Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Am J Kidney Dis. 2010 May;55(5):856-66. doi: 10.1053/j.ajkd.2009.12.021. Epub 2010 Feb 13.
A higher prevalence of chronic kidney disease (CKD) has been found in genetic relatives of patients with end-stage renal disease. However, the risk of CKD in nongenetic spouses of patients with end-stage renal disease is still unknown.
Cross-sectional study.
SETTING & PARTICIPANTS: 196 first- and second-degree relatives and 95 spouses of 178 hemodialysis (HD) patients were enrolled. Two sex- and age-stratified matched counterpart controls were randomly selected from the population of a community screening program for CKD.
Relatives or spouses of HD patients and kidney disease risk factors.
Prevalence of CKD (albuminuria or low estimated glomerular filtration rate).
Albuminuria (urine albumin-creatinine ratio > or = 30 mg/g), low estimated glomerular filtration rate (<60 mL/min/1.73 m(2)), and kidney disease risk factors of age, hypertension, diabetes mellitus, metabolic syndrome, and lifestyle.
A significantly higher prevalence of CKD was found in relatives (15.8% vs 7.5%; P = 0.01) and spouses (41.1% vs 15.8%; P < 0.001) of HD patients compared with their counterpart controls. Multiple logistic regression analysis showed that age (OR, 1.05) and hypertension (OR, 3.13) were significant independent risk factors for CKD in relatives of HD patients, whereas diabetes mellitus (OR, 3.51) was a significant risk factor for CKD in spouses of HD patients. For all pooled participants, being relatives (OR, 2.55) or spouses (OR, 2.80) of HD patients, age (OR, 1.06), female sex (OR, 1.81), diabetes mellitus (OR, 3.95), hypertension (OR, 1.85), and hyperuricemia (OR, 2.06) were independent significant risk factors for CKD.
Cross-sectional research design, single laboratory measurement, and limited numbers of participants.
A comprehensive screening program for CKD is equally important in both relatives and spouses of HD patients, especially for participants with the renal risk factors of older age, hypertension, and diabetes mellitus. Spousal concordance of CKD suggests that the shared environmental factors and health behaviors might have important roles in the development of CKD.
患有终末期肾病的患者的遗传亲属中，慢性肾脏病（CKD）的患病率更高。然而，终末期肾病患者的非遗传配偶患 CKD 的风险仍不清楚。
横断面研究。
纳入了 178 名血液透析（HD）患者的 196 名一级和二级亲属以及 95 名配偶。从 CKD 社区筛查计划的人群中，随机选择了 2 名与性别和年龄匹配的对照者。
HD 患者的亲属或配偶以及肾脏疾病的危险因素。
CKD 的患病率（白蛋白尿或估计肾小球滤过率降低）。
白蛋白尿（尿白蛋白/肌酐比值>或=30mg/g）、估计肾小球滤过率降低（<60mL/min/1.73m2）和年龄、高血压、糖尿病、代谢综合征以及生活方式等肾脏疾病危险因素。
HD 患者的亲属（15.8%对 7.5%；P=0.01）和配偶（41.1%对 15.8%；P<0.001）的 CKD 患病率明显高于对照组。多因素逻辑回归分析显示，年龄（OR，1.05）和高血压（OR，3.13）是 HD 患者亲属 CKD 的显著独立危险因素，而糖尿病（OR，3.51）是 HD 患者配偶 CKD 的显著危险因素。对于所有汇总参与者，HD 患者的亲属（OR，2.55）或配偶（OR，2.80）、年龄（OR，1.06）、女性（OR，1.81）、糖尿病（OR，3.95）、高血压（OR，1.85）和高尿酸血症（OR，2.06）是 CKD 的独立显著危险因素。
横断面研究设计、单一实验室测量以及参与者数量有限。
对 HD 患者的亲属和配偶进行 CKD 全面筛查同样重要，特别是对于具有年龄较大、高血压和糖尿病等肾脏危险因素的参与者。CKD 的配偶一致性表明，共同的环境因素和健康行为可能在 CKD 的发生中发挥重要作用。
