BACKGROUND AND OBJECTIVE: There are very few European cohort studies assessing the risk factors of end-stage renal disease (ESRD) in a community-based population. This study investigated the predictors of ESRD in Finland. DESIGN: Prospective cohort study. SETTING: Eastern Finland. SUBJECTS: A random sample of 25,821 men and women aged 25-64 years from the national population register participating in three independent cross-sectional population surveys in 1972, 1977 and 1982. Only the subjects without diagnosis of ESRD or chronic kidney disease based on the national register data were included in the study. MAIN OUTCOME MEASURE: Initiation of renal replacement therapy (dialysis or kidney transplantation) identified from the Finnish Registry for Kidney Diseases through December 31, 2006. RESULTS: A total of 94 cases with ESRD were identified during a mean follow-up period of 26.5 years. In a multivariate proportional subdistribution hazard regression analysis, taking into account death as a competing risk event, diabetes (hazard ratio [HR] 4.76, 95% confidence interval [CI] 2.32-9.79), hypertension (HR 2.21, 95% CI 1.19-4.12), obesity defined as body mass index > or =30 kg m(-2) (HR 2.02, 95 %CI 1.10-3.71) and male gender (HR 1.68, 95% CI 1.19-4.12) were independent risk factors for ESRD. CONCLUSION: The findings of the present study confirm that modifiable risk factors play a major role in the development of ESRD in the North-European population. People with diabetes, hypertension or obesity should be considered as the target groups when planning preventive measures to control the future epidemic of ESRD.
BACKGROUND AND OBJECTIVE: There are very few European cohort studies assessing the risk factors of end-stage renal disease (ESRD) in a community-based population. This study investigated the predictors of ESRD in Finland. DESIGN: Prospective cohort study. SETTING: Eastern Finland. SUBJECTS: A random sample of 25,821 men and women aged 25-64 years from the national population register participating in three independent cross-sectional population surveys in 1972, 1977 and 1982. Only the subjects without diagnosis of ESRD or chronic kidney disease based on the national register data were included in the study. MAIN OUTCOME MEASURE: Initiation of renal replacement therapy (dialysis or kidney transplantation) identified from the Finnish Registry for Kidney Diseases through December 31, 2006. RESULTS: A total of 94 cases with ESRD were identified during a mean follow-up period of 26.5 years. In a multivariate proportional subdistribution hazard regression analysis, taking into account death as a competing risk event, diabetes (hazard ratio [HR] 4.76, 95% confidence interval [CI] 2.32-9.79), hypertension (HR 2.21, 95% CI 1.19-4.12), obesity defined as body mass index > or =30 kg m(-2) (HR 2.02, 95 %CI 1.10-3.71) and male gender (HR 1.68, 95% CI 1.19-4.12) were independent risk factors for ESRD. CONCLUSION: The findings of the present study confirm that modifiable risk factors play a major role in the development of ESRD in the North-European population. People with diabetes, hypertension or obesity should be considered as the target groups when planning preventive measures to control the future epidemic of ESRD.
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Authors: Afshin Parsa; Christian Fuchsberger; Anna Köttgen; Conall M O'Seaghdha; Cristian Pattaro; Mariza de Andrade; Daniel I Chasman; Alexander Teumer; Karlhans Endlich; Matthias Olden; Ming-Huei Chen; Adrienne Tin; Young J Kim; Daniel Taliun; Man Li; Mary Feitosa; Mathias Gorski; Qiong Yang; Claudia Hundertmark; Meredith C Foster; Nicole Glazer; Aaron Isaacs; Madhumathi Rao; Albert V Smith; Jeffrey R O'Connell; Maksim Struchalin; Toshiko Tanaka; Guo Li; Shih-Jen Hwang; Elizabeth J Atkinson; Kurt Lohman; Marilyn C Cornelis; Asa Johansson; Anke Tönjes; Abbas Dehghan; Vincent Couraki; Elizabeth G Holliday; Rossella Sorice; Zoltan Kutalik; Terho Lehtimäki; Tõnu Esko; Harshal Deshmukh; Sheila Ulivi; Audrey Y Chu; Federico Murgia; Stella Trompet; Medea Imboden; Barbara Kollerits; Giorgio Pistis; Tamara B Harris; Lenore J Launer; Thor Aspelund; Gudny Eiriksdottir; Braxton D Mitchell; Eric Boerwinkle; Helena Schmidt; Edith Hofer; Frank Hu; Ayse Demirkan; Ben A Oostra; Stephen T Turner; Jingzhong Ding; Jeanette S Andrews; Barry I Freedman; Franco Giulianini; Wolfgang Koenig; Thomas Illig; Angela Döring; H-Erich Wichmann; Lina Zgaga; Tatijana Zemunik; Mladen Boban; Cosetta Minelli; Heather E Wheeler; Wilmar Igl; Ghazal Zaboli; Sarah H Wild; Alan F Wright; Harry Campbell; David Ellinghaus; Ute Nöthlings; Gunnar Jacobs; Reiner Biffar; Florian Ernst; Georg Homuth; Heyo K Kroemer; Matthias Nauck; Sylvia Stracke; Uwe Völker; Henry Völzke; Peter Kovacs; Michael Stumvoll; Reedik Mägi; Albert Hofman; Andre G Uitterlinden; Fernando Rivadeneira; Yurii S Aulchenko; Ozren Polasek; Nick Hastie; Veronique Vitart; Catherine Helmer; Jie Jin Wang; Bénédicte Stengel; Daniela Ruggiero; Sven Bergmann; Mika Kähönen; Jorma Viikari; Tiit Nikopensius; Michael Province; Helen Colhoun; Alex Doney; Antonietta Robino; Bernhard K Krämer; Laura Portas; Ian Ford; Brendan M Buckley; Martin Adam; Gian-Andri Thun; Bernhard Paulweber; Margot Haun; Cinzia Sala; Paul Mitchell; Marina Ciullo; Peter Vollenweider; Olli Raitakari; Andres Metspalu; Colin Palmer; Paolo Gasparini; Mario Pirastu; J Wouter Jukema; Nicole M Probst-Hensch; Florian Kronenberg; Daniela Toniolo; Vilmundur Gudnason; Alan R Shuldiner; Josef Coresh; Reinhold Schmidt; Luigi Ferrucci; Cornelia M van Duijn; Ingrid Borecki; Sharon L R Kardia; Yongmei Liu; Gary C Curhan; Igor Rudan; Ulf Gyllensten; James F Wilson; Andre Franke; Peter P Pramstaller; Rainer Rettig; Inga Prokopenko; Jacqueline Witteman; Caroline Hayward; Paul M Ridker; Murielle Bochud; Iris M Heid; David S Siscovick; Caroline S Fox; W Linda Kao; Carsten A Böger Journal: J Am Soc Nephrol Date: 2013-09-12 Impact factor: 10.121
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