Kidney Week

Abstract: TH-PO1063

Determinants of Intraregional Differences in Renal Function in the Northern Netherlands: The Lifelines Cohort Study

Session Information

• CKD: Epidemiology, Risk Factors, Prevention - I
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Cai, Qingqing, University Medical Center Groningen, Groningen, Netherlands

Qingqing Cai,

• Dekker, Louise H., University Medical Center Groningen, Groningen, Netherlands

Louise H. Dekker,

• Bakker, Stephan J.L., University Medical Center Groningen, Groningen, Netherlands

Stephan J.L. Bakker,

• De Borst, Martin H., University Medical Center Groningen, Groningen, Netherlands

Martin H. De Borst,

• Navis, Gerjan, University Medical Center Groningen, Groningen, Netherlands

Gerjan Navis,

Background

Although interregional disparity in CKD prevalence has been reported globally, it is unclear which factors drive renal function clustering within regions. We studied the intraregional distribution of renal function in the Northern Netherlands and identified factors associated with its geographic variability.

Methods

We included 130,545 participants in LifeLines, a prospective population-based cohort in the Northern Netherlands. Spatial analysis was performed to identify spatial clusters of eGFR (CKD-EPI), and multivariable logistic regression was used to identify demographic, clinical and environmental factors associated with 99% confidence hot vs cold spot clusters.

Results

Significant spatial clustering of high (hot spot) and low (cold spot) eGFR was found independent of age, sex and BSA (Figure). Participants in cold spot area had lower eGFR (95.47±15.50 vs. 98.47±14.61 ml/min/1.73 m²) and lower 24h creatinine clearance (126.75±35.48 vs. 130.94±33.72 ml/min) compared to those in hot spot area (p<0.05). In multivariable logistic regression, blood pressure (OR for being in cold spot: 1.01 [95% CI 1.00-1.01] ), BMI (1.03[1.03-1.04]), serum potassium (0.38[0.34-0.43]), diuretics use (0.73[0.60-0.90]), education level (1.10[1.05-1.15]) and urbanity (2.77[2.66-2.88]) were all independently associated with spatial distribution of renal function (model R²=0.301). Subanalysis in 6,535 individuals showed that PM10 (3.67[3.07-4.39]), PM2.5 (5.02[3.90-6.47]), NO₂ (1.11[1.07-1.15]) were independently associated with renal function distribution, respectively.

Conclusion

Intraregional clustering of renal function was observed in the Northern Netherlands; determinants included blood pressure, BMI, serum potassium, diuretics use, education level, urbanity, and air pollution.

Funding

• Government Support - Non-U.S.