Prevalence and Risk Factors for CKD: Spouses and Relatives of Dialysis Patients

ABSTRACT
Prevalence and Risk Factors for CKD in Spouses and Relatives of Hemodialysis Patients

Jer-Chia Tsai, MD12, Szu-Chia Chen, MD13, Shang-Jyh Hwang, MD12, Jer-Ming Chang, MD, PhD123, Ming-Yen Lin, MPH1, Hung-Chun Chen, MD, PhD12Corresponding Author Informationemail address

Received 18 May 2009; accepted 11 December 2009. published online 16 February 2010.
Corrected Proof
Background

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.
Study Design

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.
Predictors

Relatives or spouses of HD patients and kidney disease risk factors.
Outcomes

Prevalence of CKD (albuminuria or low estimated glomerular filtration rate).
Measurement

Albuminuria (urine albumin-creatinine ratio ≥ 30 mg/g), low estimated glomerular filtration rate (<60 mL/min/1.73 m2), and kidney disease risk factors of age, hypertension, diabetes mellitus, metabolic syndrome, and lifestyle.
Results

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.
Limitations

Cross-sectional research design, single laboratory measurement, and limited numbers of participants.
Conclusions

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.
Index words: Chronic kidney disease (CKD), albuminuria, relatives, spouses, hemodialysis (HD), renal risk factors

1 Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan

2 Faculty of Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

3 Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan

Corresponding Author InformationAddress correspondence to Hung-Chun Chen, MD, PhD, Division of Nephrology, Department of Internal Medicine, Chung-Ho Memorial Hospital, Kaohsiung Medical University, 100 Shih-Chuan 1st Rd, Kaohsiung 807, Taiwan

Originally published online as doi:10.1053/j.ajkd.2009.12.021

PII: S0272-6386(09)01659-X

doi:10.1053/j.ajkd.2009.12.021

© 2010 National Kidney Foundation, Inc. Published by Elsevier Inc All rights reserved.

http://www.ajkd.org/article/S0272-6386%2809%2901659-X/abstract