Kar Debasish, Byng Richard, Sheikh Aziz, Nath Mintu, Zabeen Bedowra, Kar Shubharthi, Banu Shakila, Sarker Mohammad Habibur Rahman, Khan Navid, Acharjee Durjoy, Islam Shafiqul, Allgar Victoria, Ordóñez-Mena José M, El-Wazir Aya, Song Soon, Verma Ashish, Kadam Umesh, de Lusignan Simon
Community and Primary Care Research Group, University of Plymouth, Plymouth, UK.
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
BMC Nephrol. 2025 Apr 1;26(1):168. doi: 10.1186/s12882-025-04090-7.
The global prevalence of end-stage kidney disease (ESKD) is increasing despite optimal management of traditional risk factors such as hyperglycaemia, hypertension, and dyslipidaemia. This study examines the influence of cardiorenal risk factors, socioeconomic status, and ethnic and cardiovascular comorbidities on ESKD outcomes in the general population.
This cross-sectional study analysed data from 502,408 UK Biobank study participants recruited between 2006 and 2010. Multivariable logistic regression models were fitted to assess risk factors for ESKD, with results presented as adjusted odds ratio (aOR) and 95% confidence intervals (95% CI).
A total of 1191 (0.2%) of the study participants reported ESKD. Diabetes increased ESKD risk by 62% [1.62 (1.36-1.93)], with early-onset diabetes (before age 40) conferring higher odds compared to later-onset (after age 40) [2.26 (1.57-3.24)]. Similarly, early-onset hypertension (before age 40), compared to later onset (after age 40), increased ESKD odds by 73% [1.73 (1.21-2.44)]. Cardiovascular comorbidities, including stroke, hypertension, myocardial infarction and angina, were strongly associated with ESKD [5.97 (3.99-8.72), 5.35 (4.38-6.56), 4.94 (3.56-6.78), and 4.89 (3.47-6.81)], respectively. Males were at 22% higher risk of ESKD than females [1.22 (1.04-1.43)]. Each additional year of diabetes duration increased ESKD odds by 2% [1.02 (1.01-1.03)]. Non-white ethnicity, compared to white and socioeconomically most deprived, compared to the least deprived quintiles, were at 70% and 83% higher odds of ESKD. Each unit of HbA1c rise increased the odds of ESKD by 2%. Compared to microalbuminuria, macroalbuminuria increased the odds of ESKD by almost 10-fold [9.47 (7.95-11.27)] while normoalbuminuria reduced the odds by 73% [0.27 (0.22-0.32)].
Early onset of diabetes and hypertension, male sex, non-white ethnicity, deprivation, poor glycaemic control, and prolonged hyperglycaemia are significant risk factors for ESKD. These findings highlight the complexity of ESKD and the need for multifactorial targeted interventions in high-risk populations.
Not applicable.
尽管对高血糖、高血压和血脂异常等传统危险因素进行了优化管理，但全球终末期肾病（ESKD）的患病率仍在上升。本研究探讨了心肾危险因素、社会经济地位以及种族和心血管合并症对普通人群ESKD结局的影响。
这项横断面研究分析了2006年至2010年间招募的502408名英国生物银行研究参与者的数据。采用多变量逻辑回归模型评估ESKD的危险因素，结果以调整后的优势比（aOR）和95%置信区间（95%CI）表示。
共有1191名（0.2%）研究参与者报告患有ESKD。糖尿病使ESKD风险增加62%[1.62（1.36 - 1.93）]，早发性糖尿病（40岁之前）相比晚发性糖尿病（40岁之后）具有更高的患病几率[2.26（1.57 - 3.24）]。同样，早发性高血压（40岁之前）相比晚发性高血压（40岁之后）使ESKD患病几率增加73%[1.73（1.21 - 2.44）]。心血管合并症，包括中风、高血压、心肌梗死和心绞痛，与ESKD密切相关[分别为5.97（3.99 - 8.72）、5.35（4.38 - 6.56）、4.94（3.56 - 6.78）和4.89（3.47 - 6.81）]。男性患ESKD的风险比女性高22%[1.22（1.04 - 1.43）]。糖尿病病程每增加一年，ESKD患病几率增加2%[1.02（1.01 - 1.03）]。与白人相比，非白人种族、与最贫困五分位数相比处于社会经济最贫困状态的人群患ESKD的几率分别高70%和83%。糖化血红蛋白（HbA1c）每升高一个单位，ESKD患病几率增加2%。与微量白蛋白尿相比，大量白蛋白尿使ESKD患病几率增加近10倍[9.47（7.95 - 11.27）]，而正常白蛋白尿使患病几率降低73%[0.27（0.22 - 0.32）]。
糖尿病和高血压的早发、男性、非白人种族、贫困、血糖控制不佳以及长期高血糖是ESKD的重要危险因素。这些发现凸显了ESKD的复杂性以及对高危人群进行多因素针对性干预的必要性。
不适用。
