title: Prevalence of CKD and its relationship to eGFR-related genetic loci and clinical risk factors in the SardiNIA study cohort.
abstract: The prevalence of CKD and of renal failure vary worldwide, yet parallel increases in leading risk factors explain only part of the differential prevalence. We measured CKD prevalence and eGFR, and their relationship with traditional and additional risk factors, in a Sardinian founder population cohort. The eGFR was calculated using equations from the CKD Epidemiology Collaboration and Modification of Diet in Renal Disease studies. With use of the Kidney Disease Improving Global Outcomes guidelines, a cross-sectional analysis of 4842 individuals showed that CKD prevalence was 15.1%, including 3.6% of patients in the high-risk and 0.46% in the very-high-risk categories. Longitudinal analyses performed on 4074 of these individuals who completed three visits with an average follow-up of 7 years revealed that, consistent with other populations, average eGFR slope was -0.79 ml/min per 1.73 m(2) per year, but 11.4% of the participants had an eGFR decline >2.3 ml/min per 1.73 m(2) per year (fast decline). A genetic score was generated from 13 reported eGFR- and CKD-related loci, and univariable and multivariable analyses were applied to assess the relationship between clinical, ultrasonographic, and genetic variables with three outcomes: CKD, change in eGFR, and fast eGFR decline. Genetic risk score, older age, and female sex independently correlated with each outcome. Diabetes was associated with CKD prevalence, whereas hypertension and hyperuricemia correlated more strongly with fast eGFR decline. Diabetes, hypertension, hyperuricemia, and high baseline eGFR were associated with a decline of eGFR. Along with differential health practices, population variations in this spectrum of risk factors probably contributes to the variable CKD prevalence worldwide.
authors: Struttura complessa di Nefrologia e Dialisi, Azienda Ospedaliera "G. Brotzu", Cagliari, Italy; antonellopani@aob.it.
authors: Antonello
authors: A
authors: Pani
authors: Center for Statistical Genetics, University of Michigan, Ann Arbor, Michigan;
authors: Jennifer
authors: J
authors: Bragg-Gresham
authors: Istituto di Ricerca Genetica e Biomedica (IRGB), CNR, Monserrato, Italy;
authors: Marco
authors: M
authors: Masala
authors: Struttura complessa di Nefrologia e Dialisi, Azienda Ospedaliera "G. Brotzu", Cagliari, Italy;
authors: Doloretta
authors: D
authors: Piras
authors: Struttura complessa di Nefrologia e Dialisi, Azienda Ospedaliera "G. Brotzu", Cagliari, Italy;
authors: Alice
authors: A
authors: Atzeni
authors: Center ProgeNIA, Istituto di Ricerca Genetica e Biomedica (IRGB), CNR, Lanusei, Italy;
authors: Maria G
authors: MG
authors: Pilia
authors: Center ProgeNIA, Istituto di Ricerca Genetica e Biomedica (IRGB), CNR, Lanusei, Italy;
authors: Liana
authors: L
authors: Ferreli
authors: Center ProgeNIA, Istituto di Ricerca Genetica e Biomedica (IRGB), CNR, Lanusei, Italy;
authors: Lenuta
authors: L
authors: Balaci
authors: Center ProgeNIA, Istituto di Ricerca Genetica e Biomedica (IRGB), CNR, Lanusei, Italy;
authors: Nicolò
authors: N
authors: Curreli
authors: Center ProgeNIA, Istituto di Ricerca Genetica e Biomedica (IRGB), CNR, Lanusei, Italy;
authors: Alessandro
authors: A
authors: Delitala
authors: Center ProgeNIA, Istituto di Ricerca Genetica e Biomedica (IRGB), CNR, Lanusei, Italy;
authors: Francesco
authors: F
authors: Loi
authors: Center for Statistical Genetics, University of Michigan, Ann Arbor, Michigan;
authors: Gonçalo R
authors: GR
authors: Abecasis
authors: Laboratory of Genetics, National Institute on Aging, Baltimore, Maryland; and.
authors: David
authors: D
authors: Schlessinger
authors: Istituto di Ricerca Genetica e Biomedica (IRGB), CNR, Monserrato, Italy; Dipartimento di Scienze Biomediche, Università di Sassari, Sassari, Italy.
authors: Francesco
authors: F
authors: Cucca
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D056426:Genetic Loci; D005919:Glomerular Filtration Rate / Q000235:genetics*; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology* / Q000235:genetics* / Q000503:physiopathology; D012307:Risk Factors; D055815:Young Adult
keywords: chronic kidney disease; clinical epidemiology; ethnicity; glomerular filtration rate; human genetics; renal function decline