Prevalence and Predictors of Renal Disease in a National Representative Sample of the Romanian Adult Population: Data from the SEPHAR IV Survey
Abstract
:1. Introduction
2. Materials and Methods
2.1. SEPHAR IV: Sample Selection and Data Collection
2.2. Blood Pressure Measurement and Definition
2.3. Risk Factors and Diagnostic Categories
2.4. Statistical Analyses
3. Results
3.1. Socio-Demographic Characteristics
3.2. Prevalence of CKD
3.3. Study Groups’ Clinical Characteristics and Related Comorbidities
3.4. Treatment and Control of Hypertension
3.5. Determinants of CKD
4. Discussion
Study Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | Overall | eGFR ≥ 60 mL/min/1.73m2 | eGFR < 60 mL/min/1.73 m2 | p | CI (95% Confidence Level) |
---|---|---|---|---|---|
Total subjects (N, %) | 883 (100%) | 864 (100%) | 19 (100%) | <0.0001 | (0.96, 0.98) |
Known Hypertensives (N, %) | 311 (35.22%) | 294 (34.03%) | 17 (89.47%) | <0.0001 | (0.75, 0.84) |
New Hypertensives (N, %) | 68 (7.7%) | 68 (7.87%) | 0 (0%) | 0.402 | (1, 1) |
Total hypertensives | 379 (42.93%) | 362 (41.9%) | 17 (89.47%) | <0.0001 | (0.93, 0.97) |
Controlled hypertensives | 87 (9.85%) | 82 (9.49%) | 5 (26.32%) | 0.041 | (0.89, 0.99) |
Age (years) | 60.9 ± 10.12 | 50.3 ± 16.21 | 71.94 ± 7.4 | <0.0001 | (50.39, 52.09) |
Male (N, %) | 360 (40.7%) | 350 (40.51%) | 10 (52.63) | 0.1611 | (0.95, 0.98) |
Female (N, %) | 523 (59.23%) | 514 (59.49%) | 9 (47.37%) | 0.053 | (0.97, 0.99) |
High level education (N, %) | 380 (43.03%) | 376 (43.52%) | 4 (21.05%) | 0.0850 | (0.97, 0.99) |
Low/medium level education (N, %) | 503 (56.96%) | 488 (56.48%) | 15 (78.95%) | 0.08520 | (0.95, 0.98) |
Rural residence (N, %) | 341 (38.5%) | 330 (38.19%) | 11 (57.89%) | 0.1319 | (0.94, 0.98) |
Smoker (N, %) | 232 (26.27%) | 230 (26.62%) | 2 (10.53%) | 0.1891 | (0.97, 1) |
Non or past smoker (N, %) | 650 (73.61%) | 633 (73.26%) | 17 (89.47%) | 0.1859 | (0.96, 0.98) |
Waist (cm) | 96.35 ± 16.51 | 96.08 ± 16.54 | 108.37 ± 9.01 | 0.0013 | (95.25, 97.44) |
BMI (kg/m2) | 29.038 ± 3.24 | 28.22 ± 5.61 | 30.76 ± 4.6 | 0.0507 | (28.54, 29.16) |
MS | 284 (32.16%) | 272 (31.5%) | 12 (62.8%) | 0.001 | (0.91, 0.98) |
Creatinine (mg/dL) | 0.91 ± 0.12 | 0.79 ± 0.16 | 1.407 ± 0.38 | <0.0001 | (0.79, 0.81) |
Acid uric (mg/dL) | 5.76 ± 1.61 | 5.26 ± 1.57 | 7.44 ± 1.51 | 0.0001 | (5.15, 5.49) |
Albuminuria (mg/dL) | 12.01 ± 50.12 | 11.86 ± 54.24 | 16.63 ± 6.93 | 0.0474 | (8.18, 15.34) |
ACR (mg/g) | 14.25 ± 186.24 | 9.19 ± 19.07 | 58.1 ± 218.2 | <0.0001 | (7.81, 13.04) |
Urinary sodium (mmol/L) | 120.81 ± 53.72 | 120.4 ± 53.6 | 122.7 ± 53.3 | 0.8952 | (115.89, 124.46) |
Blood glucose (mg/dL) | 102.09 ± 20.12 | 99.89 ± 22.94 | 124.52 ± 42.9 | <0.0001 | (98.56, 101.69) |
Glycated hemoglobin % | 5.72 ± 0.96 | 5.62 ± 0.78 | 6.36 ± 1.49 | <0.0001 | (5.58, 5.68) |
TC (mg/dL) | 201.5 ± 52.1 | 202.1 ± 46.7 | 192.7 ± 62.3 | 0.38928 | (198.42, 204.42) |
LDL (mg/dL) | 129.02 ± 51.2 | 132.6 ± 43.4 | 117.5 ± 57.7 | 0.15309 | (128.88, 134.47) |
HDL (mg/dL) | 53.01 ± 14.1 | 53.87 ± 13.6 | 50.42 ± 16.77 | 0.2783 | (52.73, 54.49) |
TG (mg/dL) | 122.24 ± 80.1 | 119.77 ± 79.8 | 152.35 ± 78.5 | 0.0965 | (115.30, 126.02) |
TG/HDL ratio > 3.0 | 283 (32.04) | 270 (31.25%) | 13 (68.8%) | 0.001 | (0.92, 0.97) |
Apo B (g/L) | 0.95 ± 0.32 | 0.95 ± 0.28 | 0.96 ± 0.368 | 0.8776 | (0.93, 0.97) |
EFLV ≤ 50 % (N, %) | 145 (16.42%) | 140 (16.2%) | 5 (26.32%) | 0.3876 | (0.93, 0.99) |
Diastolic dysfunction (N, %) | 244 (27.63%) | 232 (26.85%) | 12 (63.16%) | 0.0011 | (0.92, 0.97) |
Heart rate (b/min) | 71.3 ± 12 | 72.21 ± 11.3 | 70.87 ± 8.6 | 0.6382 | (71.16, 72.48) |
Modified Cornell criteria > 12 mm (N, %) | 685 (77.58%) | 670 (77.55%) | 15 (78.95%) | 1.0 | (0.96, 0.98) |
IV troubles of conduction (N, %) | 609 (68.9%) | 599 (69.33 %) | 10 (53.63 %) | 0.1917 | (0.97, 0.99) |
LV mass (g) | 122.6 ± 62 | 114.4 ± 71.7 | 154.67 ± 89.6 | 0.0238 | (100.7, 110.19) |
Thickness of the LV posterior wall (mm) | 7.21 ± 2.2 | 7.41 ± 3.9 | 8.47 ± 4.54 | 0.2710 | (6.57, 7.11) |
Carotid plaques (N, %) | 198 (22.42%) | 185 (21.41%) | 13 (68.42%) | <0.0001 | (0.89, 0.96) |
DM (N, %) | 121 (13.7%) | 110 (12.73%) | 11 (57.89%) | <0.0001 | (0.85, 0.96) |
Stroke (N, %) | 33 (3.74%) | 31 (3.59 %) | 2 (10.53%) | 0.3341 | (0.85, 1) |
AF (N, %) | 55 (6.23%) | 51 (5.9%) | 4 (21.05%) | 0.0262 | (0.85, 0.99) |
MI (N, %) | 21 (2.38%) | 20 (2.31%) | 1 (5.26%) | 0.941 | (0.86, 1) |
HF (N, %) | 44 (4.98%) | 40 (4.63 %) | 4 (21.05%) | 0.00650 | (0.82, 0.99) |
Grade/Stages eGFR mL/min/1.73 m2 | Total (N, %) 883, 100% | Urine Albumin-to-Creatinine Ratio (mg/g) | Urinary Sodium (mmol/L) |
---|---|---|---|
G1 ≥ 90 | 636 (72.03%) | 7.88 ± 13.17 | 120.58 ± 54.59 |
G2 60–89 | 228 (25.82%) | 12.98 ± 29.85 | 119.92 ± 50.58 |
G3a 45–59 | 15 (1.7%) | 6.6 ± 5.87 | 124.43 ± 56.79 |
G3b 30–44 | 3 (0.34%) | 324.93 ± 550.43 | 117.0 ± 7.0 |
G4 15–29 | 1 (0.11%) | 30 ± 0.9 | - |
G5 < 15 | 0 | - | - |
Variables | Overall (N, %) | eGFR ≥ 60 mL/min/1.73 m2 (N, %) | eGFR < 60 mL/min/1.73 m2 (N, %) | p | CI |
---|---|---|---|---|---|
Total hypertensives | 379 | 362 | 17 | 0.009 | (0.93, 0.97) |
Controlled hypertensives | 177 (46.7%) | 172 (47.51%) | 5 (29.41%) | 0.04 | (0.89, 0.99) |
Mean SBP (mmHg) | 127.7 ± 17.5 | 127.46 ± 17.44 | 139.32 ± 19.45 | 0.003 | (126.55, 128.8) |
Mean DBP (mmHg) | 80.6 ± 10.53 | 80.65 ± 10.53 | 82.21 ± 10.65 | 0.52 | (79.9, 81.37) |
RASi | 126 (33.24%) | 120 (33.14%) | 6 (35.29%) | 0.06 | (0.91, 0.98) |
Diuretics | 136 (35.88%) | 126 (34.8%) | 10 (58.82%) | 0.002 | (0.88, 0.97) |
CCB | 70 (18.46%) | 65 (17.95%) | 5 (29.41%) | 0.01 | (0.75, 0.91) |
Beta blockers | 62 (16.35%) | 57 (15.74%) | 5 (29.41%) | 0.03 | (0.9, 0.97) |
AA | 5 (1.31%) | 4 (1.1%) | 1 (5.88%) | 0.02 | (0.44, 1.0) |
Central antihypertensive | 17 (4.48%) | 16 (4.41%) | 1 (5.88%) | 0.1 | - |
Monotherapy | 116 (30.6%) | 114 (31.49%) | 2 (11.76%) | 0.05 | (0.93, 0.99) |
Bitherapy | 85 (22.42%) | 81 (22.37%) | 4 (23.52%) | 1.0 | (0.94, 1.0) |
Tritherapy | 54 (14.2%) | 47 (12.98%) | 7 (41.17%) | 0.0004 | (0.81, 0.96) |
More than 3 antihypertensive drugs | 13 (3.43%) | 12 (3.31%) | 1 (5.8%) | 0.01 | (0.94, 1.0) |
Lipid-lowering drugs | 137 (15.5%) | 129 (14.93%) | 8 (42.11%) | 0.003 | (0.9, 0.98) |
Antiplatelets | 101 (11.44%) | 96 (11.11%) | 5 (26.32%) | 0.08 | (0.9, 0.99) |
Variables | Univariate (Unadjusted) | Multivariate (Adjusted for Age, Sex, and Diabetes) | ||
---|---|---|---|---|
p-Value (CI) | OR | p-Value (CI) | OR | |
Age > 50 years | 0.07 (0.57, 3.84) | 1.12 | 0.854 (−1.48, 6.07) | 0.66 |
Female sex | 0.03 (0.4, 1.42) | 1.16 | 0.32 (−1.46, 0.47) | 0.611 |
Controlled hypertensives | 0.22 (0.17, 2.27) | 0.21 | 0.799 (−1.3, 1.007) | 0.26 |
Hypertension awareness | 0.31 (1.33, 4.27) | 0.17 | 0.165 (−0.45, 2.670) | 0.25 |
Smoker | 0.666 (−0.71, 1.11) | 0.82 | 0.395 (−0.65, 1.64) | 0.64 |
Uric acid > 6.9 (mg/dL) | 0.0004 (2.72, 9.52) | 6.71 | 0.004 (2.063, 10.83) | 6.61 |
ACR (mg/g) | 0.05 (1.02, 3.34) | 1.43 | 0.490 (−1.2, 6.1) | 0.7 |
DM | 0.03 (2.08, 7.08) | 2.8 | 0.299 (−1.8, 5.8) | 0.66 |
HbA1c % > 7.5 | 0.04 (1.93, 4.87) | 2.1 | 0.40 (1.25, 5.5) | 0.78 |
Diastolic dysfunction | 0.14 (−0.45, 3.17) | 0.49 | 0.62 (−1.5, 2.28) | 0.69 |
LV mass > 140 g | 0.02 (0.39, 3.63) | 1.46 | 0.24 (−1.05, 2.1) | 0.45 |
Carotid plaques | 0.001 (0.84, 4.1) | 2.2 | 0.07 (1.1, 2.31) | 2.09 |
Stroke | 0.135 (−0.35, 2.65) | 0.51 | 0.49 (−2.2, 1.06) | 0.56 |
Obesity | 0.04 (1.40, 1.98) | 1.23 | 0.38 (0.26, 0.47) | 0.85 |
AF | 0.01 (0.34, 2.63) | 1.42 | 0.46 (−0.79, 1.72) | 0.59 |
MI | 0.421 (−1.21, 2.9) | 0.33 | 0.376 (−1.17, 1.2) | 0.37 |
HF | 0.04 (0.54, 2.8) | 1.4 | 0.465 (−0.76, 1.68) | 0.57 |
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Pop, C.; Gheorghe Fronea, O.F.; Branea, I.A.; Itu, L.M.; Darabont, R.; Parepa, I.; Benedek, T.; Dorobantu, M. Prevalence and Predictors of Renal Disease in a National Representative Sample of the Romanian Adult Population: Data from the SEPHAR IV Survey. Diagnostics 2022, 12, 3199. https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12123199
Pop C, Gheorghe Fronea OF, Branea IA, Itu LM, Darabont R, Parepa I, Benedek T, Dorobantu M. Prevalence and Predictors of Renal Disease in a National Representative Sample of the Romanian Adult Population: Data from the SEPHAR IV Survey. Diagnostics. 2022; 12(12):3199. https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12123199
Chicago/Turabian StylePop, Călin, Oana Florentina Gheorghe Fronea, Ioana Antonia Branea, Lucian Mihai Itu, Roxana Darabont, Irinel Parepa, Theodora Benedek, and Maria Dorobantu. 2022. "Prevalence and Predictors of Renal Disease in a National Representative Sample of the Romanian Adult Population: Data from the SEPHAR IV Survey" Diagnostics 12, no. 12: 3199. https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12123199