Risk factors for development of decreased kidney function in a Southeast Asian population : A 12-year cohort study

• Published in: Journal of the American Society of Nephrology Vol. 16; no. 3; pp. 791 - 799
• Main Authors: DOMRONGKITCHAIPORN, Somnuek, SRITARA, Piyamitr, KITIYAKARA, Chagriya, STITCHANTRAKUL, Wasana, KRITTAPHOL, Vorasakdi, LOLEKHA, Porntip, CHEEPUDOMWIT, Sayan, YIPINTSOI, Tada
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01-03-2005
• Subjects: Adult; Asian Continental Ancestry Group - statistics & numerical data; Biological and medical sciences; Cohort Studies; Female; Follow-Up Studies; Humans; Hypertension, Renal - ethnology; Incidence; Male; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Prevalence; Proteinuria - ethnology; Proteinuria - prevention & control; Renal failure; Renal Insufficiency - ethnology; Renal Insufficiency - prevention & control; Risk Factors; Thailand - epidemiology; Tropical medicine; Thailand; Asia; Kidney disease; Human; Hypertension; Nephrology; Urinary system disease; Prevalence; Cardiovascular disease; Metabolic diseases; Uric acid; Epidemiology; Urology; Body mass index; Functional renal failure; Hyperuricemia; Cohort study; Risk factor; Purine; Public health
• ISSN: 1046-6673; 1533-3450
• DOI: 10.1681/ASN.2004030208

End-stage kidney disease has become an increasing burden in all regions of the world. However, limited epidemiologic data on chronic kidney disease in Southeast Asian populations are available. Therefore, a cohort study over a period of 12 yr (1985 to 1997) in 3499 employees of the Electric Generation Authority of Thailand, aged 35 to 55 yr, was conducted to determine the prevalence of decreased kidney function and risk factors associated with future development of decreased kidney function. The prevalence of decreased kidney function (GFR <60 ml/min) increased from 1.7% (95% confidence interval [CI], 1.3 to 2.1) in 1985 to 6.8% (95% CI, 5.7 to 7.9) in 1997, and the prevalence of elevated serum creatinine was 6.1% (95% CI, 5.3 to 6.9) and 16.9% (95% CI, 15.3 to 18.5) in 1985 and 1997 surveys, respectively. The adjusted odds ratio for future development of decreased kidney function was 2.57 (1.0 to 6.81) for systolic hypertension (>159 mmHg), 1.82 (1.12 to 2.98) for hyperuricemia (>6.29 mg/dl), 1.68 (1.02 to 2.77) for elevated body mass index (>24.9 kg/m(2)) compared with subjects with systolic BP <140 mmHg, serum uric acid <4.5 mg/dl, and body mass index 20.8 to 22.8 kg/m(2). The rising prevalence of decreased kidney function in this population resulted mainly from the increasing prevalence of the risk factors in the population. Screening to detect decreased kidney function and early intervention to modify the associated risk factors should be considered in otherwise healthy individuals. Future studies are also necessary to determine whether implementation of these measures results in a reduction of ESRD incidence in the population.