title: Risk factors for renal function decline in adults with normal kidney function: a 7-year cohort study.
abstract: BACKGROUND
  We aimed to examine the risk factors for renal function decline (RFD) in a community-based cohort of a rural Chinese population with normal kidney function (estimated glomerular filtration rate, eGFR ≥60 mL/min/1.73 m(2)), both for the population as a whole and stratified by sex.
  
  
  METHODS
  2518 participants were included in the current analysis. RFD was defined as follows: a drop in the eGFR category accompanied by a 25% or greater drop in eGFR from baseline; or a sustained decline in eGFR of more than 5 mL/min/1.73 m(2)/year.
  
  
  RESULTS
  The incidence rate of RFD was 8.7% (women 7.4% and men 9.8%). In the multivariable logistic regression model, the ORs (95% CI) of developing RFD was 1.60 (1.01 to 2.54) for men versus women, and 1.51 (1.09 to 2.08) for participants with obesity or abdominal obesity versus none (1.35 (0.85 to 2.14) for men, and 1.65 (1.04 to 2.64) for women). However, prehypertension (OR=1.64; 95% CI 1.02 to 2.63) or hypertension (2.05; 1.21 to 3.47), higher mean blood pressure (≥90 vs <80 mm Hg, 2.63; 1.11 to 6.20), higher pulse pressure (≥50 vs <40 mm Hg, 2.00; 1.26 to 3.18), lower high-density lipoprotein cholesterol (<0.9 vs ≥0.9 mmol/L, 2.65; 1.08 to 6.50) and low physical activity levels (vs high, 3.11; 1.59 to 6.10) were major risk factors for RFD in men. Current smoking (3.22; 1.22 to 2.64) and worse self-reported health (vs better, 2.57; 1.20 to 5.50) were major risk factors for RFD in women.
  
  
  CONCLUSIONS
  Our findings suggested that sex-specific risk factors should be considered in prevention of RFD in the Chinese rural population with normal kidney function.
authors.affiliation: National Clinical Research Center for Kidney Disease; State Key Laboratory for Organ Failure Research; Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Xianhui
authors.initials: X
authors.lastname: Qin
authors.affiliation: National Clinical Research Center for Kidney Disease; State Key Laboratory for Organ Failure Research; Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Yuejuan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: National Clinical Research Center for Kidney Disease; State Key Laboratory for Organ Failure Research; Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Youbao
authors.initials: Y
authors.lastname: Li
authors.affiliation: National Clinical Research Center for Kidney Disease; State Key Laboratory for Organ Failure Research; Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Di
authors.initials: D
authors.lastname: Xie
authors.affiliation: Institute of Biomedicine, Anhui Medical University, Hefei, China.
authors.forename: Genfu
authors.initials: G
authors.lastname: Tang
authors.affiliation: National Clinical Research Center for Kidney Disease; State Key Laboratory for Organ Failure Research; Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Binyan
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Population, Family and Reproductive Health, Center on the Early Life Origins of Disease, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Xiaobin
authors.initials: X
authors.lastname: Wang
authors.affiliation: National Clinical Research Center for Kidney Disease; State Key Laboratory for Organ Failure Research; Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Xu
authors.affiliation: National Clinical Research Center for Kidney Disease; State Key Laboratory for Organ Failure Research; Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Xiping
authors.initials: X
authors.lastname: Xu
authors.affiliation: National Clinical Research Center for Kidney Disease; State Key Laboratory for Organ Failure Research; Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Fanfan
authors.initials: F
authors.lastname: Hou
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology; D002681:China / Q000453:epidemiology; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D015994:Incidence; D008075:Lipoproteins, HDL / Q000097:blood / Q000172:deficiency / Q000502:physiology; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D056128:Obesity, Abdominal / Q000150:complications / Q000453:epidemiology; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data; D017678:Sex Distribution; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology
chemical_list: D008075:Lipoproteins, HDL
keywords: Cohort studies; GENDER; RENAL