Age differences in the relationships between risk factors and loss of kidney function: a general population cohort study
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RESEARCH ARTICLE
Open Access
Age differences in the relationships between risk factors and loss of kidney function: a general population cohort study Tadashi Toyama1,2* , Kiyoki Kitagawa3, Megumi Oshima1, Shinji Kitajima1, Akinori Hara1, Yasunori Iwata1, Norihiko Sakai1, Miho Shimizu1, Atsushi Hashiba4, Kengo Furuichi5 and Takashi Wada1
Abstract Background: Annual decline in kidney function is a widely applied surrogate outcome of renal failure. It is important to understand the relationships between known risk factors and the annual decline in estimated glomerular filtration rate (eGFR) according to baseline age; however, these remain unclear. Methods: A community-based retrospective cohort study of adults who underwent annual medical examinations between 1999 and 2013 was conducted. The participants were stratified into different age groups (40–49, 50–59, 60–69, 70–79, and ≥ 80 years) to assess the risk for loss of kidney function. A mixed-effects model was used to estimate the association between risk factors and annual changes in eGFR. Results: In total, 51,938 participants were included in the analysis. The age group of ≥80 years included 8127 individuals. The mean annual change in eGFR was − 0.39 (95% confidence interval: − 0.41 to − 0.37) mL/min/1.73 m2 per year. Older age was related to faster loss of kidney function. In the older age group, higher systolic blood pressure, proteinuria, and current smoking were related to faster loss of kidney function (p trend < 0.01, 0.03, and < 0.01, respectively). Conversely, each age group showed similar annual loss of kidney function related to lower hemoglobin levels and diabetes mellitus (p trend 0.47 and 0.17, respectively). Conclusions: Higher systolic blood pressure, proteinuria, and smoking were related to faster loss of kidney function, and a greater effect size was observed in the older participants. More risk assessments for older people are required for personalized care. Keywords: Aged, Chronic renal insufficiency, Glomerular filtration rate
* Correspondence: [email protected] 1 Department of Nephrology and Laboratory Medicine, Kanazawa University, Kanazawa, Japan 2 Innovative Clinical Research Center, Kanazawa University, Kanazawa, Japan Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain per
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