Department of Medicine, Emory University, Atlanta, GA; Department of Epidemiology, Emory University, Atlanta, GA 30220, USA.
Am J Kidney Dis. 2012 Jan;59(1):25-31. doi: 10.1053/j.ajkd.2011.09.018. Epub 2011 Nov 10.
The contribution of albuminuria to the increased risk of incident end-stage renal disease (ESRD) in individuals with a family history of ESRD has not been well studied.
Prospective cohort study. STUDY SETTING & PARTICIPANTS: We analyzed data for family history of ESRD collected from 19,409 participants of the Renal REGARDS (Reasons for Geographic and Racial Differences in Stroke) cohort study.
Family history of ESRD was ascertained by asking "Has anyone in your immediate family ever been told that he or she had kidney failure? This would be someone who is on or had been on dialysis or someone who had a kidney transplant."
Incidence rate for ESRD.
Morning urine albumin-creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR). Incident cases of ESRD were identified through the US Renal Data System.
A family history of ESRD was reported by 11.1% of participants. Mean eGFRs for those with and without a family history of ESRD were 87.5 ± 22.2 (SD) and 86.5 ± 19.3 mL/min/1.73 m(2), respectively (P = 0.05) and the respective geometric mean ACRs were 12.2 and 9.7 mg/g (P < 0.001). ESRD incidence rates for those with and without a family history of ESRD were 244.3 and 106.1/100,000 person-years, respectively. After adjusting for age, sex, and race, the ESRD HR for those with versus those without a family history of ESRD was 2.13 (95% CI, 1.18-3.83). Adjustment for comorbid conditions and socioeconomic status attenuated this association (HR, 1.82; 95% CI, 1.00-3.28), and further adjustment for baseline eGFR and ACR completely attenuated the association between family history of ESRD and incident ESRD (HR, 1.12; 95% CI, 0.69-1.80).
The report of a family history of ESRD was not validated.
Family history of ESRD is common in older Americans and the increased risk of ESRD associated with a family history reflects lower GFR, higher albuminuria, and comorbid conditions.
家族性终末期肾病（ESRD）病史对个体发生 ESRD 的风险增加的影响尚未得到很好的研究。
前瞻性队列研究。
我们分析了来自 19409 名雷纳尔德（REasons for Geographic and Racial Differences in Stroke）队列研究参与者的 ESRD 家族史数据。
通过询问“您的直系亲属中是否有人曾经被告知他/她患有肾衰竭？这可能是正在接受透析或已经接受过肾移植的人。”来确定 ESRD 家族史。
ESRD 的发病率。
早晨尿白蛋白-肌酐比值（ACR）和估计肾小球滤过率（eGFR）。通过美国肾脏数据系统确定 ESRD 的新发病例。
11.1%的参与者报告有 ESRD 家族史。有和没有 ESRD 家族史的参与者的平均 eGFR 分别为 87.5 ± 22.2（SD）和 86.5 ± 19.3 mL/min/1.73 m²（P=0.05），相应的几何平均 ACR 分别为 12.2 和 9.7 mg/g（P<0.001）。有和没有 ESRD 家族史的 ESRD 发病率分别为 244.3 和 106.1/100000 人年。在校正年龄、性别和种族后，有家族史与无家族史的 ESRD 的 HR 为 2.13（95%CI，1.18-3.83）。调整合并症和社会经济状况后，这种关联减弱（HR，1.82；95%CI，1.00-3.28），进一步调整基线 eGFR 和 ACR 完全减弱了 ESRD 家族史与新发 ESRD 之间的关联（HR，1.12；95%CI，0.69-1.80）。
ESRD 家族史的报告未经证实。
ESRD 家族史在老年美国人中很常见，与家族史相关的 ESRD 风险增加反映了较低的 GFR、较高的白蛋白尿和合并症。
