Tsai JC, Chen SC, Hwang SJ, Chang JM, Lin MY, Chen HC. Prevalence and risk factors for CKD in spouses and relatives of hemodialysis patients.
Am J Kidney Dis 2010;
55:856-66. [PMID:
20153917 DOI:
10.1053/j.ajkd.2009.12.021]
[Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2009] [Accepted: 12/11/2009] [Indexed: 12/12/2022]
Abstract
BACKGROUND
A higher prevalence of chronic kidney disease (CKD) has been found in genetic relatives of patients with end-stage renal disease. However, the risk of CKD in nongenetic spouses of patients with end-stage renal disease is still unknown.
STUDY DESIGN
Cross-sectional study.
SETTING & PARTICIPANTS
196 first- and second-degree relatives and 95 spouses of 178 hemodialysis (HD) patients were enrolled. Two sex- and age-stratified matched counterpart controls were randomly selected from the population of a community screening program for CKD.
PREDICTORS
Relatives or spouses of HD patients and kidney disease risk factors.
OUTCOMES
Prevalence of CKD (albuminuria or low estimated glomerular filtration rate).
MEASUREMENT
Albuminuria (urine albumin-creatinine ratio > or = 30 mg/g), low estimated glomerular filtration rate (<60 mL/min/1.73 m(2)), and kidney disease risk factors of age, hypertension, diabetes mellitus, metabolic syndrome, and lifestyle.
RESULTS
A significantly higher prevalence of CKD was found in relatives (15.8% vs 7.5%; P = 0.01) and spouses (41.1% vs 15.8%; P < 0.001) of HD patients compared with their counterpart controls. Multiple logistic regression analysis showed that age (OR, 1.05) and hypertension (OR, 3.13) were significant independent risk factors for CKD in relatives of HD patients, whereas diabetes mellitus (OR, 3.51) was a significant risk factor for CKD in spouses of HD patients. For all pooled participants, being relatives (OR, 2.55) or spouses (OR, 2.80) of HD patients, age (OR, 1.06), female sex (OR, 1.81), diabetes mellitus (OR, 3.95), hypertension (OR, 1.85), and hyperuricemia (OR, 2.06) were independent significant risk factors for CKD.
LIMITATIONS
Cross-sectional research design, single laboratory measurement, and limited numbers of participants.
CONCLUSIONS
A comprehensive screening program for CKD is equally important in both relatives and spouses of HD patients, especially for participants with the renal risk factors of older age, hypertension, and diabetes mellitus. Spousal concordance of CKD suggests that the shared environmental factors and health behaviors might have important roles in the development of CKD.
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