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Novel Risk Factors for End-Stage Renal Disease

Strategic Insights

— 1 min read

A comprehensive study of 177,570 individuals in northern California has identified several new risk factors for end-stage renal disease (ESRD), in addition to established risk factors such as male sex, older age, and diabetes mellitus. Researchers from the University of California, led by C.Y. Hsu, used data from a large integrated health care delivery system to evaluate the prognostic value of potential novel risk factors for ESRD. The study found that proteinuria and excess weight were the two most potent risk factors, with adjusted hazard ratios of 7.90 and 4.39, respectively.

Key Takeaways:

  • Established risk factors for ESRD, including male sex, older age, proteinuria, diabetes mellitus, lower educational attainment, and African American race, were confirmed as important predictors of ESRD.
  • Proteinuria and excess weight were the two most potent risk factors, with adjusted hazard ratios of 7.90 and 4.39, respectively.
  • Novel risk factors for ESRD included lower hemoglobin level, higher serum uric acid level, self-reported history of nocturia, and family history of kidney disease.
  • The study found that individuals with lower hemoglobin level had a 33% increased risk of developing ESRD.
  • Those with higher serum uric acid level had a 114% increased risk of developing ESRD.
  • Individuals with self-reported history of nocturia had a 36% increased risk of developing ESRD.
  • Those with family history of kidney disease had a 40% increased risk of developing ESRD.

Statistics:

  • Total number of participants: 177,570
  • Number of cases of ESRD: 842
  • Person-years of follow-up: 5,275,957
  • Adjusted hazard ratios for proteinuria:

+ 4+ on urine dipstick: 7.90 (95% CI, 5.35-11.67)

+ 1 to 2+ on urine dipstick: 3.59 (2.82-4.57)

+ Trace vs negative on urine dipstick: 2.37 (1.79-3.14)

  • Adjusted hazard ratios for excess weight:

+ Class 2 to class 3 obesity: 4.39 (95% CI, 3.38-5.70)

+ Class 1 obesity: 3.11 (2.51-3.84)

+ Overweight vs normal weight: 1.65 (1.39-1.97)

Sources:

  • Hsu C.Y. et al. (2009) Risk Factors for End-Stage Renal Disease 25-Year Follow-up. Archives of Internal Medicine, 169(4), 342-350.
  • University of California, Dept. of Medical, 521 Parnassus Avenue, Room C443, Box 0532, San Francisco, CA 94143, USA.
  • American Medical Association, 515 N State St., Chicago, IL 60610-0946, USA.

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