title: Clinical and biological determinants of kidney outcomes in a population-based cohort study.
abstract: OBJECTIVE
  Prospective studies on factors associated with adverse kidney outcomes in European general populations are scant. Also, few studies consider the potential confounding effect of baseline kidney function.
  
  
  METHODS
  We used baseline (2003-2006) and 5-year follow-up data of adults from the general population to evaluate the effect of baseline kidney function and proteinuria on the association of clinical, biological (e.g. uric acid, homocysteine, cytokines), and socioeconomic factors with change in kidney function, rapid decline in kidney function, and incidence of chronic kidney disease (CKD). Estimated glomerular filtration rate (eGFR) and urinary albuminuria-to-creatinine ratio (UACR) were collected. Kidney outcomes were modeled using multivariable regressions.
  
  
  RESULTS
  A total of 4,441 subjects were included in the analysis. Among participants without CKD at baseline, 11.4% presented rapid decline in eGFR and/or incident CKD. After adjustment for baseline eGFR and log UACR, only age (Odds Ratio; 1.25 [95%CI 1.18-1.33]), diabetes (OR 1.48 [1.03-2.13]), education (OR middle vs. high 1.51 [1.08-2.11]) and log ultrasensitive CRP (OR 1.16 [1.05-1.22]) were associated with rapid decline in eGFR or incident CKD. Baseline log UACR (OR 1.18 [1.06-1.32]) but not eGFR was associated with rapid decline in eGFR and/or incident CKD.
  
  
  CONCLUSIONS
  In addition to age and diabetes, education and CRP levels are associated with adverse kidney outcomes independently of baseline kidney function.
authors.affiliation: Community Prevention Unit, Institute of Social and Preventive Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Idris
authors.initials: I
authors.lastname: Guessous
authors.forename: Belén
authors.initials: B
authors.lastname: Ponte
authors.forename: Pedro
authors.initials: P
authors.lastname: Marques-Vidal
authors.forename: Fred
authors.initials: F
authors.lastname: Paccaud
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Gaspoz
authors.forename: Michel
authors.initials: M
authors.lastname: Burnier
authors.forename: Gérard
authors.initials: G
authors.lastname: Waeber
authors.forename: Peter
authors.initials: P
authors.lastname: Vollenweider
authors.forename: Murielle
authors.initials: M
authors.lastname: Bochud
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000419:Albuminuria / Q000453:epidemiology; D015331:Cohort Studies; D003404:Creatinine / Q000652:urine*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D015994:Incidence; D007668:Kidney / Q000502:physiology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D044382:Population Groups; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology; D012189:Retrospective Studies; D012959:Socioeconomic Factors
chemical_list: D003404:Creatinine