Predictors of change in estimated GFR: a population-based 7-year follow-up from the Tromso study.
BACKGROUND
Chronic kidney disease is associated with increased cardiovascular mortality, and even mild impairment of renal function is a cardiovascular risk factor. Several studies have investigated the risk factors for the development of end-stage renal disease, but little is known about predictors of change in renal function in the general population.


METHODS
The present study included 2249 men and 2192 women without signs of kidney disease at baseline who were followed for 7 years from 1994 to 1995 in the Tromsø Study. Estimated glomerular filtration rate (eGFR) was calculated from the Modification of Diet in Renal Disease study equation. Gender-specific multiple linear regression analyses were used to assess predictors of change in eGFR (DeltaGFR).


RESULTS
Change in eGFR, measured in ml/min/1.73 m(2)/year, was associated with systolic blood pressure (SBP) [beta-value for a 10-mmHg increase in SBP, men = -0.14, 95% confidence interval (CI) = -0.18 to -0.09; women = -0.07, 95% CI = -0.11 to -0.03] and fibrinogen [beta-value for 1 SD increase in fibrinogen, men (1 SD: 0.85 g/L) = -0.12, 95% CI -0.20 to -0.03; women (1 SD: 0.80) = -0.11, 95% CI -0.20 to -0.02]. High alcohol consumption in men and high physical activity in women predicted an increase in eGFR. Higher albumin/creatinine ratio was associated with a decline in eGFR in men only.


CONCLUSIONS
Some risk factors for change in GFR seem to be gender specific but both high SBP and high levels of fibrinogen contribute to a more rapid decline in GFR for both men and women.
Kronborg
Jens
J
Department of Internal Medicine, Innlandet Hospital Trust, Olav Aukrustsvej 6 N-2618, Lillehammer, Norway. kronborg@broadpark.no
Solbu
Marit
M
Njølstad
Inger
I
Toft
Ingrid
I
Eriksen
Bjørn O
BO
Jenssen
Trond
T
D000368:Aged; D000428:Alcohol Drinking; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000503:physiopathology; D003404:Creatinine / Q000097:blood; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology; D006306:Health Surveys; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000503:physiopathology*; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology
D005340:Fibrinogen; D003404:Creatinine