Obesity, Smoking, and Physical Inactivity as Risk Factors for CKD: Are Men More Vulnerable?

Leiden University, Leyden, South Holland, Netherlands
American Journal of Kidney Diseases (Impact Factor: 5.9). 03/2006; 47(3):396-405. DOI: 10.1053/j.ajkd.2005.11.027
Source: PubMed


The incidence of end-stage renal disease is especially high in men, and some studies indicated that smoking is a risk factor for men only. We investigated associations between obesity, smoking, and physical inactivity and chronic kidney disease (CKD) in the general population and whether risk for CKD was restricted to men.
This was a cross-sectional health survey of the entire adult population of Nord-Trondelag County, Norway, 1995 to 1997, with a 70.6% participation rate. Glomerular filtration rate (GFR) was estimated in all subjects 20 years and older from calibrated serum creatinine levels by using the simplified Modification of Diet in Renal Disease Study formula, and CKD cases are defined as those with a GFR less than 45 mL/min/1.73 m2 (< 0.75 mL/s).
A total of 30,485 men and 34,708 women were included, and prevalences of GFR less than 45 mL/min/1.73 m2 (< 0.75 mL/s) were 0.8% and 1.1%, respectively. Age- and sex-adjusted logistic regression analyses showed dose-response relations for body mass index, smoking history, and physical activity. Relative risks were 1.77 (95% confidence interval [CI], 1.47 to 2.14) for obesity (body mass index > or = 30 kg/m2), 1.52 (95% CI, 1.13 to 2.06) for smoking (> 25 pack-years), and 2.14 (95% CI, 1.39 to 3.30) for physical inactivity (no or some physical activity in leisure time). For subjects with all these risk factors, relative risk was 5.10 (95% CI, 2.36 to 11.01). These results remained significant after adjusting for other known risk factors. No biological interactions between sex and obesity, smoking, or physical activity were found.
Obesity, smoking, and physical inactivity were associated significantly with CKD. Men were not more susceptible to these risk factors than women.

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Available from: Knut Aasarød, Oct 03, 2015
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    • "The increasing prevalence of CKD requests us to find out more efficient markers for monitoring the prevalence of CKD. Several studies have suggested that obesity and the metabolic syndrome are independent predictors of CKD [17], [26]–[29]. Body mass index (BMI) was widely used as a marker of obesity. But fluid overload and body fat distribution should be considered. "
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    ABSTRACT: To examine the relationship between the HW phenotype and risk for CKD in a community population aged 40 years and older. A cross-sectional study was conducted in Zhuhai from June to October 2012. The participants were divided into three groups: Group 1, Waist circumference >90 cm in men or >85 cm in women and triglycerides ≥2 mmol/l; Group 3, Waist circumference ≤90 cm in men or ≤85 cm in women and triglycerides <2 mmol/l; Group 2, The remaining participants. The prevalence of the three subgroups and CKD were determined. The association between HW phenotype and CKD was then analyzed using SPSS (version 13.0). After adjusting for age and sex, Group 1 was associated with CKD (OR 3.08, 95% CI 2.01, 4.73, P<0.001), when compared with Group 3. Further adjustment for factors which were potential confounders and unlikely to be in the causal pathway between the HW phenotype and CKD, Group 1 was still significantly associated with CKD. The OR for CKD was 2.65 (95% CI 1.65, 4.26, P<0.001). When adjusted for diabetes and hypertension, the association of Group 1 and CKD was still significant (OR 2.09, 95% CI 1.26, 3.45, P = 0.004). Group 2 was associated with CKD (OR 1.81, 95% CI 1.29, 2.53, P = 0.001), when compared with Group 3. Further adjustment for factors which were potential confounders, Group 2 was still significantly associated with CKD. The OR for CKD was 1.75 (95% CI 1.22, 2.51, P = 0.002). When adjusted for diabetes and hypertension, the association between Group 2 and CKD still existed. The OR for CKD was 1.48 (95% CI 1.01, 2.16, P = 0.046). Our results showed that HW phenotype was associated with CKD in the population aged 40 years and older.
    PLoS ONE 03/2014; 9(3):e92322. DOI:10.1371/journal.pone.0092322 · 3.23 Impact Factor
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    • "Meanwhile, about 25.3% of patients with hypertension were reported to experience kidney injury in Turkey [9]. Obesity conferred a high susceptibility to CKD in Norway with a relative risk of 1.77 [10]. "
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    ABSTRACT: The prevalence of chronic kidney disease (CKD) and metabolic diseases has increased at different rates in different regions in China. The aim of our study was to estimate the prevalence of CKD and to analyze associated risk factors of CKD in Zhejiang province, Eastern China. A cross-sectional survey of 11,013 adults was conducted from September 2009 to June 2012 in Zhejiang Province, located in Eastern China. CKD was defined as having an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 or the presence of albuminuria. Medical history, physical examination and laboratory data were used to diagnose metabolic diseases. Age- and sex-standardized prevalence was calculated using the data on the population distribution in China in 2010. We examined risk factors associated with decreased renal function and albuminuria using multivariate logistic regression. A total of 10,384 adults (94.3%) completed the screening. The standardized prevalence of reduced renal function (eGFR < 60 mL/min/1.73 m2) was 1.83% (95% CI 1.52-2.13) and that of albuminuria was 8.65% (95% CI 7.98-9.31). The overall prevalence of CKD was 9.88% (95% CI 9.18-10.59). The prevalence of reduced renal function was greater in the eastern rural areas in Zhejiang province. Multivariate logistic regression revealed that metabolic diseases such as diabetes, obesity, hypertension, and hyperuricemia were independent risk factors of CKD. Patients with metabolic diseases had a significantly (P < 0.001) higher prevalence of CKD than those without such diseases. CKD has become a severe public health problem in Zhejiang Province, and metabolic diseases may increase the risk of CKD in Zhejiang population.
    BMC Nephrology 02/2014; 15(1):36. DOI:10.1186/1471-2369-15-36 · 1.69 Impact Factor
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    • "In the present study daily physical activity was positively correlated with creatinine clearance. Indeed, previous studies have shown that habitual physical activity was positively associated with renal function [31–33]. Why decrease in creatinine clearance was associated with decreased physical activity? "
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    ABSTRACT: The present study was carried out to investigate independent relationship between daily physical activity, microalbuminuria, and kidney function. The demographic characteristics and laboratory parameters were recorded for all patients. The determination of daily activities was carried out by Nottingham Extended Activities of Daily Living Scale (NEADLS) which was performed for each patient in an interview. Totally 139 patients were enrolled. In the whole group NEADLS score was correlated with age (rho: -0.759, P < 0.0001), clinical systolic blood pressure (rho: -0.212, P: 0.018), blood urea nitrogen (rho: -0.516, P < 0.0001), creatinine (rho: -0.501, P < 0.0001), uric acid (rho: -0.308, P < 0.0001), albumin (rho: 0.382, P < 0.0001), total cholesterol (rho: -0.194, P: 0.022), LDL-cholesterol (rho: -0.230, P: 0.008), hemoglobin (rho: 0.256, P: 0.002), creatinine clearance (rho: 0.565, P < 0.0001), 24-hour urinary protein excretion (rho: -0.324, P < 0.0001), and 24-hour urinary albumin excretion (UAE) (rho: -0.483, P < 0.0001). The multivariate linear regression of independent factors corelated with logarithmically converted NEADLS score (as a dependent variable) has shown that age (P < 0.0001), presence of coronary artery disease (P: 0.011), hemoglobin (P: 0.020), 24-hour creatinine clearance (P: 0.004), and 24-hour urinary albumin excretion (P < 0.0001) were independently corelated with NEADLS score. In conclusion, both UAE and kidney function were independently associated with daily physical activity.
    International Journal of Nephrology 12/2013; 2013:248416. DOI:10.1155/2013/248416
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