Abstract
Background and Aim: To determine risk factors for incident chronic kidney disease (CKD) in a large population-based cohort.
Methods: This prospective opt-in population-based cohort study is based on the 45 and Up Study, where New South Wales residents aged ≥45 years were randomly sampled from the Services Australia database and agreed to complete the 45 and Up Study baseline questionnaire and have their responses linked to their health data in routinely collected databases. The primary outcome was the development of incident CKD, defined as eGFR < 60 mL/min/1.73 m 2. CKD incidence was calculated using Poisson regression. Risk factors for incident CKD were assessed using Cox regression in multivariable models.
Results: In 39 574 participants who did not have CKD at enrolment, independent factors associated with developing CKD included: older age, regional residence (HR 1.38 (1.27–1.50) for outer regional vs major city), smoking (1.13 (1.00–1.27) for current smoker vs non-smoker), obesity (1.25 (1.16–1.35) for obese vs normal body mass index), diabetes mellitus (1.41 (1.33–1.50)), hypertension (1.53 (1.44–1.62)), coronary heart disease (1.13 (1.07–1.20)), depression/anxiety (1.16 (1.09–1.24)) and cancer (1.29 (1.20–1.39)). Migrants were less likely to develop CKD compared with people born in Australia (0.88 (0.83–0.94)). Gender, partner status and socioeconomic factors were not independently associated with developing CKD.
Conclusions: This large population-based study found multiple modifiable and non-modifiable factors were independently associated with developing CKD. In the Australian setting, the risk of CKD was higher with regional residence. Differences according to socioeconomic status were predominantly explained by age, comorbidities and harmful health-related behaviours.
| Original language | English |
|---|---|
| Pages (from-to) | 808-817 |
| Number of pages | 10 |
| Journal | Internal Medicine Journal |
| Volume | 52 |
| Issue number | 5 |
| Early online date | Oct 2020 |
| DOIs | |
| Publication status | Published - 1 May 2022 |
Bibliographical note
Funding Information:AK is supported by a National Health and Medical Research Centre postgraduate scholarship via the University of New South Wales and an Australian Government Research Training Program Fees Offset. LS is supported by a University Postgraduate Award via the University of Sydney. BLN is supported by a National Health and Medical Research Centre postgraduate scholarship. TL is supported by a National Health and Medical Research Council Early Career Fellowship and the National Heart Foundation Postdoctoral Fellowship. RPF was supported by a scholarship from CAPES (Brazilian Agency for the Development of Higher Education). MJJ is currently in receipt of a Next Generation Clinical Researchers Program – Career Development Fellowship funded from the Australian Government Medical Research Future Fund.
Funding Information:
This research was completed using data collected through the 45 and Up Study ( www.saxinstitute.org.au ). The 45 and Up Study is managed by the Sax Institute in collaboration with major partner Cancer Council NSW; and partners; the National Heart Foundation of Australia (NSW Division); NSW Ministry of Health; NSW Government Family & Community Services‐Ageing, Carers and the Disability Council NSW; and the Australian Red Cross Blood Service. We thank the many thousands of people participating in the 45 and Up Study who made this study possible.
Publisher Copyright:
© 2020 Royal Australasian College of Physicians.
