and who were free of kidney disease at baseline. Main Outcome Measures : Kidney disease was assessed by the Modification of Diet in Renal Disease Study equation and defined by a glomerular filtration rate (GFR) in the fifth or lower percentile (<=59.25 mL/min per 1.73 m2 in women,<=64.25 mL/min per 1.73 m2 in men). Stepwise logistic regression was used to determine the impact of risk factors on the occurrence of new-onset kidney disease. Baseline and long-term, 12-year, averaged risk factor models were explored. Results : At baseline, there were 1223 men and 1362 women, with a mean age of 43 years, who were free of preexisting kidney disease. After a mean follow-up of 18.5 years, 244 participants (9.4%) had developed kidney disease. In multivariable models, baseline age (odds ratio [OR], 2.36 per 10-year increment ; 95% confidence interval [Cl], 2.00-2.78), GFR (<90 mL/min per 1.73 m2 : OR, 3.01 ; 95% Cl, 1.98-4.58 ; 90-119 mL/min per 1.73 m2 : OR, 1.84 ; 95% Cl, 1.16-2.93), body mass index (OR, 1.23 per 1 SD ; 95% Cl, 1.08-1.41), diabetes (OR, 2.60 ; 95% Cl, 1.44-4.70), and smoking (OR, 1.42 ; 95% Cl, 1.06-1.91) were related to the development of kidney disease. In addition to baseline age and GFR, the long-term, averaged risk factors that were predictive of kidney disease included hypertension (OR, 1.57 ; 95% Cl, 1.17-2.12), high-density lipoprotein cholesterol level (OR, 0.80 per 1 SD ; 95% Cl, 0.69-0.92), and diabetes (OR, 2.38 ; 95% Cl, 1.45-3.92). Compared with a normal GFR (>=120 mL/min per 1.73 m2), a mildly reduced GFR (<90 mL/min per 1.73 m2) predicted a 3-fold odds of progression to kidney disease (OR, 2.95 ; 95% Cl, 1.94-4.49). Conclusions : Established cardiovascular disease risk factors are associated with the development of new-onset kidney disease. Patients with a mildly reduced GFR should be monitored for progression to kidney disease. |
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