Cited by 1,241Chronic Kidney Disease and DiabetesAcute Kidney Injury ResearchBlood Pressure and Hypertension Studies

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Predictors of New-Onset Kidney Disease in a Community-Based Population

Fox, Caroline S.·2004·JAMA

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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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Crossref · 10.1001/jama.291.7.844

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Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy
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Non-insulin-based insulin resistance indices for predicting all-cause mortality and renal outcomes in patients with stage 1–4 chronic kidney disease: another paradox
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“The components of Mets including obesity, diabetes, hypertension, and dyslipidemia are also important risk factors for the development and progression of CKD [1,13].”
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Spot urine protein/creatinine ratio as a reliable estimate of 24-hour proteinuria in patients with immunoglobulin A nephropathy, but not membranous nephropathy
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“The association between CKD and dyslipidemia has not been demonstrated in prospective studies, and is still subject to controversy [35, 36].”
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Association between obesity and risk of chronic kidney disease: A nationwide Cohort study in Taiwan
Lai, Y., Hu, H., Lee, Y.-J., Ku, P., Yen, Y., & Chu, D. (2017) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2017.08.006 · Cited by 21
The measured glomerular filtration rate (mGFR) before and 6 months after bariatric surgery: A pilot study
Clerté, M., Wagner, S., Carette, C., Sartorius, A. B., Vilaine, É., Alvarez, J., Abé, E., Barsamian, C., Czernichow, S., & Massy, Z. A. (2017) · Néphrologie & Thérapeutique · doi:10.1016/j.nephro.2016.10.002 · Cited by 23
Prevalence of obesity and risk of chronic kidney disease among young adults in Egypt
Fouad, M., Ismail, M., Gaballah, A., Reyad, E., & Eldeeb, S. (2016) · Indian Journal of Nephrology · doi:10.4103/0971-4065.172597 · Cited by 20
“Our findings were consistent with other reports that link higher BMI with albuminuria, CKD, [21] and higher prevalence of CKD among MS subjects.”
Result
Increased urine podocyte‐associated messenger RNAs in severe obesity are evidence of podocyte injury
Pereira, S. V., dos Santos, M., Rodrigues, P., Nascimento, J. F. D., Timm, J. T., Zancan, R., Friedman, R., & Veronese, F. (2015) · Obesity · doi:10.1002/oby.21156 · Cited by 20
Chronic Kidney Disease in the Elderly
Chow, K. M., & Li, P. K. (2014) · Springer eBooks · doi:10.1007/978-3-642-54637-2_30 · Cited by 1
“Recent data reveal that around 45% of that subjects should be attributed to diabetes mellitus (20).”
Background
Smoking Is a Risk Factor for the Progression of Idiopathic Membranous Nephropathy
Yamaguchi, M., Ando, M., Yamamoto, R., Akiyama, S., Kato, S., Katsuno, T., Kosugi, T., Sato, W., Tsuboi, N., Yasuda, Y., et al. (2014) · PLoS ONE · doi:10.1371/journal.pone.0100835 · Cited by 20
“It has recently become apparent that cigarette smoking, in addition to promoting cardiovascular disease (CVD), is an important independent renal risk factor [12–21].”
Background
Analysis of factors predicting mortality of new patients commencing renal replacement therapy 10 years of follow-up
Browne, O. T., Allgar, V. L., & Bhandari, S. (2014) · BMC Nephrology · doi:10.1186/1471-2369-15-20 · Cited by 24
“are predictive of those who will go on to require dialysis [3].”
Background
Male sex and vascular risk factors affect cystatin C-derived renal function in older people without diabetes or overt vascular disease
Werner, K., Elmståhl, S., Christensson, A., & Pihlsgård, M. (2013) · Age and Ageing · doi:10.1093/ageing/aft191 · Cited by 20
“[8, 26].”
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Nagel, G., Zitt, E., Peter, R. S., Alfonso Pompella, C., Concin, H., & Lhotta, K. (2013) · BMC Nephrology · doi:10.1186/1471-2369-14-177 · Cited by 19
“An association between high BMI and obesity and CKD has been reported in several previous population-based studies with rather long follow-up [2,12,15,17,18].”
Result
Subclinical cerebral abnormalities in chronic kidney disease.
Yao, H., Takashima, Y., Hashimoto, M., Uchino, A., & Yuzuriha, T. (2013) · Contributions to Nephrology · doi:10.1159/000346719 · Cited by 20
Progression of Chronic Kidney Disease: Mechanisms and Interventions in Retardation
Balasubramanian, S. (2013) · Apollo Medicine · doi:10.1016/j.apme.2013.01.009 · Cited by 18
“Several population-based studies have shown an increased risk of developing progressive renal failure with higher levels of blood pressure, 76 e 79 and is exempliﬁed by ﬁndings from the Multiple Risk Factor Intervention Trial (MRFIT).”
Management of Obesity-Induced Kidney Disease: A Critical Review of the Literature
Kiortsis, D., & Christou, M. (2012) · Obesity Facts · doi:10.1159/000345919 · Cited by 20
Genetic Variation at Selected SNPs in the Leptin Gene and Association of Alleles with Markers of Kidney Disease in a Xhosa Population of South Africa
Okpechi, I., Rayner, B., van der Merwe, L., Mayosi, B., Adeyemo, A., Tiffin, N., & Ramesar, R. (2010) · PLoS ONE · doi:10.1371/journal.pone.0009086 · Cited by 20
“Recently, obesity has been identified as a major driver for progressive kidney injury [8,9].”
Background
A model to predict the cost‐effectiveness of disease management programs
Gandjour, A. (2009) · Health Economics · doi:10.1002/hec.1503 · Cited by 21
Decreased body mass index as an independent risk factor for developing chronic kidney disease
Tokashiki, K., Tozawa, M., Iseki, C., Kohagura, K., Kinjo, K., Takishita, S., & Iseki, K. (2009) · Clinical and Experimental Nephrology · doi:10.1007/s10157-008-0085-y · Cited by 20
“Obesity is related to hemodynamic changes leading to hyperfiltration, inflammation, coagulation, and therefore to hypertension, diabetes mellitus (DM), and components of metabolic syndrome [9–12].”
Background
Indexes of Kidney Function and Coronary Artery and Abdominal Aortic Calcium (from the Framingham Offspring Study)
Parikh, N. I., Hwang, S., Larson, M. G., Hoffmann, U., Levy, D. A., Meigs, J. B., O’Donnell, C. J., & Fox, C. S. (2008) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2008.04.007 · Cited by 19
Self-citation
Relations of Measures of Endothelial Function and Kidney Disease: The Framingham Heart Study
Foster, M., Keyes, M., Larson, M., Vita, J., Mitchell, G., Meigs, J., Vasan, R., Benjamin, E., & Fox, C. (2008) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2008.04.027 · Cited by 20
Self-citation
Supersized kidneys: Lessons from the preclinical obese kidney.
D'Agati, V. D., & Markowitz, G. S. (2008) · Kidney International · doi:10.1038/ki.2008.42 · Cited by 20
Cross-classification by systolic and diastolic blood pressure levels and chronic kidney disease, proteinuria, or kidney function decline
Suenaga, T., Satoh, M., Murakami, T., Hirose, T., Obara, T., Nakayama, S., Hashimoto, H., Toyama, M., Muroya, T., Kanno, A., et al. (2023) · Hypertension Research · doi:10.1038/s41440-023-01267-1 · Cited by 19
Anthropometric Measures and Incident Diabetic Nephropathy in Participants With Type 2 Diabetes Mellitus
Hukportie, D. N., Li, F., Zhou, R., Zheng, J., Wu, X., & Wu, X. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2021.706845 · Cited by 24
Blood pressure measurement device selection in low‐resource settings: Challenges, compromises, and routes to progress
Brady, T., Padwal, R., Blakeman, D. E., Farrell, M., Frieden, T., Kaur, P., Moran, A. E., & Jaffe, M. (2020) · The Journal of Clinical Hypertension · doi:10.1111/jch.13867 · Cited by 19
Risk Factors for Prognosis in Patients With Severely Decreased GFR
Evans, M., Grams, M. E., Sang, Y., Astor, B. C., Blankestijn, P. J., Brunskill, N. J., Collins, J. F., Kalra, P. A., Kovesdy, C. P., Levin, A., et al. (2018) · Kidney International Reports · doi:10.1016/j.ekir.2018.01.002 · Cited by 52
“In this large meta-analysis, we studied risk factors for KRT, CVD, and death in 185,244 people with stages 4 – 5 CKD. Traditional risk factors were of important prognostic value in this population, although associations varied by outcome of interest.”
Influential
Kidney Disease and Psoriasis. A New Comorbidity?
González-Parra, E., Daudén, E., Carrascosa, J., Olveira, A., Botella, R., Bonanad, C., & Rivera, R. (2016) · Actas Dermo-Sifiliográficas · doi:10.1016/j.ad.2016.05.009 · Cited by 19
Association of anthropometric measures with kidney disease progression and mortality: a retrospective cohort study of pre-dialysis chronic kidney disease patients referred to a specialist renal service
Davis, E., Campbell, K. L., Gobe, G. C., Hawley, C. M., Isbel, N. M., & Johnson, D. W. (2016) · BMC Nephrology · doi:10.1186/s12882-016-0290-y · Cited by 22
“fied as a risk factor for new onset kidney disease [6] and mortality in the general population [7], the evidence in”
Background
Renal function trajectory over time and adverse clinical outcomes
Sohel, B. M., Rumana, N., Ohsawa, M., Turin, T., Kelly, M., & Mamun, M. A. (2016) · Clinical and Experimental Nephrology · doi:10.1007/s10157-015-1213-0 · Cited by 19
The prodromal phase of obesity-related chronic kidney disease: early alterations in cardiovascular and renal function in obese children and adolescents
Doyon, A., & Schaefer, F. (2013) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gft263 · Cited by 21
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Background
Job stress strengthens the link between metabolic risk factors and renal dysfunction in adult men.
Tsurugano, S., Nakao, M., Takeuchi, T., Nomura, K., & Yano, E. (2012) · Tohoku journal of experimental medicine · doi:10.1620/tjem.226.101 · Cited by 19
“Not only is CKD a predictor for endstage renal disease, but numerous epidemiological studies have indicated that CKD is an important risk factor for the onset and mortality of people with cardiovascular disease (CVD) (Go et al. 2004; Fox et al. 2004).”
BackgroundInfluential
Proteinuria and decreased body mass index as a significant risk factor in developing end-stage renal disease
Iseki, K., Tokashiki, K., Iseki, C., Kohagura, K., Kinjo, K., & Takishita, S. (2008) · Clinical and Experimental Nephrology · doi:10.1007/s10157-008-0061-6 · Cited by 19
“Obesity is related to hemodynamic changes leading to hyperfiltration, inflammation, and coagulation, which in turn lead to hypertension, diabetes mellitus (DM), and components of metabolic syndrome [9–12].”
Background
Relation of low glomerular filtration rate to metabolic disorders in individuals without diabetes and with normoalbuminuria.
Lorenzo, C., Nath, S., Hanley, A., Abboud, H., & Haffner, S. (2008) · American Society of Nephrology. Clinical Journal · doi:10.2215/cjn.02730707 · Cited by 19
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“In a somewhat different community-based population initially free of kidney disease, an independent association between elevated SBP and increased risk for developing kidney disease (defined as a glomerular filtration rate [GFR] in the fifth or lower percentile) was reported in the Framingham Offspring Study [ 18 ].”
Smoking Timing, Healthy Diet, and Risk of Incident CKD Among Smokers: Findings From UK Biobank.
Tang, R., Hu, Y., Zhou, J., Wang, X., Li, X., Heianza, Y., & Qi, L. (2024) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2024.04.011 · Cited by 18
Serum triglycerides level is independently associated with renal outcomes in patients with non-dialysis chronic kidney disease: Results from KNOW-CKD study
Suh, S.-H.-O., Oh, T. R., Choi, H.-S., Kim, C., Bae, E., Oh, K., Han, S., Ma, S., & Kim, S. (2022) · Frontiers in Nutrition · doi:10.3389/fnut.2022.1037618 · Cited by 18
“A community-based, longitudinal cohort study of 2,585 participants from Framingham Offspring Study showed that HDL-C level is inversely associated with the risk of new-onset CKD among those free of CKD at the baseline (17).”
Background
Association of blood pressure and renal outcome in patients with chronic kidney disease; a post hoc analysis of FROM-J study
Tsuchida-Nishiwaki, M., Uchida, H., Takeuchi, H., Nishiwaki, N., Maeshima, Y., Saito, C., Sugiyama, H., Wada, J., Narita, I., Watanabe, T., et al. (2021) · Scientific Reports · doi:10.1038/s41598-021-94467-z · Cited by 18
Glomerular function in relation to fine airborne particulate matter in a representative population sample
Feng, Y.-M., Thijs, L., Zhang, Z.-Y., Bijnens, E., Yang, W.-Y., Wei, F.-F., Janssen, B., Nawrot, T., & Staessen, J. (2021) · Scientific Reports · doi:10.1038/s41598-021-94136-1 · Cited by 18
Association of Longitudinal Trajectories of Systolic BP with Risk of Incident CKD: Results from the Korean Genome and Epidemiology Study.
Joo, Y. S., Lee, C., Kim, H., Jhee, J., Yun, H., Park, J., Chang, T., Yoo, T., Kang, S.-W., & Han, S. (2020) · Journal of the American Society of Nephrology · doi:10.1681/asn.2020010084 · Cited by 18

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
DOI: 10.1001/jama.291.7.844
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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Predictors of New-Onset Kidney Disease in a Community-Based Population

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