Abdias Hurtado-Arestegui1,2, Raul Plata-Cornejo3, Arturo Cornejo3, Guiliana Mas4, Luz Carbajal4, Shailendra Sharma5, Erik R Swenson6, Richard J Johnson7, Jackelina Pando8. 1. Division of Nephrology, Hospital Arzobispo Loayza, Lima, Peru. ahurtadoa@hotmail.com. 2. Cayetano Heredia University, Av. Tejada 215, Dpto: 202, Miraflores, Lima 18, Lima, Peru. ahurtadoa@hotmail.com. 3. Instituto de Nefrología, La Paz, Bolivia. 4. Cayetano Heredia University, Av. Tejada 215, Dpto: 202, Miraflores, Lima 18, Lima, Peru. 5. Division of Renal Disease and Hypertension, The George Washington University, Washington, DC, USA. 6. Division of Pulmonary, Critical Care and Sleep Medicine, Medical Service, VA Puget Sound Health Care System, University of Washington, Seattle, WA, USA. 7. Division of Renal Diseases and Hypertension, University of Colorado, Denver, CO, USA. 8. Department of Paediatrics and Child Health, University College Cork, Cork, Ireland.
Abstract
BACKGROUND: High altitude renal syndrome has been described in populations with excessive erythrocytosis. We evaluated whether high altitude (HA) dwellers might be at increased risk for kidney disease. METHODS: We performed a cross-sectional study to investigate differences in prevalence of kidney function and metabolic syndrome in healthy subjects living at HA vs. sea level (SL) without any known history of hypertension, diabetes or chronic kidney disease. RESULTS: We examined 293 subjects, aged 40 to 60 years: 125 SL (154 m) and 168 HA (3640 m) dwellers. HA dwellers had higher serum creatinine, lower estimated glomerular function rate (eGFR) (69.5 ± 15.2 vs. 102.1 ± 17.8 ml/min/1.73 m2, p < 0.0001), more proteinuria and higher hemoglobin concentrations compared to SL subjects. HA subjects had a lower prevalence of metabolic syndrome. Hemoglobin concentrations correlated inversely with eGFR in female (p = 0.001) and male (p = 0.03) HA dwellers. Using logistic regression analysis to compare subjects with eGFR < 90 vs. > 90 ml/min/1.73 m2, a lower eGFR was associated with female gender (odds ratio adjusted: 5.65 [95% confidence interval: 2.43-13.13]; p = 0.001), high altitude (14.78 [6.46-33.79]; p = 0.001), hemoglobin (1.68 [1.16-2.43]; p = 0.001) and uric acid (1.93 [1.36-2.72]; p = 0.001). CONCLUSIONS: Dwellers at high altitude who are considered healthy have worse kidney function, a higher prevalence of proteinuria and a lower prevalence of metabolic syndrome compared to people living at SL.
BACKGROUND:High altitude renal syndrome has been described in populations with excessive erythrocytosis. We evaluated whether high altitude (HA) dwellers might be at increased risk for kidney disease. METHODS: We performed a cross-sectional study to investigate differences in prevalence of kidney function and metabolic syndrome in healthy subjects living at HA vs. sea level (SL) without any known history of hypertension, diabetes or chronic kidney disease. RESULTS: We examined 293 subjects, aged 40 to 60 years: 125 SL (154 m) and 168 HA (3640 m) dwellers. HA dwellers had higher serum creatinine, lower estimated glomerular function rate (eGFR) (69.5 ± 15.2 vs. 102.1 ± 17.8 ml/min/1.73 m2, p < 0.0001), more proteinuria and higher hemoglobin concentrations compared to SL subjects. HA subjects had a lower prevalence of metabolic syndrome. Hemoglobin concentrations correlated inversely with eGFR in female (p = 0.001) and male (p = 0.03) HA dwellers. Using logistic regression analysis to compare subjects with eGFR < 90 vs. > 90 ml/min/1.73 m2, a lower eGFR was associated with female gender (odds ratio adjusted: 5.65 [95% confidence interval: 2.43-13.13]; p = 0.001), high altitude (14.78 [6.46-33.79]; p = 0.001), hemoglobin (1.68 [1.16-2.43]; p = 0.001) and uric acid (1.93 [1.36-2.72]; p = 0.001). CONCLUSIONS: Dwellers at high altitude who are considered healthy have worse kidney function, a higher prevalence of proteinuria and a lower prevalence of metabolic syndrome compared to people living at SL.
Entities:
Keywords:
Cardiovascular risk; High altitude; Kidney function; Proteinuria
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