Dyslipidemias, Obesity, and Smoking Raise CKD Risk
Kidney Int. 2007;71:159-166
Like hypertension and diabetes, dyslipidemias, obesity, and current smoking are among the independent risk factors for CKD, according to Japanese investigators.
They conducted a 10-year follow-up study with 123,764 subjects aged 40 years and older who received community-based annual examinations. During the follow-up period, CKD developed in 23,718 subjects (19.2%). CKD stage I or II (proteinuria) developed in 4,307 subjects and CKD stage III or higher (estimated glomerular filtration rate less than 60 mL/min/1.73 m2) developed in 19,411.
In men and women, obesity was associated, respectively, with a 42% and 56% increased risk of CKD stage I or II. Treated diabetes was associated with a 2.48 and 2.91 times higher risk of proteinuria in men and women, respectively, and current smoking was associated with a 26% and 40% increased risk. Treated hypertension increased the risk by 85% in men and more than twofold in women.
Hypercholesterolemia increased the risk by 13% in both genders. Low HDL increased the risk by 14% in men and 17% in women. High hematuria levels were associated with a 66% increased in men and a 60% increased risk in women. In addition, alcohol intake of less than 20 grams per day was associated with a significant 14% decreased risk in men and 20% decreased risk in women. Alcohol consumption above 20 grams per day did not affect the risk in either gender.
With respect to development of CKD stage III or higher, high proteinuria levels increased the risk by 2.26 and 1.78 times in men and women, respectively. Treated hypertension increased the risk by 39% and 20%, respectively, and treated diabetes increased the risk by 20% and 12%.
Hypercholesterolemia lowered the risk in women by 5% but did not affect the risk in men; low HDL increased the risk in men by 10%, but did not affect the risk in women. Obesity increased the risk slightly in both men and women. Current smoking increased the risk by 13% in men and 16% in women compared with individuals who never smoked. Alcohol intake of less than 20 grams per day lowered the risk by 8% in men and 9% in women, but alcohol intake of more than 20 grams per day did not affect risk.