Yang Wang1,2, Ming-Fei Du1, Wei-Hua Gao3, Bo-Wen Fu1, Qiong Ma6, Yu Yan1,2, Yue Yuan1,2, Chao Chu1,2, Chen Chen1, Yue-Yuan Liao1,2, Ke Gao1, Ke-Ke Wang1,2, Min Li1, Yue Sun1, Jia-Wen Hu4, Xin Chen5, Qiong Ma6, Dan Wang1, Xiao-Yu Zhang1, Chun-Hua Li7, Hao-Wei Zhou1, Wan-Hong Lu8, Zu-Yi Yuan1,2, John Chang9,10, Jian-Jun Mu11,12. 1. Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China. 2. Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China. 3. Department of Cardiology, Xi'an NO.1 Hospital, Xi'an, China. 4. Department of Cardiovascular Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China. 5. Department of Dermatology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China. 6. Department of Stomatology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China. 7. Department of Ophthalmology, Xi'an NO.4 Hospital, Xi'an, China. 8. Department of Nephrology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China. 9. Department of Medicine, Yale School of Medicine, New Haven, CT, USA. john.j.chang@yale.edu. 10. Department of Medicine, Veterans Administration Healthcare System, West Haven, CT, USA. john.j.chang@yale.edu. 11. Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China. mujjun@163.com. 12. Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China. mujjun@163.com.
Abstract
BACKGROUND/ OBJECTIVES: Chronic kidney disease (CKD) is a global public health problem, including in China. The aim of this study was to identify the risk factors for the development and progression of subclinical renal disease (SRD) in a Chinese population. We also examined whether the impact of the risk factors on SRD changed over time. SUBJECTS/ METHODS: To identify the predictors of SRD, we performed a cross-sectional study of the 2432 subjects in our Hanzhong Adolescent Hypertension Cohort. A subgroup of 202 subjects was further analyzed over a 12-year period from 2005 to 2017 to determine the risk factors for the development and progression of SRD. RESULTS: In cross-sectional analysis, elevated blood pressure, male gender, diabetes, body mass index, and triglyceride were independently associated with a higher risk of SRD. In longitudinal analysis, an increase in total cholesterol over a 4-year period and an increase in serum triglyceride over a 12-year period were independently associated with progression of albuminuria. Finally, increases in both total cholesterol and serum uric acid over a 4-year follow-up showed an independent association with a modest reduction in estimated glomerular filtration rate (eGFR). CONCLUSIONS: In this study of a Chinese cohort, we show several metabolic abnormalities as independent risk factors for subclinical renal disease in a Chinese cohort. In addition, we demonstrate that the effects of total cholesterol, triglycerides and uric acid on the development and progression of albuminuria or the decline in eGFR vary at different points of follow-up. These findings highlight the importance of early detection of metabolic abnormalities to prevent SRD.
BACKGROUND/ OBJECTIVES: Chronic kidney disease (CKD) is a global public health problem, including in China. The aim of this study was to identify the risk factors for the development and progression of subclinical renal disease (SRD) in a Chinese population. We also examined whether the impact of the risk factors on SRD changed over time. SUBJECTS/ METHODS: To identify the predictors of SRD, we performed a cross-sectional study of the 2432 subjects in our Hanzhong Adolescent Hypertension Cohort. A subgroup of 202 subjects was further analyzed over a 12-year period from 2005 to 2017 to determine the risk factors for the development and progression of SRD. RESULTS: In cross-sectional analysis, elevated blood pressure, male gender, diabetes, body mass index, and triglyceride were independently associated with a higher risk of SRD. In longitudinal analysis, an increase in total cholesterol over a 4-year period and an increase in serum triglyceride over a 12-year period were independently associated with progression of albuminuria. Finally, increases in both total cholesterol and serum uric acid over a 4-year follow-up showed an independent association with a modest reduction in estimated glomerular filtration rate (eGFR). CONCLUSIONS: In this study of a Chinese cohort, we show several metabolic abnormalities as independent risk factors for subclinical renal disease in a Chinese cohort. In addition, we demonstrate that the effects of total cholesterol, triglycerides and uric acid on the development and progression of albuminuria or the decline in eGFR vary at different points of follow-up. These findings highlight the importance of early detection of metabolic abnormalities to prevent SRD.
Authors: Daniel E Weiner; Hocine Tighiouart; Manish G Amin; Paul C Stark; Bonnie MacLeod; John L Griffith; Deeb N Salem; Andrew S Levey; Mark J Sarnak Journal: J Am Soc Nephrol Date: 2004-05 Impact factor: 10.121
Authors: K Yamagata; K Ishida; T Sairenchi; H Takahashi; S Ohba; T Shiigai; M Narita; A Koyama Journal: Kidney Int Date: 2006-11-22 Impact factor: 10.612
Authors: Ron T Gansevoort; Kunihiro Matsushita; Marije van der Velde; Brad C Astor; Mark Woodward; Andrew S Levey; Paul E de Jong; Josef Coresh Journal: Kidney Int Date: 2011-02-02 Impact factor: 10.612
Authors: Marije van der Velde; Kunihiro Matsushita; Josef Coresh; Brad C Astor; Mark Woodward; Andrew Levey; Paul de Jong; Ron T Gansevoort; Marije van der Velde; Kunihiro Matsushita; Josef Coresh; Brad C Astor; Mark Woodward; Andrew S Levey; Paul E de Jong; Ron T Gansevoort; Andrew Levey; Meguid El-Nahas; Kai-Uwe Eckardt; Bertram L Kasiske; Toshiharu Ninomiya; John Chalmers; Stephen Macmahon; Marcello Tonelli; Brenda Hemmelgarn; Frank Sacks; Gary Curhan; Allan J Collins; Suying Li; Shu-Cheng Chen; K P Hawaii Cohort; Brian J Lee; Areef Ishani; James Neaton; Ken Svendsen; Johannes F E Mann; Salim Yusuf; Koon K Teo; Peggy Gao; Robert G Nelson; William C Knowler; Henk J Bilo; Hanneke Joosten; Nanno Kleefstra; K H Groenier; Priscilla Auguste; Kasper Veldhuis; Yaping Wang; Laura Camarata; Beverly Thomas; Tom Manley Journal: Kidney Int Date: 2011-02-09 Impact factor: 10.612
Authors: Josef Coresh; Elizabeth Selvin; Lesley A Stevens; Jane Manzi; John W Kusek; Paul Eggers; Frederick Van Lente; Andrew S Levey Journal: JAMA Date: 2007-11-07 Impact factor: 56.272