TY - UNPB
T1 - Navigating the Complexities of End-Stage Renal Disease (ESRD) from Risk Factors to Outcome: Insights from the UK Biobank Cohort
AU - Kar, Debasish
AU - Acharjee, Durjoy
AU - Allgar, Victoria
AU - El-wazir, Aya
AU - Song, Soon
AU - Verma, Ashish
AU - Kadam, Umesh
AU - de Lusignan, Simon
AU - Byng, Richard
AU - Sheikh, Aziz
AU - Nath, Mintu
AU - Zabeen, Bedowra
AU - Kar, Shubharthi
AU - Banu, Shakila
AU - Rahman, Habibur
AU - Khan, Navid
PY - 2024/9/16
Y1 - 2024/9/16
N2 - SummaryBackgroundThe prevalence of end-stage renal disease (ESRD) is rising worldwide. Hyperglycaemia, hypertension, and dyslipidaemia are known risk factors. However, despite managing these risk factors optimally, ESRD cases are increasing. This study aims to explore the relationship between different cardiorenal risk factors and ESRD to address this global challenge.MethodsThis cross-sectional study used data from participants recruited between 2006 and 2010 in UK Biobank. Seven multivariable logistic regression models were fitted to analyse the risk factors for ESRD. Results are presented as adjusted odds ratio (aOR) and 95% confidence intervals (95% CI).FindingsAmong 502,408 study participants, 1191 (0.2%) were diagnosed with ESRD. Individuals diagnosed with diabetes before 40 had more than twice, and those with hypertension had 73% higher odds of ESRD, compared to those who were diagnosed between 40 and 60 years [aOR 2.26 (1.57 – 3.24)], and [aOR 1.73 (1.21 – 2.44)], respectively. In contrast to those without any cardiovascular disease (CVD), those with stroke, hypertension, myocardial infarction, and angina had higher odds of ESRD [aOR 5.97 (3.99 - 8.72), 5.35 (4.38 - 6.56), 4.94 (3.56 - 6.78), and 4.89 (3.47 - 6.81)], respectively. Each additional year of diabetes duration increased ESRD odds by 2% [aOR 1.02 (1.01 - 1.03)]. Non-white ethnicity was linked to a 70% higher ESRD risk compared to white ethnicity [aOR 1.70 (1.23 -2.31)], and individuals with diabetes had a 62% higher ESRD odds compared to those without [aOR 1.62 (1.36 - 1.93)]. The most socioeconomically deprived quintile had 83% higher ESRD risk [aOR 1.83 (1.48 - 2.26)] than the least deprived. Elevated HbA1c levels were also associated with higher ESRD risk [aOR 1.03 (1.02 - 1.03)], while each unit increase in high-density lipoprotein (HDL) decreased ESRD risk by 55% [aOR 0.45 (0.35 - 0.57)]. Proteinuria increased the ESRD odds 11-fold compared to microalbuminuria [aOR 11.0 (9.25 - 13.07), while normoalbuminuria reduced the odds by 76% [aOR 0.24 (0.20 - 0.28)].InterpretationEarly onset of diabetes and hypertension is linked to higher odds of ESRD. Male gender, non-white ethnicity, higher HbA1c levels and prolonged hyperglycaemia are independently associated with ESRD. Microalbuminuria serves as a reliable early indicator of ESRD risk.
AB - SummaryBackgroundThe prevalence of end-stage renal disease (ESRD) is rising worldwide. Hyperglycaemia, hypertension, and dyslipidaemia are known risk factors. However, despite managing these risk factors optimally, ESRD cases are increasing. This study aims to explore the relationship between different cardiorenal risk factors and ESRD to address this global challenge.MethodsThis cross-sectional study used data from participants recruited between 2006 and 2010 in UK Biobank. Seven multivariable logistic regression models were fitted to analyse the risk factors for ESRD. Results are presented as adjusted odds ratio (aOR) and 95% confidence intervals (95% CI).FindingsAmong 502,408 study participants, 1191 (0.2%) were diagnosed with ESRD. Individuals diagnosed with diabetes before 40 had more than twice, and those with hypertension had 73% higher odds of ESRD, compared to those who were diagnosed between 40 and 60 years [aOR 2.26 (1.57 – 3.24)], and [aOR 1.73 (1.21 – 2.44)], respectively. In contrast to those without any cardiovascular disease (CVD), those with stroke, hypertension, myocardial infarction, and angina had higher odds of ESRD [aOR 5.97 (3.99 - 8.72), 5.35 (4.38 - 6.56), 4.94 (3.56 - 6.78), and 4.89 (3.47 - 6.81)], respectively. Each additional year of diabetes duration increased ESRD odds by 2% [aOR 1.02 (1.01 - 1.03)]. Non-white ethnicity was linked to a 70% higher ESRD risk compared to white ethnicity [aOR 1.70 (1.23 -2.31)], and individuals with diabetes had a 62% higher ESRD odds compared to those without [aOR 1.62 (1.36 - 1.93)]. The most socioeconomically deprived quintile had 83% higher ESRD risk [aOR 1.83 (1.48 - 2.26)] than the least deprived. Elevated HbA1c levels were also associated with higher ESRD risk [aOR 1.03 (1.02 - 1.03)], while each unit increase in high-density lipoprotein (HDL) decreased ESRD risk by 55% [aOR 0.45 (0.35 - 0.57)]. Proteinuria increased the ESRD odds 11-fold compared to microalbuminuria [aOR 11.0 (9.25 - 13.07), while normoalbuminuria reduced the odds by 76% [aOR 0.24 (0.20 - 0.28)].InterpretationEarly onset of diabetes and hypertension is linked to higher odds of ESRD. Male gender, non-white ethnicity, higher HbA1c levels and prolonged hyperglycaemia are independently associated with ESRD. Microalbuminuria serves as a reliable early indicator of ESRD risk.
KW - Chronic Kidney Disease
KW - Diabetes
KW - End-Stage Renal Disease
KW - Renal Replacement Therapy
U2 - 10.2139/ssrn.4955291
DO - 10.2139/ssrn.4955291
M3 - Preprint
T3 - THELANCET-D-24-05451
BT - Navigating the Complexities of End-Stage Renal Disease (ESRD) from Risk Factors to Outcome: Insights from the UK Biobank Cohort
ER -
