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Jaques DA, Vollenweider P, Bochud M, Ponte B. Aging and hypertension in kidney function decline: A 10 year population-based study. Front Cardiovasc Med 2022; 9:1035313. [PMID: 36277793 PMCID: PMC9582457 DOI: 10.3389/fcvm.2022.1035313] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
Background Aging is associated with a physiological decline in kidney function (KFD). In this study, we aimed to describe the impact of age on the rate of KFD and its interplay with risk factors for chronic kidney disease (CKD), considering mainly hypertension (HT), in the general population. Materials and methods Participants of European descent, aged 35-75, were recruited from a populational cohort in Lausanne, Switzerland. Participants with a 10 year follow-up were selected. KFD was defined as the difference in estimated glomerular filtration rate (eGFR) between baseline and follow-up, divided by the observation period. Multivariate linear regressions were used with KFD as the outcome and age as the main predictor. HT was tested as a modifying factor. Results We included 4,163 participants with mean age 52.2 ± 10.4, 44.7% men, 31.9% HT, and 5.0% diabetics. Mean baseline eGFR was 85.9 ± 14.6 ml/min/1.73 m2. Mean KFD was -0.49 ± 1.08 ml/min/1.73 m2 per year with 70% of participants decreasing their eGFR during follow-up. The relationship between age and KFD was non-linear and age was divided in tertiles. Old participants had faster rates of KFD as compared to young and middle-age participants (p < 0.001). A significant interaction was found between age and HT on KFD prediction (p < 0.001). In HT participants, KFD was significantly different across tertiles of age (p < 0.001). On contrary, KFD was not different across tertiles of age in non-HT participants. Conclusion A physiological KFD is present over time in the general population. Age contributes non-linearly to the rate of this decline with older subjects declining the fastest. The presence of HT is a major contributing factor in this setting as KFD worsened with age only in hypertensive participants. Thus, HT represents an important pathological factor aggravating the age-related physiological decline in eGFR in the general population.
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Affiliation(s)
- David A. Jaques
- Division of Nephrology, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland,*Correspondence: David A. Jaques,
| | - Peter Vollenweider
- Department of Internal Medicine, University Hospital of Lausanne, Lausanne, Switzerland
| | - Murielle Bochud
- Department of Epidemiology and Health Systems, University Center of General Medicine and Public Health, Lausanne, Switzerland
| | - Belen Ponte
- Division of Nephrology, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland,Department of Epidemiology and Health Systems, University Center of General Medicine and Public Health, Lausanne, Switzerland,Belen Ponte,
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Fransson F, Werneke U, Harju V, Öhlund L, de Man Lapidoth J, Jonsson PA, Stegmayr B, Renberg ES, Ott M. Kidney function in patients with bipolar disorder with and without lithium treatment compared with the general population in northern Sweden: results from the LiSIE and MONICA cohorts. Lancet Psychiatry 2022; 9:804-814. [PMID: 36108668 DOI: 10.1016/s2215-0366(22)00265-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/01/2022] [Accepted: 07/04/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND The clinical relevance of lithium nephropathy is subject to debate. Kidney function decreases with age and comorbidities, and this decline might lead to attribution bias when erroneously ascribed to lithium. We aimed to investigate whether patients with bipolar or schizoaffective disorder had faster decline in estimated glomerular filtration rate (eGFR) compared with the general population, whether observed differences in the steepness of the decline were attributable to lithium, and whether such changes depended on the length of lithium exposure. METHODS In this cross-sectional cohort study, we used clinical data from the Lithium-Study into Effects and Side-effects (LiSIE) retrospective cohort study, which included patients with bipolar disorder or schizoaffective disorder whose medical records were reviewed up to Dec 31, 2017, and the WHO Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) study, covering a representative sample of the general population in northern Sweden aged 25-74 years. The primary outcome was the age-associated decline of creatinine-based eGFR, assessed using linear regression. We adjusted for sex and grouped for different lengths of lithium exposure (never or <1 year, 1-5 years, >5-10 years, and >10 years). For patients with moderate-to-severe kidney disease we identified the underlying nephropathy in the case records. FINDINGS From LiSIE, we included 785 patients (498 [63%] female and 287 [37%] male), with a mean age of 49·8 years (SD 13·2; range 25-74). From MONICA, we included 1549 individuals (800 [52%] female and 749 [48%] male), with a mean age of 51·9 years (13·8; 25-74). No ethnicity data were collected. Adjusted for duration of lithium exposure, eGFR declined by 0·57 mL/min/1·73 m2/year (95% CI 0·50-0·63) in patients with bipolar disorder or schizoaffective disorder and by 0·57 mL/min/1·73 m2/year (0·53-0·61) in the reference population. Lithium added 0·54 mL/min/1·73 m2 (0·43-0·64) per year of treatment (p<0·0001). After more than 10 years on lithium, decline was significantly steeper than in all other groups including the reference population (p<0·0001). Lithium nephropathy was judged to be the commonest cause of moderate-to-severe chronic kidney disease, but comorbidities played a role. The effect of lithium on eGFR showed a high degree of inter-individual variation. INTERPRETATION Steeper eGFR decline in patients with bipolar disorder or schizoaffective disorder can be attributed to lithium, but the trajectory of kidney function decline varies widely. Comorbidities affecting kidneys should be treated assertively as one possible means to affect the trajectory. In patients with a fast trajectory, a trade-off is required between continuing lithium to treat mental health problems and discontinuing lithium for the sake of renal health. FUNDING Norrbotten County Research and Learning Fund Sweden, Visare Norr (Northern County Councils Regional Federation Fund), Swedish Kidney Foundation (Njurfonden), Swedish Kidney Association (Njurförbundet), Norrbotten section. TRANSLATION For the Swedish translation of the Summary see Supplementary Materials section.
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Affiliation(s)
- Filip Fransson
- Medicine Section, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | | | - Vesa Harju
- Medical Clinic, Kalix Hospital, Kalix, Sweden
| | - Louise Öhlund
- Sunderby Research Unit, Umeå University, Umeå, Sweden
| | - Julia de Man Lapidoth
- Medicine Section, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - P Andreas Jonsson
- Medicine Section, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Bernd Stegmayr
- Medicine Section, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | | | - Michael Ott
- Medicine Section, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
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Ghorbaninejad P, Mohammadpour S, Djafari F, Tajik S, Shab-Bidar S. Dietary Total Antioxidant Capacity and Its Association with Renal Function and Progression of Chronic Kidney Disease in Older Adults: a Report from a Developing Country. Clin Nutr Res 2020; 9:296-306. [PMID: 33204669 PMCID: PMC7644366 DOI: 10.7762/cnr.2020.9.4.296] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/20/2020] [Accepted: 10/22/2020] [Indexed: 01/15/2023] Open
Abstract
While evidence exists for an association between the dietary total antioxidant capacity (DTAC), mortality, metabolic syndrome, and cardiovascular diseases, data about DTAC and renal function, and progression of chronic kidney disease (CKD) are scarce. This study aimed to determine the associations between DTAC, renal function, and progression of CKD in older adults. The present cross-sectional study consisted of 226 older adults aged ≥ 60 years old from five districts of Tehran, Iran. DTAC was estimated using the oxygen radical absorbance capacity (ORAC) method. Dietary intake, socio-demographic data, medical history, and anthropometric measurements were collected using a validated questionnaire. The estimated glomerular filtration rate (eGFR) was assessed from serum creatinine. Albumin to creatinine ratio (ACR) was calculated by dividing albumin concentration by creatinine concentration and reported as mg/g. The DTAC ranged from 112.8 to 2,553.9. Analyses indicated that DTAC was not associated with eGFR (p = 0.35) and ACR (p = 0.91) even after controlling for confounding variables. Additionally, in logistic regression, no association between eGFR < 60 mL/min/1.73 m2 (p = 0.32) and ACR ≥ 30 mg/g (p = 0.32) with DTAC was observed, which was independent of confounding variables. We observed that more compliance with DTAC is not associated with renal function and CKD progression. Further studies are needed to confirm the findings of the present study in larger samples on different populations.
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Affiliation(s)
- Parivash Ghorbaninejad
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran 14167-53955, Iran
| | - Saba Mohammadpour
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran 14167-53955, Iran
| | - Farhang Djafari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran 14167-53955, Iran
| | - Somayeh Tajik
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran 14167-53955, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran 14167-53955, Iran
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You X, Wu W, Xu J, Jiao Z, Ke M, Huang P, Lin C. Development of a Physiologically Based Pharmacokinetic Model for Prediction of Pramipexole Pharmacokinetics in Parkinson's Disease Patients With Renal Impairment. J Clin Pharmacol 2020; 60:999-1010. [PMID: 32090332 DOI: 10.1002/jcph.1593] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 01/23/2020] [Indexed: 12/18/2022]
Affiliation(s)
- Xiang You
- Department of Pharmacythe First Affiliated Hospital of Fujian Medical University Taijiang Fuzhou People's Republic of China
| | - Wanhong Wu
- Department of Pharmacythe First Affiliated Hospital of Fujian Medical University Taijiang Fuzhou People's Republic of China
| | - Jing Xu
- Department of Pharmacythe First Affiliated Hospital of Fujian Medical University Taijiang Fuzhou People's Republic of China
| | - Zheng Jiao
- Department of Pharmacy, Shanghai Chest HospitalShanghai Jiao Tong University Shanghai People's Republic of China
| | - Meng Ke
- Department of Pharmacythe First Affiliated Hospital of Fujian Medical University Taijiang Fuzhou People's Republic of China
| | - Pinfang Huang
- Department of Pharmacythe First Affiliated Hospital of Fujian Medical University Taijiang Fuzhou People's Republic of China
| | - Cuihong Lin
- Department of Pharmacythe First Affiliated Hospital of Fujian Medical University Taijiang Fuzhou People's Republic of China
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Ohtsu I, Ishikawa M, Matsunaga N, Karita K, Yoshida M, Ochiai H, Shirasawa T, Yoshimoto T, Minoura A, Sai S, Kokaze A. Longevity-associated mitochondrial DNA 5178 C/A polymorphism modifies effect of aging on renal function in male Japanese health checkup examinees: an exploratory cross-sectional study. J Physiol Anthropol 2019; 38:12. [PMID: 31488191 PMCID: PMC6729028 DOI: 10.1186/s40101-019-0204-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 08/27/2019] [Indexed: 12/15/2022] Open
Abstract
Background Mitochondrial DNA 5178 (Mt5178) C/A polymorphism is reportedly associated with longevity in the Japanese population. The objective of this study was to investigate whether Mt5178 C/A polymorphism influences the effect of physiological aging on renal function in male Japanese health checkup examinees. Methods A total of 404 male subjects (mean age ± SD, 53.9 ± 7.8 years; range, 29–76 years) were selected from among individuals visiting the hospital for regular medical checkups. After Mt5178 C/A genotyping, a cross-sectional study assessing the joint effects of Mt5178 C/A polymorphism and aging on renal function was then conducted. Renal function was evaluated by estimated glomerular filtration rate (eGFR). Subjects were divided into three age groups (< 50, 50–59, ≥ 60 years). Results In simple linear regression analysis, a significant negative association between aging and eGFR was observed in both Mt5178C and Mt5178A genotypic men (P < 0.001 and P = 0.003, respectively). However, in multiple linear regression analysis, a significant effect of aging on reduced eGFR was observed only in Mt5178C genotypic men (P < 0.001). Logistic regression analysis showed that, in the case of reduced eGFR defined as < 75 mL/min/1.73 m2, reduced eGFR was dependent on aging in both Mt5178C and Mt5178A genotypic men (P for trend < 0.001 and P for trend = 0.002, respectively). After adjusting for smoking status and alcohol consumption, reduced eGFR was also dependent on aging in both Mt5178C and Mt5178A genotypic men (P for trend < 0.001 and P for trend = 0.014, respectively). However, in reduced eGFR defined as < 90 mL/min/1.73 m2, reduced eGFR was dependent on aging only in Mt5178C genotypic men (P for trend < 0.001). Conclusions This cross-sectional study suggests that Mt5178 C/A polymorphism modulates the effects of physiological aging on kidney function in Japanese men.
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Affiliation(s)
- Iichiro Ohtsu
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| | - Mamoru Ishikawa
- Department of Public Health, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan.,Mito Red Cross Hospital, 3-12-48 Sannomaru, Mito-shi, Ibaraki, 310-0011, Japan
| | - Naomi Matsunaga
- Department of Public Health, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Kanae Karita
- Department of Public Health, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Masao Yoshida
- Department of Public Health, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Hirotaka Ochiai
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| | - Takako Shirasawa
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| | - Takahiko Yoshimoto
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| | - Akira Minoura
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| | - Shogo Sai
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| | - Akatsuki Kokaze
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan.
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Prediction model for acute kidney injury after coronary artery bypass grafting: a retrospective study. Int Urol Nephrol 2019; 51:1605-1611. [DOI: 10.1007/s11255-019-02173-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 05/14/2019] [Indexed: 10/26/2022]
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Kaburaki S, Yoshimura E, Kojima N, Ueno H, Sugawara M, Takekuma Y. Improvement of renal function estimation equations for elderly Japanese people. Health Sci Rep 2018; 1:e85. [PMID: 30623041 PMCID: PMC6266418 DOI: 10.1002/hsr2.85] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 06/25/2018] [Accepted: 07/27/2018] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND AND AIM The Cockcroft-Gault (C-G) equation for estimation of creatinine clearance (CCr) is still used in a clinical setting for drug dosage adjustment. Because differences between measured and estimated CCr values have been reported, particularly for Japanese elderly people, the aim of this study was to improve the accuracy of CCr estimation equations, such as C-G and Orita-Horio, by fitting to newly obtained data. Also, glomerular filtration rate (GFR) estimation equations, such as the Modification of Diet in Renal Disease (MDRD), the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), and the eGFR equation for Japanese people, were studied to compare with measured CCr. METHOD Data from 313 subjects over the age of 40 years with laboratory data available were used for analysis in this study. Special attention was paid to elderly people, and approximately 70% of the subjects were over the age of 65 years. RESULTS The accuracy of estimation by the two conventional (C-G, Orita-Horio) CCr estimation equations was greatly improved by introducing adjusted body weight for which the degree of obesity is over 30% instead of measured body weight. By fitting the coefficients of the estimation equations to the present population, the mean error was reduced by almost half, particularly for people over the age of 75. Although all the values calculated by the GFR estimation equations were underestimated compared with measured CCr due to secretion, a coefficient of determination of above 0.65 was obtained for all GFR estimation equations. CONCLUSIONS Improvement of the fitted CCr estimation equations suggests that reconstruction of renal function estimation equations is required, especially for old people. Further work is required to find optimal renal function (CCr and/or GFR) estimation equations for drug dosage adjustment.
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Affiliation(s)
- Soyoko Kaburaki
- Graduate School of Life ScienceHokkaido UniversitySapporoJapan
| | - Eri Yoshimura
- Department of PharmacySunagawa City Medical CenterSunagawaJapan
| | - Nozomi Kojima
- Department of PharmacySunagawa City Medical CenterSunagawaJapan
| | - Hidefumi Ueno
- Department of PharmacySunagawa City Medical CenterSunagawaJapan
| | - Mitsuru Sugawara
- Faculty of Pharmaceutical SciencesHokkaido UniversitySapporoJapan
| | - Yoh Takekuma
- Faculty of Pharmaceutical SciencesHokkaido UniversitySapporoJapan
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Quantification of Single-Kidney Function and Volume in Living Kidney Donors Using Dynamic Contrast-Enhanced MRI. AJR Am J Roentgenol 2016; 207:1022-1030. [DOI: 10.2214/ajr.16.16168] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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