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All-cause mortality attributable to chronic kidney disease: a prospective cohort study based on 462 293 adults in Taiwan

Summary Background Both end-stage renal disease and chronic kidney disease are increasing worldwide; however, the full effect of chronic kidney disease is unknown because mortality risks for all five stages are unavailable. We assessed prevalence and mortality risks for all stages of chronic kidney... Full description

Journal Title: The Lancet (British edition) 2008, Vol.371 (9631), p.2173-2182
Main Author: Wen, Chi Pang, MD
Other Authors: Cheng, Ting Yuan David, MS , Tsai, Min Kuang, MS , Chang, Yen Chen, MS , Chan, Hui Ting, MS , Tsai, Shan Pou, PhD , Chiang, Po Huang, PhD , Hsu, Chih Cheng, MD , Sung, Pei Kun, MD , Hsu, Yi Hua, MS , Wen, Sung Feng, MD
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: England: Elsevier Ltd
ID: ISSN: 0140-6736
Link: https://www.ncbi.nlm.nih.gov/pubmed/18586172
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title: All-cause mortality attributable to chronic kidney disease: a prospective cohort study based on 462 293 adults in Taiwan
format: Article
creator:
  • Wen, Chi Pang, MD
  • Cheng, Ting Yuan David, MS
  • Tsai, Min Kuang, MS
  • Chang, Yen Chen, MS
  • Chan, Hui Ting, MS
  • Tsai, Shan Pou, PhD
  • Chiang, Po Huang, PhD
  • Hsu, Chih Cheng, MD
  • Sung, Pei Kun, MD
  • Hsu, Yi Hua, MS
  • Wen, Sung Feng, MD
subjects:
  • Abridged Index Medicus
  • Adult
  • Age Distribution
  • Awareness
  • Cardiovascular disease
  • Chronic Disease
  • Cohort Studies
  • Creatinine - blood
  • Death Certificates
  • Deaths
  • Female
  • Glomerular Filtration Rate
  • Herbal medicine
  • Humans
  • Internal Medicine
  • Kidney diseases
  • Kidney Diseases - classification
  • Kidney Diseases - epidemiology
  • Kidney Diseases - mortality
  • Kidney Failure, Chronic - epidemiology
  • Kidney Failure, Chronic - mortality
  • Male
  • Mass Screening - methods
  • Medical Records Systems, Computerized
  • Medical research
  • Medical tests
  • Medicine
  • Middle Aged
  • Mortality
  • Physical examinations
  • Prevalence
  • Risk
  • Sample size
  • Severity of Illness Index
  • Social Class
  • Students, Public Health
  • Taiwan - epidemiology
ispartof: The Lancet (British edition), 2008, Vol.371 (9631), p.2173-2182
description: Summary Background Both end-stage renal disease and chronic kidney disease are increasing worldwide; however, the full effect of chronic kidney disease is unknown because mortality risks for all five stages are unavailable. We assessed prevalence and mortality risks for all stages of chronic kidney disease and quantified its attributable mortality in Taiwan. Methods The cohort consisted of 462 293 individuals aged older than 20 years who participated in a standard medical screening programme since 1994. As of Dec 31, 2006, we identified 14 436 deaths. Chronic kidney disease was determined by glomerular filtration rate and urinary protein. We estimated national prevalence in Taiwan from the cohort by adjusting age and educational levels. Hazard ratios (HRs) were calculated with Cox proportionate hazards model. We calculated mortality attributable to chronic kidney disease for national population and for low socioeconomic status. Findings The national prevalence of chronic kidney disease was 11·93% (95% CI 11·66–12·28), but only 3·54% (3·37–3·68) of participants in the cohort were aware of their disorder. Prevalence was substantially higher in the group with low socioeconomic status than in the high status group (19·87% [19·84–19·91] vs 7·33% [7·31–7·35]). 56 977 (12%) of cohort participants had chronic kidney disease; those with disease had 83% higher mortality for all cause (HR 1·83 [1·73–1·93]) and 100% higher for cardiovascular diseases (2·00 [1·78–2·25]), in a cohort that was observed for 13 years with median follow-up of 7·5 years (IQR 4·0–10·1). 10·3% (95% CI 9·57–11·03) of deaths in the entire population were attributable to chronic kidney disease, but 17·5% (16·27–18·67) of deaths in the low socioeconomic status population. 2350 (39%) deaths occurred before 65 years of age in those with chronic kidney disease. Regular users of Chinese herbal medicines had a 20% (odds ratio 1·20 [1·16–1·24]) increased risk of developing chronic kidney disease. Interpretation The high prevalence of chronic kidney disease and its associated all-cause mortality, especially in people with low socioeconomic status, make reduction of this disorder a public-health priority. Promotion of its recognition through the general public knowing their glomerular filtration rate and testing their urine is crucial to reduce premature deaths from all causes and to attenuate this global epidemic. Funding None.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0140-6736
fulltext: fulltext
issn:
  • 0140-6736
  • 1474-547X
url: Link


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titleAll-cause mortality attributable to chronic kidney disease: a prospective cohort study based on 462 293 adults in Taiwan
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creatorWen, Chi Pang, MD ; Cheng, Ting Yuan David, MS ; Tsai, Min Kuang, MS ; Chang, Yen Chen, MS ; Chan, Hui Ting, MS ; Tsai, Shan Pou, PhD ; Chiang, Po Huang, PhD ; Hsu, Chih Cheng, MD ; Sung, Pei Kun, MD ; Hsu, Yi Hua, MS ; Wen, Sung Feng, MD
creatorcontribWen, Chi Pang, MD ; Cheng, Ting Yuan David, MS ; Tsai, Min Kuang, MS ; Chang, Yen Chen, MS ; Chan, Hui Ting, MS ; Tsai, Shan Pou, PhD ; Chiang, Po Huang, PhD ; Hsu, Chih Cheng, MD ; Sung, Pei Kun, MD ; Hsu, Yi Hua, MS ; Wen, Sung Feng, MD
descriptionSummary Background Both end-stage renal disease and chronic kidney disease are increasing worldwide; however, the full effect of chronic kidney disease is unknown because mortality risks for all five stages are unavailable. We assessed prevalence and mortality risks for all stages of chronic kidney disease and quantified its attributable mortality in Taiwan. Methods The cohort consisted of 462 293 individuals aged older than 20 years who participated in a standard medical screening programme since 1994. As of Dec 31, 2006, we identified 14 436 deaths. Chronic kidney disease was determined by glomerular filtration rate and urinary protein. We estimated national prevalence in Taiwan from the cohort by adjusting age and educational levels. Hazard ratios (HRs) were calculated with Cox proportionate hazards model. We calculated mortality attributable to chronic kidney disease for national population and for low socioeconomic status. Findings The national prevalence of chronic kidney disease was 11·93% (95% CI 11·66–12·28), but only 3·54% (3·37–3·68) of participants in the cohort were aware of their disorder. Prevalence was substantially higher in the group with low socioeconomic status than in the high status group (19·87% [19·84–19·91] vs 7·33% [7·31–7·35]). 56 977 (12%) of cohort participants had chronic kidney disease; those with disease had 83% higher mortality for all cause (HR 1·83 [1·73–1·93]) and 100% higher for cardiovascular diseases (2·00 [1·78–2·25]), in a cohort that was observed for 13 years with median follow-up of 7·5 years (IQR 4·0–10·1). 10·3% (95% CI 9·57–11·03) of deaths in the entire population were attributable to chronic kidney disease, but 17·5% (16·27–18·67) of deaths in the low socioeconomic status population. 2350 (39%) deaths occurred before 65 years of age in those with chronic kidney disease. Regular users of Chinese herbal medicines had a 20% (odds ratio 1·20 [1·16–1·24]) increased risk of developing chronic kidney disease. Interpretation The high prevalence of chronic kidney disease and its associated all-cause mortality, especially in people with low socioeconomic status, make reduction of this disorder a public-health priority. Promotion of its recognition through the general public knowing their glomerular filtration rate and testing their urine is crucial to reduce premature deaths from all causes and to attenuate this global epidemic. Funding None.
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subjectAbridged Index Medicus ; Adult ; Age Distribution ; Awareness ; Cardiovascular disease ; Chronic Disease ; Cohort Studies ; Creatinine - blood ; Death Certificates ; Deaths ; Female ; Glomerular Filtration Rate ; Herbal medicine ; Humans ; Internal Medicine ; Kidney diseases ; Kidney Diseases - classification ; Kidney Diseases - epidemiology ; Kidney Diseases - mortality ; Kidney Failure, Chronic - epidemiology ; Kidney Failure, Chronic - mortality ; Male ; Mass Screening - methods ; Medical Records Systems, Computerized ; Medical research ; Medical tests ; Medicine ; Middle Aged ; Mortality ; Physical examinations ; Prevalence ; Risk ; Sample size ; Severity of Illness Index ; Social Class ; Students, Public Health ; Taiwan - epidemiology
ispartofThe Lancet (British edition), 2008, Vol.371 (9631), p.2173-2182
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descriptionSummary Background Both end-stage renal disease and chronic kidney disease are increasing worldwide; however, the full effect of chronic kidney disease is unknown because mortality risks for all five stages are unavailable. We assessed prevalence and mortality risks for all stages of chronic kidney disease and quantified its attributable mortality in Taiwan. Methods The cohort consisted of 462 293 individuals aged older than 20 years who participated in a standard medical screening programme since 1994. As of Dec 31, 2006, we identified 14 436 deaths. Chronic kidney disease was determined by glomerular filtration rate and urinary protein. We estimated national prevalence in Taiwan from the cohort by adjusting age and educational levels. Hazard ratios (HRs) were calculated with Cox proportionate hazards model. We calculated mortality attributable to chronic kidney disease for national population and for low socioeconomic status. Findings The national prevalence of chronic kidney disease was 11·93% (95% CI 11·66–12·28), but only 3·54% (3·37–3·68) of participants in the cohort were aware of their disorder. Prevalence was substantially higher in the group with low socioeconomic status than in the high status group (19·87% [19·84–19·91] vs 7·33% [7·31–7·35]). 56 977 (12%) of cohort participants had chronic kidney disease; those with disease had 83% higher mortality for all cause (HR 1·83 [1·73–1·93]) and 100% higher for cardiovascular diseases (2·00 [1·78–2·25]), in a cohort that was observed for 13 years with median follow-up of 7·5 years (IQR 4·0–10·1). 10·3% (95% CI 9·57–11·03) of deaths in the entire population were attributable to chronic kidney disease, but 17·5% (16·27–18·67) of deaths in the low socioeconomic status population. 2350 (39%) deaths occurred before 65 years of age in those with chronic kidney disease. Regular users of Chinese herbal medicines had a 20% (odds ratio 1·20 [1·16–1·24]) increased risk of developing chronic kidney disease. Interpretation The high prevalence of chronic kidney disease and its associated all-cause mortality, especially in people with low socioeconomic status, make reduction of this disorder a public-health priority. Promotion of its recognition through the general public knowing their glomerular filtration rate and testing their urine is crucial to reduce premature deaths from all causes and to attenuate this global epidemic. Funding None.
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titleAll-cause mortality attributable to chronic kidney disease: a prospective cohort study based on 462 293 adults in Taiwan
authorWen, Chi Pang, MD ; Cheng, Ting Yuan David, MS ; Tsai, Min Kuang, MS ; Chang, Yen Chen, MS ; Chan, Hui Ting, MS ; Tsai, Shan Pou, PhD ; Chiang, Po Huang, PhD ; Hsu, Chih Cheng, MD ; Sung, Pei Kun, MD ; Hsu, Yi Hua, MS ; Wen, Sung Feng, MD
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abstractSummary Background Both end-stage renal disease and chronic kidney disease are increasing worldwide; however, the full effect of chronic kidney disease is unknown because mortality risks for all five stages are unavailable. We assessed prevalence and mortality risks for all stages of chronic kidney disease and quantified its attributable mortality in Taiwan. Methods The cohort consisted of 462 293 individuals aged older than 20 years who participated in a standard medical screening programme since 1994. As of Dec 31, 2006, we identified 14 436 deaths. Chronic kidney disease was determined by glomerular filtration rate and urinary protein. We estimated national prevalence in Taiwan from the cohort by adjusting age and educational levels. Hazard ratios (HRs) were calculated with Cox proportionate hazards model. We calculated mortality attributable to chronic kidney disease for national population and for low socioeconomic status. Findings The national prevalence of chronic kidney disease was 11·93% (95% CI 11·66–12·28), but only 3·54% (3·37–3·68) of participants in the cohort were aware of their disorder. Prevalence was substantially higher in the group with low socioeconomic status than in the high status group (19·87% [19·84–19·91] vs 7·33% [7·31–7·35]). 56 977 (12%) of cohort participants had chronic kidney disease; those with disease had 83% higher mortality for all cause (HR 1·83 [1·73–1·93]) and 100% higher for cardiovascular diseases (2·00 [1·78–2·25]), in a cohort that was observed for 13 years with median follow-up of 7·5 years (IQR 4·0–10·1). 10·3% (95% CI 9·57–11·03) of deaths in the entire population were attributable to chronic kidney disease, but 17·5% (16·27–18·67) of deaths in the low socioeconomic status population. 2350 (39%) deaths occurred before 65 years of age in those with chronic kidney disease. Regular users of Chinese herbal medicines had a 20% (odds ratio 1·20 [1·16–1·24]) increased risk of developing chronic kidney disease. Interpretation The high prevalence of chronic kidney disease and its associated all-cause mortality, especially in people with low socioeconomic status, make reduction of this disorder a public-health priority. Promotion of its recognition through the general public knowing their glomerular filtration rate and testing their urine is crucial to reduce premature deaths from all causes and to attenuate this global epidemic. Funding None.
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pmid18586172
doi10.1016/S0140-6736(08)60952-6