14 research outputs found
Anthropometric and Metabolic Risk Factors for ESRD Are Disease-Specific: Results from a Large Population-Based Cohort Study in Austria.
Anthropometric and metabolic risk factors for all-cause end-stage renal disease (ESRD) may vary in their impact depending on the specific primary renal disease.In this Austrian population-based prospective cohort study (n = 185,341; 53.9% women) the following data were collected between 1985 and 2005: age, sex, body mass index (BMI), fasting blood glucose (FBG) from 1988, blood pressure, total cholesterol (TC), triglycerides (TG), gamma-glutamyl transferase (GGT) and smoking status. These data were merged with the Austrian Dialysis and Transplant Registry to identify ESRD patients. Cox proportional hazards models were applied to calculate hazard ratios (HR) for all-cause ESRD as well as for cause-specific ESRD due to the following primary renal diseases: autosomal dominant polycystic kidney disease (ADPKD), vascular nephropathy (VN), diabetic nephropathy (DN) and other diseases (OD).During a mean follow-up of 17.5 years 403 participants developed ESRD (ADPKD 36, VN 97, DN 86, and OD 184). All parameters except TG and GGT were significantly associated with all-cause ESRD risk. Particular cause-specific ESRD risk factor patterns were found: for ADPKD increased risk from hypertension (HR 11.55); for VN from smoking (HR 1.81), hypertension (HR 2.37), TG (≥5.70 vs. <1.17 mmol/L: HR 9.27); for DN from smoking (HR 1.77), BMI (≥30 vs. 18.5-24.9 kg/m2: HR 7.55), FBG (≥6.94 vs. <5.55 mmol/L: HR 7.67), hypertension (HR 1.08), TG (≥5.70 vs. <1.17 mmol/L: HR 2.02), GGT (HR 2.14); and for OD from hypertension (HR 2.29), TG (≥5.70 vs. <1.17 mmol/L: HR 6.99) and TC (≥6.22 vs. <5.18 mmol/L: HR 1.56).Particular anthropometric and metabolic ESRD risk factors differ in importance depending on the primary renal disease. This needs to be considered for future preventive and therapeutic strategies addressing cause-specific ESRD
Sex- and Time-Dependent Patterns in Risk Factors of End-Stage Renal Disease: A Large Austrian Cohort with up to 20 Years of Follow-Up.
We investigated the association between metabolic factors and End-Stage Renal Disease (ESRD) and quantified the magnitude of their influence dependent on sex and time of exposure up to 20 years.A prospective cohort study was conducted to determine risk factors for the development of ESRD. From 1988 to 2005 185,341 persons (53.9% women) participated in the "Vorarlberg Health Monitoring and Promotion Programme" (VHM&PP). Data on body mass index (BMI), fasting blood glucose (FBG), systolic (BPsys) and diastolic (BPdia) blood pressure, total cholesterol (TC), triglycerides (TG), gamma-glutamyltransferase (GGT) and smoking status were collected. Data of the population-based VHM&PP were merged with the Austrian Dialysis and Transplant Registry. Cox proportional hazards models were applied to calculate hazard ratios (HRs) for ESRD, stratified by sex and 5-year time intervals.During a mean follow-up of 17.5 years 403 patients (39.1% women) developed ESRD. Significant risk factors were: BMI (per 1 kg/m2) HR 1.04 (95% CI 1.01-1.06), FBG (per 1 mmol/L) HR 1.09 (1.05-1.12), BPsys (per 5 mmHg) HR 1.10 (1.07-1.14), BPdia (per 5 mmHg) HR 1.09 (1.03-1.15), TG (per 1 mmol/L) HR 1.07 (1.02-1.13), TC (per 1 mmol/L) HR 1.22 (1.13-1.32). We observed a sex-specific risk pattern with an increased ESRD risk for men for increasing TG and smoking, and for women for increasing BMI and GGT. In time interval analyses BPsys and TC were associated with early ESRD onset, whereas BMI, FBG, BPdia and GGT were associated with later onset.Anthropometric and metabolic factors are differentially associated with the long-term risk for ESRD in a sex- and time-dependent manner. Consideration of these patterns in preventive and therapeutic strategies could have an impact on ESRD incidence
Baseline characteristics of study population.
<p>Baseline characteristics of study population.</p
Associations between risk factors and end-stage renal disease.
<p>*Basic adjustment model, adjusted for age, sex and smoking status.</p><p>**Fully adjusted model including all metabolic factors simultaneously adjusted for age, sex and smoking status</p><p>Associations between risk factors and end-stage renal disease.</p
Hazard ratio (dark line, 95% CI: light lines) for cause-specific ESRD for body mass index (BMI) and blood glucose levels, modeled using cubic restricted splines.
<p>(a) ADPKD, (b) vascular nephropathy, (c) diabetic nephropathy and (d) other diseases. Medians of metabolic parameters were used as reference. Models were adjusted for age, sex, smoking status and mutually adjusted for metabolic parameters (as linear terms, logarithmized for triglycerides and gamma-GT).</p
Hazard ratios (HR) for all-cause and cause-specific ESRD for discrete variables.
<p>Hazard ratios (HR) for all-cause and cause-specific ESRD for discrete variables.</p
Associations between risk factors and end-stage renal disease for continuous data.
<p>*Basic adjustment model, adjusted for age, sex and smoking status.</p><p>**Fully adjusted model including all metabolic factors simultaneously adjusted for age, sex and smoking status).</p><p>Associations between risk factors and end-stage renal disease for continuous data.</p
Hazard ratio (dark line, 95% CI: light lines) for cause-specific ESRD for systolic and diastolic blood pressure (BP), modeled using cubic restricted splines.
<p>(a) ADPKD, (b) vascular nephropathy, (c) diabetic nephropathy and (d) other diseases. Medians of metabolic parameters were used as reference. Models were adjusted for age, sex, smoking status and mutually adjusted for metabolic parameters (as linear terms, logarithmized for triglycerides and gamma-GT).</p
Association between risk factors and end-stage renal disease for continuous data considering 5-year time intervals.
<p>*Cox models including all metabolic factors simultaneously adjusted for, age, sex, smoking status) for each time interval.; HR: Hazard Ratios; CI: Confidence Interval.</p><p>Association between risk factors and end-stage renal disease for continuous data considering 5-year time intervals.</p
Event rates for all-cause and cause-specific ESRD.
<p>Event rates for all-cause and cause-specific ESRD.</p