Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-01-30 Cooperative journals: 《中国全科医学》
Abstract：
Background Hyperuricemia (HUA) caused by elevated serum uric acid (SUA) has been proven to be an independent risk factor for the development and progression of chronic kidney disease (CKD). However, there are few cohort studies on the correlation between SUA level and the development and progression of CKD in the Chinese elderly. Objective To investigate the association between baseline SUA level, changes in SUA levels, the risk of chronic kidney disease (CKD), and estimated glomerular filtration rate (eGFR) in the elderly in longevity areas in China. Methods Based on Healthy Aging and Biomarkers Cohort Study (HABCS), a sub cohort of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), the elderly who underwent physical examination and provided biomedical indicators from 2012 to 2014 were selected as the study subjects. The age, gender, height, weight, waist circumference, calf circumference, blood pressure, blood lipid, blood glucose, blood routine examination, urine routine examination, and other medical indicators were collected at baseline and follow-up period. Cox proportional hazards regression model was used to analyze the association between different SUA levels and the risk of CKD. Pearson linear correlation and linear regression were used to analyze the association between changes in SUA level and changes in eGFR in the elderly. Results A total of 981 subjects were included in the study, with an average age of 80.1±11.9 years. The prevalence of HUA was 6.83%. The cumulative follow-up of 2029 person-years (median 2.05 years) showed 179 new cases of CKD, the cumulative incidence rate of CKD during the follow-up was 18.25% (95%CI: 15.88-20.81%), and the incidence density was 88.22/1000 person-years (95%CI: 76.24-101.41 person-years). After multivariate adjustment, compared with the lowest quartile group of baseline SUA level (Q1: < 223 μmol/L), the HR values of CKD risk in other three high quartile groups (Q2: 223-270 μmol/L, Q3: 271-326 μmol/L, and Q4 ≥ 326 μmol/L) were 1.19 (95%CI: 0.74, 1.94; P=0.474)，1.27 (95%CI: 0.76, 2.10; P=0.362), and 2.08 (95%CI: 1.27, 3.41; P=0.004; Ptrend=0.003), respectively. And a per 10 μmol/L increase in baseline SUA level, the risk of CKD increased by 4% (95%CI: 2%, 7%; P<0.001). The risk of CKD in the elderly with HUA at baseline was 2.00 times (95%CI: 1.20, 3.24; P=0.007) higher than that in the elderly without HUA. The results of Pearson linear correlation analysis showed that changes in eGFR in the elderly (r = -0.355, P<0.001) decreased with the increase of change in SUA level. Multivariate adjusted linear regression analysis result showed that for per 10 μmol/L increase change in SUA level, change in eGFR decreased by 1.03 (95%CI: -1.23, -0.83; P<0.001) ml/min/1.73m2. Conclusion Elevated SUA level are associated with an increased risk of CKD and a decline in eGFR in an elderly Chinese population.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-01-03 Cooperative journals: 《中国全科医学》
Abstract：
Background The chronic kidney disease (CKD) seriously harms the health and the life span of the elderly. Hypertension is closely related to CKD. However, there are few cohort studies focusing on the blood pressure levels and CKD in the older adults. Objective To investigate the relationship between blood pressure and the risk of chronic kidney disease in the elderly aged 65 years and older. Methods Based on the "Chinese Longitudinal Healthy Longevity Survey (CLHLS)", 989 elderly people who underwent physical examination and biomedical indicator tests in 2012 were selected as subjects. Biomedical indicators including age, sex, height, weight, blood pressure, blood lipid, blood glucose and urine test were collected at baseline. The follow-up monitoring was conducted in 2014. Cox proportional hazard model was used to analyze the association between different blood pressure levels and the risk of CKD. Results 989 subjects, with an average age of 80.2±12.0 years, were included in the study. A total of 183 cases of CKD were diagnosed during an average follow-up time of 2.07 years. The cumulative incidence of CKD during the follow-up period was 18.5% (95%CI: 16.1%-21.1%), and the incidence density was 89.4/1000 person-years. Compared with normal blood pressure, older adults with hypertension, after adjusting for multiple factors, had a higher risk of CKD [HR (95%CI) 2.28 (1.13-4.60)]. The risk of CKD in older adults with baseline SBP ≥ 140mmHg was 1.83 times higher than that in older adults with SBP<120mmHg (95%CI: 1.02-3.29). The risk of CKD with baseline DBP ≥ 90mmHg was 1.55 times higher than those with DBP<80mmHg (95%CI: 1.02-2.35). Conclusion Elevated blood pressure is an independent risk factor for chronic kidney disease in the elderly. To increase screening and prevention of CKD is particularly important, especially for those with elevated systolic blood pressure.
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