Risk factors for subclinical renal damage and its progression: Hanzhong Adolescent Hypertension Study.

Publisher: Nature Publishing Group Country of Publication: England NLM ID: 8804070 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1476-5640 (Electronic) Linking ISSN: 09543007 NLM ISO Abbreviation: Eur J Clin Nutr Subsets: MEDLINE

Publication: <2003->: London : Nature Publishing Group
Original Publication: London : J. Libbey, c1988-

Hypertension*/epidemiology ; Hypertension*/etiology ; Renal Insufficiency, Chronic*/epidemiology ; Renal Insufficiency, Chronic*/etiology; Adolescent ; China/epidemiology ; Cross-Sectional Studies ; Disease Progression ; Glomerular Filtration Rate ; Humans ; Male ; Risk Factors ; Uric Acid

Background/objectives: Chronic kidney disease (CKD) is a global public health problem, including in China. The aim of this study was to identify the risk factors for the development and progression of subclinical renal disease (SRD) in a Chinese population. We also examined whether the impact of the risk factors on SRD changed over time.
Subjects/methods: To identify the predictors of SRD, we performed a cross-sectional study of the 2432 subjects in our Hanzhong Adolescent Hypertension Cohort. A subgroup of 202 subjects was further analyzed over a 12-year period from 2005 to 2017 to determine the risk factors for the development and progression of SRD.
Results: In cross-sectional analysis, elevated blood pressure, male gender, diabetes, body mass index, and triglyceride were independently associated with a higher risk of SRD. In longitudinal analysis, an increase in total cholesterol over a 4-year period and an increase in serum triglyceride over a 12-year period were independently associated with progression of albuminuria. Finally, increases in both total cholesterol and serum uric acid over a 4-year follow-up showed an independent association with a modest reduction in estimated glomerular filtration rate (eGFR).
Conclusions: In this study of a Chinese cohort, we show several metabolic abnormalities as independent risk factors for subclinical renal disease in a Chinese cohort. In addition, we demonstrate that the effects of total cholesterol, triglycerides and uric acid on the development and progression of albuminuria or the decline in eGFR vary at different points of follow-up. These findings highlight the importance of early detection of metabolic abnormalities to prevent SRD.

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81600327 National Natural Science Foundation of China (National Science Foundation of China); 81700368 National Natural Science Foundation of China (National Science Foundation of China); 81870319 National Natural Science Foundation of China (National Science Foundation of China)

268B43MJ25 (Uric Acid)

Date Created: 20200930 Date Completed: 20210707 Latest Revision: 20220422

20240105

10.1038/s41430-020-00752-x

32994554