title: Long-term trends in the prevalence of chronic kidney disease and the influence of cardiovascular risk factors in Norway.
abstract: Surveillance of chronic kidney disease (CKD) prevalence over time and information on how changing risk factors influence this trend are needed to evaluate the effects of general practice and public health interventions. Because very few studies addressed this, we studied the total adult population of a demographically stable county representative of Norway using cross-sectional studies 10 years apart (Nord-Trøndelag Health Study (HUNT)2 and Nord-Trøndelag Health Study (HUNT)3, 65,237 and 50,586 participants, respectively). Thorough quality-control procedures and comparisons of methods over time excluded analytical drift, and multiple imputations of missing data combined with nonattendance weights contributed to unbiased estimates. CKD prevalence remained stable in Norway from 1995 through 1997 (11.3%) to 2006 through 2008 (11.1%). The association of survey period with CKD prevalence was modified by a strong decrease in blood pressure, more physical activity, and lower cholesterol levels. Without these improvements, a 2.8, 0.7, and 0.6 percentage points higher CKD prevalence could have been expected, respectively. In contrast, the prevalence of diabetes and obesity increased moderately, but the proportion of diabetic patients with CKD decreased significantly (from 33.4% to 28.6%). A CKD prevalence of 1 percentage point lower would have been expected without these changes. Thus, CKD prevalence remained stable in Norway for more than a decade in association with marked improvements in blood pressure, lipid levels, and physical activity and despite modest increases in diabetes and obesity.
authors.affiliation: Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Nephrology, St. Olav University Hospital, Trondheim, Norway. Electronic address: stein.hallan@ntnu.no.
authors.forename: Stein I
authors.initials: SI
authors.lastname: Hallan
authors.affiliation: Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Nephrology, St. Olav University Hospital, Trondheim, Norway.
authors.forename: Marius A
authors.initials: MA
authors.lastname: Øvrehus
authors.affiliation: Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Medicine, Levanger Hospital, Levanger, Norway.
authors.forename: Solfrid
authors.initials: S
authors.lastname: Romundstad
authors.affiliation: Division of Nephrology-Hypertension, University of California San Diego, San Diego, California, USA; Nephrology Section, Veterans Affairs San Diego Healthcare System, San Diego, California, USA.
authors.forename: Dena
authors.initials: D
authors.lastname: Rifkin
authors.affiliation: HUNT Research Center, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Levanger, Norway.
authors.forename: Arnulf
authors.initials: A
authors.lastname: Langhammer
authors.affiliation: Kent Kidney Care Centre, East Kent Hospitals, University NHS Foundation Trust, Canterbury, Kent, United Kingdom.
authors.forename: Paul E
authors.initials: PE
authors.lastname: Stevens
authors.affiliation: Division of Nephrology-Hypertension, University of California San Diego, San Diego, California, USA; Nephrology Section, Veterans Affairs San Diego Healthcare System, San Diego, California, USA.
authors.forename: Joachim H
authors.initials: JH
authors.lastname: Ix
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000652:urine; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology*; D004739:England / Q000453:epidemiology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D009765:Obesity / Q000150:complications / Q000453:epidemiology*; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000453:epidemiology* / Q000652:urine; D020379:Risk Adjustment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
chemical_list: D008055:Lipids
keywords: chronic kidney disease; epidemiology; general population; prevalence; risk factors; trend