Altitude and regional gradients in chronic kidney disease prevalence in Costa Rica: Data from the Costa Rican Longevity and Healthy Aging Study.
Altitude and regional gradients in chronic kidney disease prevalence in Costa Rica: Data from the Costa Rican Longevity and Healthy Aging Study.
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DOI：
10.1111/tmi.12622
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发表时间：
2016-01
期刊：
影响因子：
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通讯作者：
Rosero Bixby L
中科院分区：
文献类型：
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作者：
Harhay MN;Harhay MO;Coto-Yglesias F;Rosero Bixby L
中美洲最近的研究表明，慢性肾脏疾病（CKD）的死亡率正在迅速上升。我们试图确定哥斯达黎加老年人CKD的患病率和地区差异，以及生物和社会经济因素与CKD风险的关系。我们使用了哥斯达黎加长寿和健康老龄化研究（CRELES）的数据。该队列由2657名1946年之前出生在哥斯达黎加的成年人组成，通过抽样算法选择，代表哥斯达黎加60岁以下的全国人口。参与者回答问卷数据并完成实验室测试。本研究的主要结局是CKD，定义为肾小球滤过率(eGFR) <60 ml/min/1.73m2。哥斯达黎加老年人CKD患病率估计为20% （95% CI 18.5 - 21.9%）。在多变量logistic回归中，年龄较大（校正优势比[aOR] 1.08 /年，95%CI 1.07-1.10, p<0.001）与CKD独立相关。居住海拔每200米，受试者CKD的几率增加26% （aOR 1.26 95% CI 1.15-1.38, p<0.001）。调整后的CKD患病率有很大的地区差异，最高的是利蒙省（40%,95% CI 30%-50%）和瓜纳卡斯特省（36%,95% CI 26-46%）。在对社会经济地位进行调整后，区域和海拔的影响仍然很强。我们观察到哥斯达黎加的CKD患病率存在较大的区域和海拔相关差异，这不能用传统CKD危险因素的分布来解释。需要更多的研究来探索地理和环境暴露与CKD风险的潜在关联。
Recent studies in Central America indicate that mortality attributable to chronic kidney disease (CKD) is rising rapidly. We sought to determine the prevalence and regional variation of CKD and the relationship of biologic and socioeconomic factors to CKD risk in the older-adult population of Costa Rica. We used data from the Costa Rican Longevity and Health Aging Study (CRELES). The cohort was comprised of 2657 adults born before 1946 in Costa Rica, chosen through a sampling algorithm to represent the national population of Costa Ricans >60 years of age. Participants answered questionnaire data and completed laboratory testing. The primary outcome of this study was CKD, defined as an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73m2. The estimated prevalence of CKD for older Costa Ricans was 20% (95% CI 18.5 – 21.9%). In multivariable logistic regression, older age (adjusted odds ratio [aOR] 1.08 per year, 95%CI 1.07–1.10, p<0.001) was independently associated with CKD. For every 200 meters above sea level of residence, subjects’ odds of CKD increased 26% (aOR 1.26 95% CI 1.15–1.38, p<0.001). There was large regional variation in adjusted CKD prevalence, highest in Limon (40%, 95% CI 30%–50%) and Guanacaste (36%, 95% CI 26–46%) provinces. Regional and altitude effects remained robust after adjustment for socioeconomic status. We observed large regional and altitude-related variations in CKD prevalence in Costa Rica, not explained by the distribution of traditional CKD risk factors. More studies are needed to explore the potential association of geographic and environmental exposures with the risk of CKD.