Association between Duration of Exercise (MET Hours per Week) and the Risk of Decreased eGFR: A Cross-Sectional Study Based on a Large Chinese Population

Prediction of incident chronic kidney disease in a population with normal renal function and normo-proteinuria

Regarding the irreversible clinical course of chronic kidney disease, identifying high-risk subjects susceptible to Chronic Kidney Disease (CKD) has an important clinical implication. Previous studies have developed risk prediction models identifying high-risk individuals within a group, including those who may have experienced minor renal damage, to provide an opportunity for initiating therapies or interventions at earlier stages of CKD. To date, there were no other studies developed a prediction model with quantitative risk factors to detect the earliest stage of CKD that individuals with normal renal function in the general population may experience. We derived 11,495,668 individuals with an estimated glomerular filtration rate (eGFR) ≥90 mL/min/1.73 m2 and normo-proteinuria, who underwent health screening ≥2 times between 2009 and 2016 from the prospective nationwide registry cohort. The primary outcome was the incident CKD, defined by an eGFR <60 mL/min/1.73 m2. Sex-specific multivariate Cox regression models predicting the 8-year incident CKD risk were developed. The performance of developed models was assessed using Harrell's C and the area under the receiver operating characteristics curve (AUROC) with 10-fold cross-validation. Both men and women, who met the definition of incident CKD, were older and had more medical treatment history in hypertension and diabetes. Harrell's C and AUROC of the developed prediction models were 0.82 and 0.83 for men and 0.79 and 0.80 for women. This study developed sex-specific prediction equations with reasonable performance in a population with normal renal function.

Association of the Reproductive Period with Decreased Estimated Glomerular Filtration Rate in Menopausal Women: A Study from the Shanghai Suburban Adult Cohort and Biobank (2016-2020)

In previous studies, it has been documented that a short reproductive period is associated with a higher risk of diabetes, cardiovascular disease, and chronic kidney disease. This study aims to investigate the association of the reproductive period length with decreased renal function. This study obtained data from “the Shanghai Suburban Adult Cohort and Biobank”. An estimated glomerular filtration rate (eGFR) below 60 mL/min/1.73 m² indicated decreased renal function during follow-up. Participants were grouped into quintiles by reproductive period. Logistic regression analysis was performed to examine the association between the reproductive period and decreased renal function. A total of 5503 menopausal women with baseline eGFR > 60 mL/min/1.73 m² were included. Age, eGFR, and metabolic equivalent of task (MET) at baseline were 61.0 (range, 36.0–74.0) years, 92.2 (range, 60.1–194.5) mL/min/1.73 m², and 1386 (range, 160–6678), respectively. A reproductive period of 37–45 years was associated with a lower risk of decreased eGFR (OR: 0.59, 95% CI: 0.35–1.00, p = 0.049) after adjusting for confounding variables. METs decreased the risk of decreased eGFR in women with a reproductive period of 37–45 years (OR: 0.43, 95% CI: 0.23–0.81, p = 0.010). Women with a longer reproductive period have a lower risk of decreased renal function. METs had an opposite influence on renal function in women with longer (decreased risk) or shorter (increased risk) reproductive periods.