Log in to MyKarger to check if you already have access to this content.

Buy FullText & PDF Unlimited re-access via MyKarger Unrestricted printing, no saving restrictions for personal use read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!

If you would like to redeem your KAB credit, please log in.

Save over 20% compared to the individual article price.

Learn more

Access via DeepDyve Unlimited fulltext viewing Of this article Organize, annotate And mark up articles Printing And downloading restrictions apply

Select

Subscribe Access to all articles of the subscribed year(s) guaranteed for 5 years Unlimited re-access via Subscriber Login or MyKarger Unrestricted printing, no saving restrictions for personal use read more

Subcription rates

Select

* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview

Received: May 08, 2022
Accepted: June 19, 2022
Published online: September 20, 2022

Number of Print Pages: 10
Number of Figures: 1
Number of Tables: 2

ISSN: 0250-8095 (Print)
eISSN: 1421-9670 (Online)

For additional information: https://www.karger.com/AJN

Abstract

Introduction: Unhealthy lifestyle factors are known to increase the risk of chronic kidney disease (CKD) and its complications. The long-term trends in these factors are unclear. Methods: The aim of the study was to assess temporal trends in the prevalence of risk factors in adults with CKD in the USA and identify sociodemographic subgroups at most risk. Subanalysis of data was carried out from a stratified, complex, multistage probability-based cross-sectional and nationally representative survey. We examined participants from National Health and Nutritional Examination Survey (NHANES) respondents aged ≥20 years with CKD from 1999 to 2018. CKD was defined as estimated glomerular filtration rate of 15–59 mL/min/1.73 m2. Evaluated risk factors included uncontrolled blood pressure, blood glucose, blood lipids, excessive sodium intake, excessive protein intake, poor diet, obesity, smoking, depression, physical inactivity, and sedentary behavior. Sociodemographic variables included age, sex, race/ethnicity, marital status, education level, family income, and employment status. Results: Blood pressure control among respondents with CKD (n = 4,342) was poor but significantly improved from the 1999–2000 (82% uncontrolled) to 2017–2018 surveys (66%; p for linear trend = 0.02). Prevalence of uncontrolled blood glucose (15–22%; p < 0.01), excessive sodium intake (72–78%; p = 0.04), and obesity (32–51%; p < 0.01) significantly increased over this time. The proportion of respondents with uncontrolled blood lipids, depression, smoking, excessive protein intake, poor diet, physical inactivity, or sedentary behavior showed no significant change over the 10-year period. Older people were more likely to have high blood pressure, high blood glucose, and high blood lipids but healthier lifestyle habits than younger people. And respondents of males, non-Hispanic blacks, Hispanics, low income, low education, widowed/divorced/separated, and employed had worse risk factor control compared to reference groups. Discussion/Conclusion: Although the control of several risk factors in US NHANES respondents with CKD improved from 1999 to 2018, further reductions remain of value.

© 2022 S. Karger AG, Basel

References Centers for Disease Control and Prevention. Chronic kidney disease (CKD) surveillance system. 2022. Available from: https://nccd.cdc.gov/CKD/. Storey BC, Staplin N, Haynes R, Reith C, Emberson J, Herrington WG, et al. Lowering LDL cholesterol reduces cardiovascular risk independently of presence of inflammation. Kidney Int. 2018;93(4):1000–7. Lewington S, Clarke R, Qizilbash N, Peto R, Collins R; Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002;360(9349):1903–13. Afkarian M, Zelnick LR, Hall YN, Heagerty PJ, Tuttle K, Weiss NS, et al. Clinical manifestations of kidney disease among US adults with diabetes, 1988–2014. JAMA. 2016;316(6):602–10. Malta D, Petersen KS, Johnson C, Trieu K, Rae S, Jefferson K, et al. High sodium intake increases blood pressure and risk of kidney disease. From the Science of Salt: a regularly updated systematic review of salt and health outcomes (August 2016 to March 2017). J Clin Hypertens. 2018;20(12):1654–65. Arnett DK, Khera A, Blumenthal RS. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: part 1, lifestyle and behavioral factors. JAMA Cardiol. 2019;4(10):1043–4. Hsu CY, McCulloch CE, Iribarren C, Darbinian J, Go AS. Body mass index and risk for end-stage renal disease. Ann Intern Med. 2006;144(1):21–8. Palmer SC, Vecchio M, Craig JC, Tonelli M, Johnson DW, Nicolucci A, et al. Association between depression and death in people with CKD: a meta-analysis of cohort studies. Am J Kidney Dis. 2013;62(3):493–505. Narasaki Y, Okuda Y, Moore LW, You AS, Tantisattamo E, Inrig JK, et al. Dietary protein intake, kidney function, and survival in a nationally representative cohort. Am J Clin Nutr. 2021;114(1):303–13. James MT, Hemmelgarn BR, Tonelli M. Early recognition and prevention of chronic kidney disease. Lancet. 2010;375(9722):1296–309. Baigent C, Landray MJ, Reith C, Emberson J, Wheeler DC, Tomson C, et al. The effects of lowering LDL cholesterol with simvastatin plus ezetimibe in patients with chronic kidney disease (Study of Heart and Renal Protection): a randomised placebo-controlled trial. Lancet. 2011;377(9784):2181–92. McMahon EJ, Campbell KL, Bauer JD, Mudge DW, Kelly JT. Altered dietary salt intake for people with chronic kidney disease. Cochrane Database Syst Rev. 2021;6:CD010070. Pugh D, Gallacher PJ, Dhaun N. Management of hypertension in chronic kidney disease. Drugs. 2019;79(4):365–79. Stevens PE, Levin A; Kidney Disease: Improving Global Outcomes Chronic Kidney Disease Guideline Development Work Group Members. Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline. Ann Intern Med. 2013;158(11):825–30. Centers for Disease Control and Prevention. National health and nutrition examination survey. 2022 [updated March 4, 2022]. Available from: https://www.cdc.gov/nchs/nhanes/index.htm. Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF, Feldman HI, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150(9):604–12. Selvin E, Manzi J, Stevens LA, Van Lente F, Lacher DA, Levey AS, et al. Calibration of serum creatinine in the National Health and Nutrition Examination Surveys (NHANES) 1988–1994, 1999–2004. Am J Kidney Dis. 2007;50(6):918–26. Levey AS, Coresh J. Chronic kidney disease. Lancet. 2012;379(9811):165–80. Tomson CRV, Cheung AK, Mann JFE, Chang TI, Cushman WC, Furth SL, et al. Management of blood pressure in patients with chronic kidney disease not receiving dialysis: synopsis of the 2021 KDIGO clinical practice guideline. Ann Intern Med. 2021;174(9):1270–81. Kidney Disease Improving Global Outcomes KDIGO Diabetes Work Group. KDIGO 2020 clinical practice guideline for diabetes management in chronic kidney disease. Kidney Int. 2020;98(4S):S1–115. Tonelli M, Wanner C; Kidney Disease Improving Global Outcomes Lipid Guideline Development Work Group Members. Lipid management in chronic kidney disease: synopsis of the Kidney Disease: Improving Global Outcomes 2013 clinical practice guideline. Ann Intern Med. 2014;160(3):182. Rehm CD, Penalvo JL, Afshin A, Mozaffarian D. Dietary intake among US adults, 1999–2012. JAMA. 2016;315(23):2542–53. Alharthi SSY, Natto ZS, Midle JB, Gyurko R, O’Neill R, Steffensen B. Association between time since quitting smoking and periodontitis in former smokers in the National Health and Nutrition Examination Surveys (NHANES) 2009 to 2012. J Periodontol. 2019;90(1):16–25. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–13. Murphy D, McCulloch CE, Lin F, Banerjee T, Bragg-Gresham JL, Eberhardt MS, et al. Trends in prevalence of chronic kidney disease in the United States. Ann Intern Med. 2016;165(7):473–81. Ene-Iordache B, Perico N, Bikbov B, Carminati S, Remuzzi A, Perna A, et al. Chronic kidney disease and cardiovascular risk in six regions of the world (ISN-KDDC): a cross-sectional study. Lancet Glob Health. 2016;4(5):e307–19. Cheung AK, Rahman M, Reboussin DM, Craven TE, Greene T, Kimmel PL, et al. Effects of intensive BP control in CKD. J Am Soc Nephrol. 2017;28(9):2812–23. Adhyaru BB, Jacobson TA. Safety and efficacy of statin therapy. Nat Rev Cardiol. 2018;15(12):757–69. Global Burden of Metabolic Risk Factors for Chronic Diseases Collaboration. Cardiovascular disease, chronic kidney disease, and diabetes mortality burden of cardiometabolic risk factors from 1980 to 2010: a comparative risk assessment. Lancet Diabetes Endocrinol. 2014;2(8):634–47. Mente A, O’Donnell MJ, Rangarajan S, McQueen MJ, Poirier P, Wielgosz A, et al. Association of urinary sodium and potassium excretion with blood pressure. N Engl J Med. 2014;371(7):601–11. Beddhu S, Wei G, Marcus RL, Chonchol M, Greene T. Light-intensity physical activities and mortality in the United States general population and CKD subpopulation. Clin J Am Soc Nephrol. 2015;10(7):1145–53. Cianciaruso B, Pota A, Pisani A, Torraca S, Annecchini R, Lombardi P, et al. Metabolic effects of two low protein diets in chronic kidney disease stage 4–5: a randomized controlled trial. Nephrol Dial Transplant. 2008;23(2):636–44. Kim SM, Kim MH, Ryu DR, Oh HJ. The dietary intake of chronic kidney disease according to stages: findings from the Korean National Health and Nutritional Examination Survey. PLoS One. 2021;16(11):e0260242. Gelber RP, Kurth T, Kausz AT, Manson JE, Buring JE, Levey AS, et al. Association between body mass index and CKD in apparently healthy men. Am J Kidney Dis. 2005;46(5):871–80. Lee S, Kang S, Joo YS, Lee C, Nam KH, Yun HR, et al. Smoking, smoking cessation, and progression of chronic kidney disease: results from KNOW-CKD Study. Nicotine Tob Res. 2021;23(1):92–8. EUROASPIRE I and II Group; European Action on Secondary Prevention by Intervention to Reduce Events. Clinical reality of coronary prevention guidelines: a comparison of EUROASPIRE I and II in nine countries. EUROASPIRE I and II group. European action on secondary prevention by intervention to reduce events. Lancet. 2001;357(9261):995–1001. Yusuf S, Rangarajan S, Teo K, Islam S, Li W, Liu L, et al. Cardiovascular risk and events in 17 low-middle-and high-income countries. N Engl J Med. 2014;371(9):818–27. Wong CW, Kwok CS, Narain A, Gulati M, Mihalidou AS, Wu P, et al. Marital status and risk of cardiovascular diseases: a systematic review and meta-analysis. Heart. 2018;104(23):1937–48. Sara JD, Prasad M, Eleid MF, Zhang M, Widmer RJ, Lerman A. Association between work-related stress and coronary heart disease: a review of prospective studies through the job strain, effort-reward balance, and organizational justice models. J Am Heart Assoc. 2018;7(9):e008073. Taylor DM, Fraser S, Dudley C, Oniscu GC, Tomson C, Ravanan R, et al. Health literacy and patient outcomes in chronic kidney disease: a systematic review. Nephrol Dial Transplant. 2018;33(9):1545–58. Article / Publication Details

First-Page Preview

Received: May 08, 2022
Accepted: June 19, 2022
Published online: September 20, 2022

Number of Print Pages: 10
Number of Figures: 1
Number of Tables: 2

ISSN: 0250-8095 (Print)
eISSN: 1421-9670 (Online)

For additional information: https://www.karger.com/AJN