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Among these measurements, eGFR significantly modified the associations of TAPSE and diastolic dysfunction with the diagnosis of PH. The model consisting of a combination of TRV, right atrial pressure, and TAPSE most accurately predicted the diagnosis of PH in a CKD population (AUC 0.82).
The optimal model to predict PH diagnosis included TRV, right atrial pressure, and TAPSE. Since TAPSE more strongly associated with PH in the CKD population, these findings support a CKD-specific approach to the development of noninvasive screening algorithms for PH.
The optimal model to predict PH diagnosis included TRV, right atrial pressure, and TAPSE. Since TAPSE more strongly associated with PH in the CKD population, these findings support a CKD-specific approach to the development of noninvasive screening algorithms for PH.
People with chronic kidney disease (CKD) experience reduced quality of life (QoL) because of the high symptom and treatment burden. Limited data exist on the factors associated with overall and domain-specific QoL across all CKD stages.
Using data from a prospective, multinational study (Australia, New Zealand, Canada, and Spain) in 1696 participants with CKD, we measured overall and domain-specific QoL (pain, self-care, activity, mobility, anxiety/depression) using the EuroQoL, 5 dimension, 3 level. Multivariable linear regression and logistic modeling were used to determine factors associated with overall and domain-specific QoL.
QoL for patients with CKD stages 3 to 5 (n= 787; mean, 0.81; SD, 0.20) was higher than in patients on dialysis (n= 415; mean, 0.76; SD, 0.24) but lower than in kidney transplant recipients (n= 494; mean, 0.84; SD, 0.21). Factors associated with reduced overall QoL (β [95% confidence intervals]) included being on dialysis (compared with CKD stages 3-5 -0.06 [-0.08 to -0.03]), female sex (-0.03 [-0.05 to -0.006]), lower educational attainment (- 0.04 [-0.06 to -0.02), lacking a partner (-0.04 [-0.06 to -0.02]), having diabetes (-0.05 [-0.07 to -0.02]), history of stroke (-0.09 [-0.13 to -0.05]), cardiovascular disease (-0.06 [-0.08 to -0.03]), and cancer (-0.03 [-0.06 to -0.009]). Pain (43%) and anxiety/depression (30%) were the most commonly affected domains, with dialysis patients reporting decrements in all 5 domains. Predictors for domain-specific QoL included being on dialysis, presence of comorbidities, lower education, female sex, and lack of a partner.
Being on dialysis, women with CKD, those with multiple comorbidities, lack of a partner, and lower educational attainment were associated with lower QoL across all stages of CKD.
Being on dialysis, women with CKD, those with multiple comorbidities, lack of a partner, and lower educational attainment were associated with lower QoL across all stages of CKD.
Chronic kidney disease (CKD) is greatly affected by social determinants of health. Whether low educational attainment is associated with incident CKD in young adults is unclear.
We evaluated the association of education with incident CKD in 3139 Coronary Artery Risk Development in Young Adults participants. We categorized education into low (high school and less), medium (college), and high (master's and professional studies) groups. Incident CKD was defined as new development of estimated glomerular filtration rate (eGFR)<60 ml/min per 1.73 m
or urine albumin to creatinine ratio (ACR)≥30 mg/g. Change in eGFR over 20 years was a secondary outcome.
At baseline, mean age was 35.0 ± 3.6 years, 47% were Black, and 55% were women. Ipatasertib nmr Participants with lower educational attainment were less likely to have high income and health insurance and to engage in a healthy lifestyle. Over 20 years, 407 participants developed CKD (13%). Compared with individuals with low educational attainment, those with medium and high educational attainment had an unadjusted hazard ratios for CKD of 0.79 (95% confidence interval [CI] 0.65-0.97) and 0.44 (95% CI, 0.30-0.63), respectively. This association was no longer significant after adjusting for income, health insurance, lifestyle, and health status. Low educational attainment was significantly associated with a change in eGFR in crude and adjusted analyses, although the association was attenuated in the multivariable models (low -0.83 [95% CI, -0.91 to -0.75], medium -0.80 (95% CI, -0.95 to -0.64), and high -0.70 (95% CI, -0.89 to -0.52) ml/min per 1.73 m
per yr).
Health care access, lifestyle, and comorbid conditions likely help explain the association between low educational attainment and incident CKD in young adults.
Health care access, lifestyle, and comorbid conditions likely help explain the association between low educational attainment and incident CKD in young adults.
Despite reports of a high prevalence of chronic kidney disease (CKD) from the coastal Uddanam region of Andhra Pradesh, India, there are no accurate data on the distribution of kidney function abnormalities and CKD risk factors in this region.
A total of 2419 participants were recruited through multistage cluster random sampling from 67 villages. Serum creatinine and urine protein creatinine ratio were measured using validated methodologies. All abnormal estimated glomerular filtration rate (eGFR) and urine protein creatinine ratio values were reconfirmed after 3 months. A range of sociodemographic factors were evaluated for their association with CKD using Poisson regression.
Of 2402 eligible subjects (mean ± SD age, 45.67 ± 13.29 years; 51% female), 506 (21.07%) had CKD (mean ± SD age, 51.79 ± 13.12 years; 41.3% female). A total of 246 (10.24%) had eGFR<60 ml/min/1.73 m
, whereas 371 (15.45%) had an elevated urine protein creatinine ratio (>0.15 g/g). The poststratified estimates, adjusted for GFR. Our data suggest the need to apply a population-based approach to screening and prevention and studies to understand the causes of CKD in this region.
We confirmed the high prevalence of CKD in the adult population of Uddanam. The cause was not apparent in a majority. Subjects with a low eGFR with or without elevated proteinuria were phenotypically distinct from those with proteinuria and preserved eGFR. Our data suggest the need to apply a population-based approach to screening and prevention and studies to understand the causes of CKD in this region.