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Predictors of New-Onset Kidney Disease in a Community-Based Population
Abstract
Context Kidney disease is associated with an increased risk for the development of cardiovascular disease and end-stage renal disease; however, risk factors for kidney disease have not been well studied. Objective To identify predictors of the development of new-onset kidney disease. Design, setting, and participants A community-based, longitudinal cohort study of 2585 participants who attended both a baseline examination in 1978-1982 and a follow-up examination in 1998-2001, and who were free of kidney disease at baseline. Main outcome measures Kidney disease was assessed by the Modification of Diet in Renal Disease Study equation and defined by a glomerular filtration rate (GFR) in the fifth or lower percentile ( Results At baseline, there were 1223 men and 1362 women, with a mean age of 43 years, who were free of preexisting kidney disease. After a mean follow-up of 18.5 years, 244 participants (9.4%) had developed kidney disease. In multivariable models, baseline age (odds ratio [OR], 2.36 per 10-year increment; 95% confidence interval [CI], 2.00-2.78), GFR ( or =120 mL/min per 1.73 m2), a mildly reduced GFR ( Conclusions Established cardiovascular disease risk factors are associated with the development of new-onset kidney disease. Patients with a mildly reduced GFR should be monitored for progression to kidney disease.
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“While dyslipidemia is a risk factor for progressive kidney disease (8,10,20,21)”
From Effects of Fibrates in Kidney Disease (2012) · cites this paper as [8]
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“Hypertension and diabetes are major risk factors for CK”
Self-citationHigh-density lipoprotein revisited: biological functions and clinical relevance
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MethodSelf-citationArora, P., Vasa, P. P., Brenner, D. R., Iglar, K., McFarlane, P., MORRISON, H. I., & Badawi, A. F. (2013) · Canadian Medical Association Journal · doi:10.1503/cmaj.120833 · Cited by 369
“The increasing prevalence of chronic kidney disease can be attributed in part to the growing elderly population and to increasing rates of diabetes and hypertension.(1,6,7) Albuminuria, which can result from abnormal vascular permeability, atherosclerosis or renal disease, has gained recognition as an independent risk…”
BackgroundA Combined Epidemiologic and Metabolomic Approach Improves CKD Prediction
Rhee, E. P., Clish, C. B., Ghorbani, A., Larson, M. G., Elmariah, S., McCabe, E., Yang, Q., Cheng, S., Pierce, K., Deik, A., et al. (2013) · Journal of the American Society of Nephrology · doi:10.1681/asn.2012101006 · Cited by 307
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Insulin Resistance, Hyperinsulinemia, and Renal Injury: Mechanisms and Implications
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Vivante, A., Golan, E., Tzur, D., Leiba, A., Tirosh, A., Skorecki, K. L., & Calderon‐Margalit, R. (2012) · Archives of Internal Medicine · doi:10.1001/2013.jamainternmed.85 · Cited by 317
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Predicting initiation and progression of chronic kidney disease: Developing renal risk scores
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“Fox et al./2004/ USA [7] • FHS: n ¼ 2585, M þ F • Age 42 years 18.5 • n ¼ 244, GFR < 59.25 ml/min/ 1.73 m2 in women, <64.25 ml/ min/1.73 m2 in men, MDRD equation Ever Age, sex, BMI, baseline GFR, DM Jee et al./2005/ Korea[8] • KMIC: n ¼ 157 377, M þ F • Age 44 (35–59) years 10 • Proteinuria: urine dipstick test • 3951…”
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Impairment of PPARα and the Fatty Acid Oxidation Pathway Aggravates Renal Fibrosis during Aging
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“Finally, evaluation of the Framingham Offspring Study, recruited from 1978-1982, found a statistically significant 23% increased risk per standard deviation increase in BMI in adjusted analyses after indirectly calibrating baseline and subsequent serum creatinine measurements (27).”
MethodDomrongkitchaiporn, S., Sritara, P., Kitiyakara, C., Stitchantrakul, W., Krittaphol, V., Lolekha, P., Cheepudomwit, S., & Yipintsoi, T. (2005) · Journal of the American Society of Nephrology · doi:10.1681/asn.2004030208 · Cited by 231
“We performed an indirect calibration of SCr by using a similar method to the recently published study from the Framingham group of investigators (9).”
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BackgroundPrevalence and risk factors of chronic kidney disease in the Thai adult population: Thai SEEK study
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“This finding was similar to one Chinese study that reported an association from the use of Chinese herbs and CKD [18].”
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Dyslipidemia and the progression of renal disease in chronic renal failure patients.
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“73 m2) in the Framingham Offspring study [10].”
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“This outcome was chosen based on previous studies evaluating relevant outcomes for kidney disease progression [14].”
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Prevention of chronic kidney disease: a global challenge.
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“A growing body of evidence suggests that conventional risk factors for CVD are also associated with increased risk of CKD [24].”
BackgroundObesity in CKD—What Should Nephrologists Know?
Stenvinkel, P., Zoccali, C., & Ikizler, T. A. (2013) · Journal of the American Society of Nephrology · doi:10.1681/asn.2013040330 · Cited by 228
A metabolome-wide association study of kidney function and disease in the general population
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Association of eGFR-Related Loci Identified by GWAS with Incident CKD and ESRD
Böger, C. A., Gorski, M., Li, M., Hoffmann, M. M., Huang, C., Yang, Q., Teumer, A., Krane, V., O’Seaghdha, C. M., Kutalik, Z., et al. (2011) · PLoS Genetics · doi:10.1371/journal.pgen.1002292 · Cited by 202
“In population based cohorts, serum creatinine measurements were calibrated to the National Health and Nutrition Examination Study (NHANES) standards in all studies to account for betweenlaboratory variation across studies, as described previously [10,16,17].”
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Fox, C. S., Larson, M. G., Leip, E. P., Meigs, J. B., Wilson, P. W. F., & Levy, D. (2005) · Diabetes Care · doi:10.2337/diacare.28.10.2436 · Cited by 197
Self-citationAssociation of age and BMI with kidney function and mortality: a cohort study
Lü, J., Molnar, M. Z., Naseer, A., Mikkelsen, M. K., Kalantar‐Zadeh, K., & Kovesdy, C. P. (2015) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(15)00128-x · Cited by 233
Chronic kidney disease, creatinine and cognitive functioning
Elias, M. F., Elias, P. K., Seliger, S. L., Narsipur, S. S., Dore, G. A., & Robbins, M. A. (2009) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gfp107 · Cited by 192
“Results of logistic regression analysis showing odds ratios (OR) and confidence intervals (CI) for performing in the lowest quartile of cognitive scores for persons with GFR < 60 (GFR ≥ 60 is the reference group) and P-values for differences between groups Cognitive measure Basic model a Basic + CVD-RF b Basic + CVD-R…”
InfluentialRisk of chronic kidney disease in patients with non-alcoholic fatty liver disease: Is there a link?
Targher, G., Chonchol, M., Zoppini, G., Abaterusso, C., & Bonora, E. (2010) · Journal of Hepatology · doi:10.1016/j.jhep.2010.11.007 · Cited by 175
“In developed countries, older age, hypertension, diabetes, obesity, and dyslipidemia are consistently associated with CKD [1,2,4–8].”
BackgroundEffects of Fibrates in Kidney Disease
Jun, M., Zhu, B., Tonelli, M., Jardine, M. J., Patel, A., Neal, B., Liyanage, T., Keech, A., Cass, A., & Perkovic, V. (2012) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2012.07.049 · Cited by 189
“While dyslipidemia is a risk factor for progressive kidney disease (8,10,20,21) the acute elevation of creatinine caused by fibrates (22) has resulted in concerns about the safety of this therapy in the CKD population (23) and there have been conflicting reports regarding the impact of fibrate therapy on kidney functi…”
BackgroundCardiovascular Complications of Diabetic Kidney Disease
Pálsson, R., & Patel, U. D. (2014) · Advances in Chronic Kidney Disease · doi:10.1053/j.ackd.2014.03.003 · Cited by 303
Fox, C., Larson, M., Vasan, R., Guo, C.-Y., Parise, H., Levy, D., Leip, E., O'Donnell, C., D'Agostino, R., & Benjamin, E. (2006) · Journal of the American Society of Nephrology · doi:10.1681/asn.2005060627 · Cited by 181
Self-citationUromodulin Levels Associate with a Common UMOD Variant and Risk for Incident CKD
Köttgen, A., Hwang, S., Larson, M. G., Eyk, J. E. V., Fu, Q., Benjamin, E. J., Dehghan, A., Glazer, N. L., Kao, W. H. L., Harris, T. B., et al. (2009) · Journal of the American Society of Nephrology · doi:10.1681/asn.2009070725 · Cited by 172
Self-citationPredictors of new-onset decline in kidney function in a general middle-european population
Obermayr, R. P., Temml, C., Knechtelsdorfer, M., Gutjahr, G., Kletzmayr, J., Heiss, S., Ponholzer, A., Madersbacher, S., Oberbauer, R. W., & Klauser‐Braun, R. (2007) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gfm790 · Cited by 184
“Current-smoking at baseline induced 20% higher odds for the development of new-onset kidney disease compared to non-smoking [32,50].”
BackgroundMethodResultInfluentialResistant hypertension—its identification and epidemiology
Sarafidis, P. A., Georgianos, P. I., & Bakris, G. L. (2012) · Nature Reviews Nephrology · doi:10.1038/nrneph.2012.260 · Cited by 183
Obesity increases the risk of end-stage renal disease among living kidney donors
Locke, J. E., Reed, R. D., Massie, A. B., MacLennan, P. A., Sawinski, D. L., Kumar, V., Mehta, S. G., Mannon, R. B., Gaston, R. S., Lewis, C. E., et al. (2016) · Kidney International · doi:10.1016/j.kint.2016.10.014 · Cited by 197
Increased risk of cardiovascular disease and chronic kidney disease in NAFLD
Bonora, E., & Targher, G. (2012) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/nrgastro.2012.79 · Cited by 171
High prevalence of chronic kidney disease in Iran: a large population-based study
Hosseinpanah, F., Kasraei, F., Nassiri, A. A., & Azizi, F. (2009) · BMC Public Health · doi:10.1186/1471-2458-9-44 · Cited by 145
Agricola, E., Ielasi, A., Oppizzi, M., Faggiano, P. M., Ferri, L., Calabrese, A., Vizzardi, E., Alfieri, O., & Margonato, A. (2009) · European Journal of Heart Failure · doi:10.1093/eurjhf/hfp051 · Cited by 180
Relation of serum lipids and lipoproteins with progression of CKD: The CRIC study.
Rahman, M., Yang, W., Akkina, S., Alper, A., Anderson, A. H., Appel, L., He, J., Raj, D., Schelling, J., Strauss, L., et al. (2014) · American Society of Nephrology. Clinical Journal · doi:10.2215/cjn.09320913 · Cited by 168
Elevated Galectin-3 Precedes the Development of CKD
O’Seaghdha, C. M., Hwang, S., Ho, J. E., Vasan, R. S., Levy, D. A., & Fox, C. S. (2013) · Journal of the American Society of Nephrology · doi:10.1681/asn.2012090909 · Cited by 168
Self-citationLipoproteins and fatty acids in chronic kidney disease: molecular and metabolic alterations
Noels, H., Lehrke, M., Vanholder, R. C., & Jankowski, J. (2021) · Nature Reviews Nephrology · doi:10.1038/s41581-021-00423-5 · Cited by 183
Kidney in Early Atherosclerosis
Chade, A., Lerman, A., & Lerman, L. (2005) · HYPERTENSION · doi:10.1161/01.hyp.0000167121.14254.a0 · Cited by 160
Evaluation of predictors of the development of azotemia in cats.
Jepson, R., Brodbelt, D., Vallance, C., Syme, H., & Elliott, J. (2009) · Journal of Veterinary Internal Medicine · doi:10.1111/j.1939-1676.2009.0339.x · Cited by 159
Overweight, obesity, and elevated serum cystatin C levels in adults in the United States.
Muntner, P., Winston, J., Uribarri, J., Mann, D. M., & Fox, C. (2008) · American Journal of Medicine · doi:10.1016/j.amjmed.2008.01.003 · Cited by 156
“5 years of followp.(3) However, sex-specific associations were not presented or this cohort.”
BackgroundSelf-citationThe Renal Pathology of Obesity
Tsuboi, N., Okabayashi, Y., Shimizu, A., & Yokoo, T. (2017) · Kidney International Reports · doi:10.1016/j.ekir.2017.01.007 · Cited by 186
“Obesity not only increases the risk of progression of preexisting renal diseases but is itself also an independent risk factor of renal injury.(4,5) Obesity-related glomerulopathy (ORG) is the best-known renal disease secondary to obesity.”
BackgroundPredicting Progression of IgA Nephropathy: New Clinical Progression Risk Score
Xie, J., Kiryluk, K., Wang, W., Wang, Z., Guo, S., Shen, P., Ren, H., Pan, X., Chen, X., Zhang, W., et al. (2012) · PLoS ONE · doi:10.1371/journal.pone.0038904 · Cited by 149
“These clinical parameters are among the most consistently reported predictors of progression, with similar findings observed across multiple cohorts [29,30,31,32].”
ResultObesity, proteinuria and progression of renal failure
Praga, M., & Morales, E. (2006) · Current Opinion in Nephrology & Hypertension · doi:10.1097/01.mnh.0000242172.06459.7c · Cited by 144
“More recent studies have shown obesityrelated glomerulopathy as an epidemic disease [4], whereas other epidemiologic investigations have concluded that obesity represents a significant risk factor for the appearance of renal insufficiency in a normal population [ 5 ,6].”
BackgroundBariatric Surgery and Kidney-Related Outcomes
Chang, A. R., Grams, M. E., & Navaneethan, S. D. (2017) · Kidney International Reports · doi:10.1016/j.ekir.2017.01.010 · Cited by 156
“In a study led by Navaneethan et al., 13 patients with serum creatinine ≥ 1.3 mg/dl underwent measurement of GFR using iothalamate clearance before surgery and 3, 6, and 12 months after bariatric surgery (RYGB, 7; LAGB, 3; LSG, 3).”
InfluentialReese, P., Feldman, H. I., McBride, M., Anderson, K., Asch, D. A., & Bloom, R. (2008) · American Journal of Transplantation · doi:10.1111/j.1600-6143.2008.02361.x · Cited by 147
“Our criteria for donor complexity, however, are supported by large epidemiological studies on risk factors for chronic kidney disease (31,32,47,48).”
BackgroundChang, A. R., Horn, L. V., Jacobs, D. R., Liu, K., Muntner, P., Newsome, B. B., Shoham, D. A., Durazo-Arvizú, R., Bibbins-Domingo, K. B., Reis, J. P., et al. (2013) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2013.02.363 · Cited by 167
Inflammation, kidney function and albuminuria in the Framingham Offspring cohort.
Upadhyay, A., Larson, M., Guo, C.-Y., Vasan, R., Lipinska, I., O'Donnell, C., Kathiresan, S., Meigs, J., Keaney, J., Rong, J., et al. (2011) · Nephrology, Dialysis and Transplantation · doi:10.1093/ndt/gfq471 · Cited by 145
“0%), and calibrated for the MDRD study equation using a previously described two-step process to minimize any potential inter-laboratory variability [20].”
MethodSelf-citationGoek, O.-N., Prehn, C., Sekula, P., Römisch-Margl, W., Döring, A., Gieger, C., Heier, M., Koenig, W., Wang-Sattler, R., Illig, T., et al. (2013) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gft217 · Cited by 143
“Associations of changes in eGFR with metabolites and ratios were obtained from linear regression analyses, adjusted for known CKD risk factors measured at baseline: age (years) [11], gender, body mass index (BMI, kg/m(2)), systolic blood pressure (mmHg), current smoking status, antihypertensive medication use, antihyp…”
MethodMetabolically healthy obesity and risk of incident CKD.
Hashimoto, Y., Tanaka, M., Okada, H., Senmaru, T., Hamaguchi, M., Asano, M., Yamazaki, M., Oda, Y., Hasegawa, G., Toda, H., et al. (2015) · American Society of Nephrology. Clinical Journal · doi:10.2215/cjn.08980914 · Cited by 143
Arterial Stiffness in Mild-to-Moderate CKD
Upadhyay, A., Hwang, S., Mitchell, G. F., Vasan, R. S., Vita, J. A., Stantchev, P., Meigs, J. B., Larson, M. G., Levy, D. A., Benjamin, E. J., et al. (2009) · Journal of the American Society of Nephrology · doi:10.1681/asn.2009010074 · Cited by 159
Self-citationStage IV Chronic Kidney Disease
Abboud, H. E., & Henrich, W. L. (2010) · New England Journal of Medicine · doi:10.1056/nejmcp0906797 · Cited by 170
Nowak, K. L., You, Z., Gitomer, B. Y., Brosnahan, G., Torres, V. E., Chapman, A. B., Perrone, R. D., Steinman, T. I., Abebe, K. Z., Rahbari-Oskoui, F. F., et al. (2017) · Journal of the American Society of Nephrology · doi:10.1681/asn.2017070819 · Cited by 177
Metadata
- Authors
- Fox, C. S.
- Affiliations
- Framingham Heart Study (US)
- Corresponding author
- Fox, Caroline S.
- ORCID
- Fox, Caroline S.
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2004-02-18
- Volume
- 291
- Issue
- 7
- Pages
- 844
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W1992283514
- Cited by
- 1,241
- References
- 0
- Citations by year
- 2026: 21 · 2025: 28 · 2024: 50 · 2023: 37 · 2022: 53 · 2021: 62 · 2020: 62 · 2019: 47 · 2018: 49 · 2017: 59 · 2016: 81 · 2015: 49 · 2014: 79 · 2013: 83 · 2012: 68
- FWCI
- 28.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (n01hc25195-41-0-1)
- National Heart, Lung, and Blood Institute (N01‐HC25195)
- Topics
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Health Sciences › Medicine › Nephrology › Acute Kidney Injury Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Keywords
- chronic kidney disease, risk factors, glomerular filtration rate, diabetes mellitus, smoking, body mass index, age, MDRD equation, cardiovascular disease, end-stage renal disease, community-based cohort, risk prediction model, renal function decline, hyperlipidemia, antihypertensive drugs, antihypertensive medication adherence
- MeSH terms
- Adult, Aged, Cardiovascular Diseases, Female, Glomerular Filtration Rate, Humans, Kidney Diseases, Longitudinal Studies, Male, Middle Aged, Risk Factors, Logistic Models
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