Illicit drug use, hypertension, and chronic kidney disease in the US adult population.
Illicit drug use, hypertension, and chronic kidney disease in the US adult population.
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DOI：
10.1016/j.trsl.2012.05.008
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发表时间：
2012-12
期刊：
影响因子：
--
通讯作者：
Lash JP
中科院分区：
文献类型：
--
作者：
Akkina SK;Ricardo AC;Patel A;Das A;Bazzano LA;Brecklin C;Fischer MJ;Lash JP
在特定人群中，非法药物使用与慢性肾脏疾病（CKD）有关，但尚不清楚在一般人群中是否存在同样的关联。利用2005-2008年全国健康与营养调查的数据，我们对5861名成年人进行了横断面分析，这些成年人被问及他们一生中使用非法药物的情况，包括可卡因、甲基苯丙胺或海洛因。主要终点是CKD，根据慢性肾脏疾病流行病学合作（CKD- epi）方程或微量白蛋白尿的估计肾小球滤过率(eGFR)≤60mL/min/1.73m2来定义。我们还研究了非法药物使用与血压(BP)≥120/80、≥130/85和≥140/90之间的关系。使用Logistic回归来检验非法药物使用与CKD和BP之间的关系。非法药物使用者和非使用者之间的平均eGFR相似（100.7 vs 101.4mL/min/1.73m2, p=0.4），蛋白尿（5.7 vs 6.0mg/g肌酐，p=0.5）。因此，在调整其他重要因素后，在逻辑回归模型中，非法药物使用与CKD没有显著相关（优势比[OR] 0.98，置信区间[CI] 0.75-1.27）。然而，与非吸毒者相比，非法药物使用者的收缩压（120比118mmHg， p=0.04）和舒张压（73比71mmHg， p=0.0003）更高。此外，可卡因使用与血压≥130/85独立相关（OR 1.24, CI 1.00-1.54），特别是在一生中使用较多时（6-49次，OR 1.42, CI 1.06-1.91）。在美国人口的代表性样本中，非法药物使用与慢性肾病无关，但可卡因使用者更有可能血压升高。
Illicit drug use has been associated with chronic kidney disease (CKD) in select populations but it is unknown if the same association exists in the general population. Using data from the National Health and Nutrition Examination Survey 2005-2008, we conducted a cross-sectional analysis of 5,861 adults who were questioned about illicit drug use including cocaine, methamphetamines, or heroin during their lifetime. The primary outcome was CKD as defined by an estimated glomerular filtration rate (eGFR) ≤60mL/min/1.73m2 using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation or by microalbuminuria. We also examined the association between illicit drug use and blood pressure (BP) ≥120/80, ≥130/85, and ≥140/90. Logistic regression was used to examine the association between illicit drug use and CKD and BP. Mean eGFR was similar between illicit drug users and non-users (100.7 vs. 101.4mL/min/1.73m2, p=0.4) as was albuminuria (5.7 vs. 6.0mg/g creatinine, p=0.5). Accordingly, illicit drug use was not significantly associated with CKD in logistic regression models (odds ratio [OR] 0.98, confidence interval [CI] 0.75-1.27) after adjusting for other important factors. However, illicit drug users had higher systolic (120 vs. 118mmHg, p=0.04) and diastolic BP (73 vs. 71mmHg, p=0.0003) compared to non-users. Also, cocaine use was independently associated with BP≥130/85 (OR 1.24, CI 1.00-1.54), especially when used more during a lifetime (6-49 times, OR 1.42, CI 1.06-1.91). In a representative sample of the U.S. population, illicit drug use was not associated with CKD but cocaine users were more likely to have elevated blood pressures.
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