Risk factors associated with the discordance in kidney function decline rate in identical twins

• Published in: PloS one Vol. 18; no. 4; p. e0284154
• Main Authors: Hwang, Jeong Ah, Shin, Jaeun, Cho, Eunjung, Ahn, Shin Young, Ko, Gang-Jee, Kwon, Young Joo, Kim, Ji Eun
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 13-04-2023; Public Library of Science (PLoS)
• Subjects: Albumin; Biology and Life Sciences; Blood; Blood levels; Body fat; Body mass; Body mass index; Body size; Cholesterol; Chronic kidney failure; Diabetes; Diabetes mellitus; Diagnosis; Discordance; Epidemiology; Epidermal growth factor receptors; Etiology; Fasting; Genomes; Genomics; Glomerular Filtration Rate; Glucose; Glycosylated hemoglobin; Health aspects; Health risk assessment; Health risks; Hemoglobin; Humans; Hypertension; Kidney; Kidney diseases; Kidneys; Laboratories; Mathematical analysis; Medical research; Medicine and Health Sciences; Medicine, Experimental; Missing data; Physical Sciences; Questionnaires; Regression analysis; Risk analysis; Risk Factors; Triglycerides; Twins; Twins, Monozygotic; Uric acid; South Korea; United States > US
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0284154

The rate of kidney function decline is different for each individual regardless of any difference in the medical histories. This study set out to identify the risk factors for high discordance in kidney function decline in an identical twin cohort.
This study included 333 identical twins from the Korean Genome and Epidemiology Study who were categorized into two groups according to the estimated glomerular filtration rate (eGFR) decline: the slow and rapid progressor groups. The mean differences of variables were compared between the two groups. We calculated the difference in the annual eGFR change between twins and analyzed the risk factors associated with high discordance in twins who had > 5 mL/min/1.73 m2 /yr of the intra-twin difference in the annual eGFR decline. Identical twins with diabetes and baseline eGFR < 60 mL/min/1.73 m2 were excluded.
The high discordance twins showed significant differences in body mass index; waist-to-hip ratio; total body fat percentage; and levels of blood hemoglobin, serum fasting glucose, albumin, triglyceride, and uric acid; however, there were no differences in low discordance twins. Multivariable logistic regression showed that blood hemoglobin level is the only significant factor associated with high discordance of eGFR decline in twins.
Blood hemoglobin level may play a role in the individual differences in kidney function decline.