1,720,973 research outputs found
GLOMERULAR FILTRATION RATE AND SERUM PHOSPHATE: AN INVERSE RELATION DILUTED BY AGE
No full textFeb 11. [Epub ahead of print] PMID: 19211647 [PubMed - as supplied by publisher
Early detection of chronic kidney disease: epidemiological data on renal dysfunction
No full textEstimated glomerular filtration rate (eGFR) and urinary albumin (U-Alb) have been suggested as indicators for the early identification of persons with kidney dysfunction. The Gubbio Study collected data on serum creatinine, UAlb, other laboratory indices, blood pressure, and medical history in a population sample of 4574 adults (2083 men and 2491 women, age range 18- 95 years). The study included analyses on six disorders which are commonly associated with kidney disease (hypertension, cardiovascular disease, anemia, high serum uric acid, high serum phosphorus/low serum calcium, and high serum potassium). Low eGFR ( 30% at > or =75 years in both sexes, p or =20 microg/min) in the presence of non-low eGFR. Low eGFR was associated with at least two disorders potentially due to kidney disease in the majority of persons but was rarely associated with a previous diagnosis of kidney disease (<5% of cases). These data support the use of eGFR for the screening of people with or at risk of developing kidney disease. Awareness of kidney disease is very low in the Italian population
Early identification of kidney disease by eGFR: What is the prevalence of eGFR in the population?
No full textEarly detection of chronic kidney disease: epidemiological data on renal dysfunction
No full textEstimated glomerular filtration rate (eGFR) and urinary albumin (U-Alb) have been suggested as indicators for the early identification of persons with kidney dysfunction. The Gubbio Study collected data on serum creatinine, UAlb, other laboratory indices, blood pressure, and medical history in a population sample of 4574 adults (2083 men and 2491 women, age range 18- 95 years). The study included analyses on six disorders which are commonly associated with kidney disease (hypertension, cardiovascular disease, anemia, high serum uric acid, high serum phosphorus/low serum calcium, and high serum potassium). Low eGFR ( 30% at > or =75 years in both sexes, p or =20 microg/min) in the presence of non-low eGFR. Low eGFR was associated with at least two disorders potentially due to kidney disease in the majority of persons but was rarely associated with a previous diagnosis of kidney disease (<5% of cases). These data support the use of eGFR for the screening of people with or at risk of developing kidney disease. Awareness of kidney disease is very low in the Italian population
Renal dysfunction as a marker of cardiovascular risk
No full textThe evaluation of urinary albumin excretion (UAE) and estimated glomerular filtration rate (eGFR) is suggested for the assessment of cardiovascular risk. It is unclear whether UAE and eGFR provide complementary information. UAE, eGFR, cardiovascular risk factors, and the incidence of cardiovascular disease were analyzed in 45- to 64-year-old individuals involved in the Gubbio study. UAE in the highest decile was defined as high (microng/min: > or = 18.6 in men and > or = 15.7 in women), eGFR in the lowest decile as low (mL/min/1.73 m(2): <64.2 in men and <57.9 in women). Kidney dysfunction was more frequent when defined by both markers than when defined by one marker only (UAE or eGFR) because high UAE and low eGFR tended to cluster in different individuals. The hazard ratio (HR) for incident cardiovascular disease was 1.85 in individuals with high UAE only (95%CI 1.04-3.25), 1.84 in individuals with low eGFR only (95%CI 1.04-3.26), and 5.93 in individuals with high UAE and low eGFR (95%CI 2.58-13.61). Concomitant evaluation of UAE and eGFR should be considered to adequately assess kidney dysfunction and cardiovascular risk
Urinary albumin excretion and coronary artery disease
No full textThe moderate elevation in urinary albumin excretion defined as microalbuminuria is common in the population and associated with cardiovascular (CV) risk factors. Microalbuminuria prevalence is low in the absence of CV risk factors and progressively increases with the number of the individual's CV risk factors. The main correlate of microalbuminuria is blood pressure (BP). The relationship between BP and microalbuminuria is continuous and graded since the prevalence of microalbuminuria increases with the severity of hypertension. Among hypertensives receiving treatment, BP control is associated with a low prevalence of microalbuminuria. Therefore, BP appears as a determinant of microalbuminuria rather than a mere correlate. For hypercholesterolemia, smoking and diabetes, the data are less strong, but point to an independent positive association with microalbuminuria. Altogether, data indicate that microalbuminuria in the population reflects the presence of CV risk factors. Data concerning microalbuminuria and coronary heart disease (CHD) support this idea. There is a continuous and graded relationship between urinary albumin excretion and CHD prevalence. High urinary albumin excretion is a likely sign of vascular damage existing both at renal and cardiac levels and induced by one or more uncontrolled CV risk factors
Protein intake and kidney function in the middle-age population: contrast between cross-sectional and longitudinal data
No full textBackground. Protein intake is considered a determinant of
glomerular filtration rate (GFR). Urinary urea is an objective
marker of protein intake. The population-based study investigated,
cross-sectionally and longitudinally, the association of
protein intake with GFR, indexed by estimated GFR (eGFR).
Methods. Data were collected on overnight urinary urea, serum
creatinine (S-cr), eGFR and other variables in 1522 men and
women aged 45–64 years who participated in the Gubbio study
(baseline). S-Cr, eGFR and other variables were re-assessed in
1144 of the 1425 survivors after 12-year follow-up.
Results. At baseline, mean ± SD was 84.0 ± 11.4 mL/min ×
1.73 m2 for eGFR calculated by CKD-Epi equation and
1.34 ± 0.57 g/day per kg of ideal weight for protein intake assessed
by measurements of overnight urine excretion of urea
nitrogen. Cross-sectional analyses of baseline data indicated a
positive correlation of protein intake with eGFR (R = 0.180,
P < 0.001). In multi-variable regression, 1 g/day higher protein
intake related to 4.7 mL/min × 1.73 m2 higher eGFR [95% confidence
interval (CI) = 3.7/5.7]. At follow-up, mean ± SD of
12-year eGFR change was −11.6 ± 9.0 mL/min × 1.73 m2. Baseline
protein intake correlated with more negative eGFR change
(R = −0.251, P < 0.001). In multi-variable regression, 1 g/day
higher protein intake related to −4.1 mL/min × 1.73 m2 more
negative eGFR change (95% CI =−5.1/−3.1) and to 1.78 risk for
incidence of eGFR < 60 mL/min × 1.73 m2 (95% CI = 1.15/2.78).
Conclusions. In middle-aged adults, high protein intake is
associated cross-sectionally with higher GFR but longitudinally
with greater GFR decline over time
Protein Intake and Kidney Function in the Population: Differences in Cross-Sectional and Longitudinal Data
No full textBackground: Protein intake is considered a determinant of glomerular ltration rate (GFR). Urinary urea (U-urea) is an objective marker of protein intake. This population-based study investigated cross-sectionally and longitudinally the association of U-urea as index of protein intake with GFR indexed by serum creatinine (S-cr) and estimated GFR (eGFR).
Methods: Data were collected about overnight U-urea, S-cr, eGFR, and other variables in 1,522 men and women aged 45-64 year who participated in the Gubbio Study (baseline). Age, S-Cr, and eGFR were re-assessed after 12-year follow-up in 1,144 of the 1,425 surviving participants.
Results: Mean±SD of U-urea was 17.0±7.1 mmol/h corresponding to an estimated daily protein intake of 71.5±29.8 g/d. U-urea associated inversely with S-cr and directly with eGFR in cross-sectional quartile analyses (P<0.001). In multi-variable cross-sectional regression, 7 mmol/h higher U-urea (approximately one SD of U-urea corresponding to 30 g/d higher protein intake) related to 0.026 mg/dL lower S-cr (95%CI= 0.020/0.032) and 2.56 mL/min higher eGFR (2.01/3.12). At follow-up, change over baseline was an increase for S-cr (+0.054±0.100 mg/dL) and a decrease for eGFR (-11.8±9.1 mL/min x 1.73 m2). Baseline U-urea associated directly with S-cr change and inversely with eGFR change in
quartile analyses (P <0.001). In multi-variable regression, 7 mmol/h higher baseline U-urea related to 0.011 mg/dL more positive S-cr change (95%CI=0.006/0.016) and -0.07 mL/min more negative eGFR change per year (95%CI=-0.111/-0.038).
Conclusions: In middle-aged adults, higher protein intake is associated crosssectionally with higher GFR but longitudinally with faster GFR decline over-time
- …
