Gumprecht Janusz, Zychma Marcin J, Moczulski Dariusz K, Gosek Katarzyna, Grzeszczak Wladyslaw
Department of Internal Medicine, Diabetology and Nephrology, Silesian School of Medicine, Zabrze, Poland.
J Nephrol. 2003 Jul-Aug;16(4):511-5.
In previous reports of end-stage renal disease (ESRD) patients, family history of ESRD was associated with race, younger age, higher education levels and ESRD etiology. This study aimed to analyze how often Polish caucasian dialysis patients reported relatives with ESRD, and to evaluate which risk factors are associated with family history of ESRD.
4808 ESRD patients provided data about renal disease etiology, diabetes and hypertensive status of first- and second-degree relatives, socioeconomic status and education level.
Reported ESRD etiologies were: chronic glomerular disease, 19.4 %; diabetic nephropathy, 11.3%; interstitial nephritris, 11.2%; hypertension, 7.8%; polycystic kidney disease (PKD), 7.1%; other or no response, 40.0%. Positive ESRD family history was reported by 745 patients (15.5%); positive history of diabetes, 932 (19.4%); hypertension, 1904 (39%). Positive ESRD family history according to kidney disease etiology was: PKD, 53.1%; glomerulonephritis, 12%; diabetic nephropathy, 11.9%; hypertension, 11.8%; interstitial nephritis, 10.8%. PKD as ESRD etiology (odds ratio (OR) 8.06, 95% confidence interval (CI) 6.35-10.23, p < 0.0001), positive family history of diabetes (OR 1.64, 95% CI 1.34-1.99, p < 0.0001) and positive history of hypertension (OR 1.64, 95% CI 1.39-1.95, p < 0.0001), were independently associated with positive ESRD history. Patients with later ESRD onset had a less frequent positive ESRD family history: for ESRD < 45 yrs, 16% (OR 1.0); 45-64 yrs, 14.4% (OR 0.83, 95% CI 0.70-0.99); > or = 65 yrs, 9.2 % (OR 0.5, 95% CI 0.35-0.72).
Results of our study strongly support the contention that familial predisposition contributes to ESRD development.
在先前关于终末期肾病（ESRD）患者的报告中，ESRD家族史与种族、较年轻的年龄、较高的教育水平及ESRD病因相关。本研究旨在分析波兰白种人透析患者报告有ESRD亲属的频率，并评估哪些危险因素与ESRD家族史相关。
4808例ESRD患者提供了关于肾病病因、一级和二级亲属的糖尿病及高血压状况、社会经济地位和教育水平的数据。
报告的ESRD病因有：慢性肾小球疾病，19.4%；糖尿病肾病，11.3%；间质性肾炎，11.2%；高血压，7.8%；多囊肾病（PKD），7.1%；其他或无应答，40.0%。745例患者（15.5%）报告有ESRD家族史阳性；糖尿病家族史阳性的有932例（19.4%）；高血压家族史阳性的有1904例（39%）。根据肾病病因，ESRD家族史阳性情况为：PKD，53.1%；肾小球肾炎，12%；糖尿病肾病，11.9%；高血压，11.8%；间质性肾炎，10.8%。PKD作为ESRD病因（比值比（OR）8.06，95%置信区间（CI）6.35 - 10.23，p < 0.0001）、糖尿病家族史阳性（OR 1.64，95% CI 1.34 - 1.99，p < 0.0001）和高血压家族史阳性（OR 1.64，95% CI 1.39 - 1.95，p < 0.0001）与ESRD家族史阳性独立相关。ESRD发病较晚的患者ESRD家族史阳性频率较低：ESRD < 45岁的患者中，16%（OR 1.0）；45 - 64岁的患者中，14.4%（OR 0.83，95% CI 0.70 - 0.99）；≥65岁的患者中，9.2%（OR 0.5，95% CI 0.35 - 0.72）。
我们的研究结果有力地支持了家族易感性促成ESRD发生这一论点。
