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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    • "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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    • "hemanski , Burke , Hansen , & Appel , 2000 ) . Not only that , smok - ing is also a significant predisposing factor for various chronic diseases other than DM . Therefore , it is important to encourage smoking patients with normal kidney functions to cease smoking , especially if they are overweight ( Iseki , 2005 ) or have a sedentary lifestyle ( Hallan et al . , 2006 ) . This is because these lifestyle factors combined with the habit of smoking increase the risk of renal diseases ."
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    ABSTRACT: Purpose: The purpose of this study was to identify health behavior and risk factors for chronic kidney disease (CKD) in Korean patients with diabetes. Methods: This study was a secondary analysis of the Fourth Korean National Health and Nutritional Examination Survey (2007-2009). Of the 24,871 participants, 1,239 aged over 19 years with diagnosis of diabetes were included. Stratified and cluster variables in the analysis-plan file for a weighted, complex sample were analyzed. CKD was confirmed by the estimated glomerular filtration rate level of 15.0-59.9 mL/min/1.732 m(2). Odds ratios between the variables and CKD were calculated using logistic regression analysis with adjustment for gender, age, educational background, income, and duration of diagnosis. Results: The results showed that 14.7% of participants with diabetes were accompanied with CKD. The risk of developing CKD in those who made efforts to take proper nutrition but failed was 1.76 times higher than those taking nutrition properly. In those who used to smoke compared to their nonsmoking counterparts, the risk was 2.06 times higher; in those who did not do vigorous exercise compared to those who did, the risk was 2.12 times higher; in those with hypertension than those without, the risk was 2.4 times higher; and in those with anemia compared to those without, the risk was 2.32 times higher. Only 19% of the participants received health education for diabetes, which did not affect the incidence of CKD. Conclusion: Since renal functions are affected by lifestyle factors, it is critical for healthcare professionals to provide diabetic patients with health education focused on changing their behavior so that it is conducive to health. It is also necessary to consider that diabetes education should be made more available and provided more effectively to these patients.
    Asian Nursing Research 03/2014; 8(1):8-14. DOI:10.1016/j.anr.2013.11.001 · 1.00 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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