title: Risk factors for development of decreased kidney function in a southeast Asian population: a 12-year cohort study.
abstract: End-stage kidney disease has become an increasing burden in all regions of the world. However, limited epidemiologic data on chronic kidney disease in Southeast Asian populations are available. Therefore, a cohort study over a period of 12 yr (1985 to 1997) in 3499 employees of the Electric Generation Authority of Thailand, aged 35 to 55 yr, was conducted to determine the prevalence of decreased kidney function and risk factors associated with future development of decreased kidney function. The prevalence of decreased kidney function (GFR <60 ml/min) increased from 1.7% (95% confidence interval [CI], 1.3 to 2.1) in 1985 to 6.8% (95% CI, 5.7 to 7.9) in 1997, and the prevalence of elevated serum creatinine was 6.1% (95% CI, 5.3 to 6.9) and 16.9% (95% CI, 15.3 to 18.5) in 1985 and 1997 surveys, respectively. The adjusted odds ratio for future development of decreased kidney function was 2.57 (1.0 to 6.81) for systolic hypertension (>159 mmHg), 1.82 (1.12 to 2.98) for hyperuricemia (>6.29 mg/dl), 1.68 (1.02 to 2.77) for elevated body mass index (>24.9 kg/m(2)) compared with subjects with systolic BP <140 mmHg, serum uric acid <4.5 mg/dl, and body mass index 20.8 to 22.8 kg/m(2). The rising prevalence of decreased kidney function in this population resulted mainly from the increasing prevalence of the risk factors in the population. Screening to detect decreased kidney function and early intervention to modify the associated risk factors should be considered in otherwise healthy individuals. Future studies are also necessary to determine whether implementation of these measures results in a reduction of ESRD incidence in the population.
authors.affiliation: Department of Medicine, Ramathibodi Hospital, Rama 6 Road, Bangkok 10400, Thailand. rasdr@mahidol.ac.th
authors.forename: Somnuek
authors.initials: S
authors.lastname: Domrongkitchaiporn
authors.forename: Piyamitr
authors.initials: P
authors.lastname: Sritara
authors.forename: Chagriya
authors.initials: C
authors.lastname: Kitiyakara
authors.forename: Wasana
authors.initials: W
authors.lastname: Stitchantrakul
authors.forename: Vorasakdi
authors.initials: V
authors.lastname: Krittaphol
authors.forename: Porntip
authors.initials: P
authors.lastname: Lolekha
authors.forename: Sayan
authors.initials: S
authors.lastname: Cheepudomwit
authors.forename: Tada
authors.initials: T
authors.lastname: Yipintsoi
mesh_terms: D000328:Adult; D044466:Asian People / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006977:Hypertension, Renal / Q000208:ethnology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011507:Proteinuria / Q000208:ethnology / Q000517:prevention & control; D051437:Renal Insufficiency / Q000208:ethnology* / Q000517:prevention & control*; D012307:Risk Factors; D013785:Thailand / Q000453:epidemiology