title: Anthropometric and Metabolic Risk Factors for ESRD Are Disease-Specific: Results from a Large Population-Based Cohort Study in Austria.
abstract: BACKGROUND
  Anthropometric and metabolic risk factors for all-cause end-stage renal disease (ESRD) may vary in their impact depending on the specific primary renal disease.
  
  
  METHODS
  In this Austrian population-based prospective cohort study (n = 185,341; 53.9% women) the following data were collected between 1985 and 2005: age, sex, body mass index (BMI), fasting blood glucose (FBG) from 1988, blood pressure, total cholesterol (TC), triglycerides (TG), gamma-glutamyl transferase (GGT) and smoking status. These data were merged with the Austrian Dialysis and Transplant Registry to identify ESRD patients. Cox proportional hazards models were applied to calculate hazard ratios (HR) for all-cause ESRD as well as for cause-specific ESRD due to the following primary renal diseases: autosomal dominant polycystic kidney disease (ADPKD), vascular nephropathy (VN), diabetic nephropathy (DN) and other diseases (OD).
  
  
  RESULTS
  During a mean follow-up of 17.5 years 403 participants developed ESRD (ADPKD 36, VN 97, DN 86, and OD 184). All parameters except TG and GGT were significantly associated with all-cause ESRD risk. Particular cause-specific ESRD risk factor patterns were found: for ADPKD increased risk from hypertension (HR 11.55); for VN from smoking (HR 1.81), hypertension (HR 2.37), TG (≥5.70 vs. <1.17 mmol/L: HR 9.27); for DN from smoking (HR 1.77), BMI (≥30 vs. 18.5-24.9 kg/m2: HR 7.55), FBG (≥6.94 vs. <5.55 mmol/L: HR 7.67), hypertension (HR 1.08), TG (≥5.70 vs. <1.17 mmol/L: HR 2.02), GGT (HR 2.14); and for OD from hypertension (HR 2.29), TG (≥5.70 vs. <1.17 mmol/L: HR 6.99) and TC (≥6.22 vs. <5.18 mmol/L: HR 1.56).
  
  
  CONCLUSIONS
  Particular anthropometric and metabolic ESRD risk factors differ in importance depending on the primary renal disease. This needs to be considered for future preventive and therapeutic strategies addressing cause-specific ESRD.
authors.affiliation: Department of Nephrology and Dialysis, Academic Teaching Hospital Feldkirch, Feldkirch, Austria.|Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Academic Teaching Hospital Feldkirch, Feldkirch, Austria.
authors.forename: Emanuel
authors.initials: E
authors.lastname: Zitt
authors.affiliation: Agency for Preventive and Social Medicine, Bregenz, Austria.|Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
authors.forename: Constanze
authors.initials: C
authors.lastname: Pscheidt
authors.affiliation: Agency for Preventive and Social Medicine, Bregenz, Austria.
authors.forename: Hans
authors.initials: H
authors.lastname: Concin
authors.affiliation: Austrian Dialysis and Transplant Registry, Rohr im Kremstal, Austria.
authors.forename: Reinhard
authors.initials: R
authors.lastname: Kramar
authors.affiliation: Department of Nephrology and Dialysis, Academic Teaching Hospital Feldkirch, Feldkirch, Austria.|Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Academic Teaching Hospital Feldkirch, Feldkirch, Austria.
authors.forename: Karl
authors.initials: K
authors.lastname: Lhotta
authors.affiliation: Agency for Preventive and Social Medicine, Bregenz, Austria.|Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Nagel
mesh_terms: D000328:Adult; D001317:Austria / Q000453:epidemiology; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D003928:Diabetic Nephropathies / Q000209:etiology; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D007690:Polycystic Kidney Diseases / Q000209:etiology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D014280:Triglycerides / Q000097:blood; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D001786:Blood Glucose; D014280:Triglycerides; D002784:Cholesterol; D005723:gamma-Glutamyltransferase