The association between urbanization and reduced renal function: findings from the China Health and Nutrition Survey
Abstract Background While chronic kidney disease (CKD) is a growing public health concern in low- and middle-income countries, such as China, few studies have investigated the association between urbanization and the occurrence of CKD in those countries. Methods We investigated the association betwe...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2017-05-01
|
| Series: | BMC Nephrology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12882-017-0577-7 |
| _version_ | 1818084604645474304 |
|---|---|
| author | Yosuke Inoue Annie Green Howard Amanda L. Thompson Michelle A. Mendez Amy H. Herring Penny Gordon-Larsen |
| author_facet | Yosuke Inoue Annie Green Howard Amanda L. Thompson Michelle A. Mendez Amy H. Herring Penny Gordon-Larsen |
| author_sort | Yosuke Inoue |
| collection | DOAJ |
| description | Abstract Background While chronic kidney disease (CKD) is a growing public health concern in low- and middle-income countries, such as China, few studies have investigated the association between urbanization and the occurrence of CKD in those countries. Methods We investigated the association between urbanization and estimated glomerular filtration rate (eGFR), an important CKD risk marker. Data came from the China Health and Nutrition Survey wave 2009, in which we collected fasting serum, individual and household data along with community level urbanization data, which was used to derive a study-specific urbanization measure, in 218 communities across nine provinces. A total of 3644 men and 4154 women participants aged 18 years or older were included in the analysis. Reduced renal function was defined as eGFR of less than 60 mL/min/1.73 m2 measured using serum creatinine concentration (mg/dL). Results After adjusting for socio-demographic (e.g., age, education and household income), a sex-stratified multilevel logistic model revealed that living in a more urbanized community was associated with higher odds of reduced eGFR (odds ratio [OR] = 1.38 per one-standard deviation [SD] increase in the CHNS specific urbanization index, 95% confidence interval [CI] = 1.11–1.73 for men; OR = 1.35, 95% CI = 1.11–1.62 for women). After adjusting for behavioral variables (i.e., alcohol consumption, smoking, physical activity and diet), as well as obesity and cardiometabolic risk factors, the association was attenuated in men (OR = 1.25, 95% CI = 0.98–1.59), but remained statistically significant in women (OR = 1.24, 95% CI = 1.01–1.52). Conclusion Our findings suggest that living in an urban environment is linked with higher odds of reduced renal function independently of behavioral and cardiometabolic risk factors, which have been shown to increase along with urbanization. |
| first_indexed | 2024-12-10T19:56:32Z |
| format | Article |
| id | doaj.art-6588effad4c640cd98cca9ff69901526 |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-12-10T19:56:32Z |
| publishDate | 2017-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-6588effad4c640cd98cca9ff699015262022-12-22T01:35:39ZengBMCBMC Nephrology1471-23692017-05-0118111010.1186/s12882-017-0577-7The association between urbanization and reduced renal function: findings from the China Health and Nutrition SurveyYosuke Inoue0Annie Green Howard1Amanda L. Thompson2Michelle A. Mendez3Amy H. Herring4Penny Gordon-Larsen5Carolina Population Center, The University of North Carolina at Chapel HillCarolina Population Center, The University of North Carolina at Chapel HillCarolina Population Center, The University of North Carolina at Chapel HillCarolina Population Center, The University of North Carolina at Chapel HillCarolina Population Center, The University of North Carolina at Chapel HillCarolina Population Center, The University of North Carolina at Chapel HillAbstract Background While chronic kidney disease (CKD) is a growing public health concern in low- and middle-income countries, such as China, few studies have investigated the association between urbanization and the occurrence of CKD in those countries. Methods We investigated the association between urbanization and estimated glomerular filtration rate (eGFR), an important CKD risk marker. Data came from the China Health and Nutrition Survey wave 2009, in which we collected fasting serum, individual and household data along with community level urbanization data, which was used to derive a study-specific urbanization measure, in 218 communities across nine provinces. A total of 3644 men and 4154 women participants aged 18 years or older were included in the analysis. Reduced renal function was defined as eGFR of less than 60 mL/min/1.73 m2 measured using serum creatinine concentration (mg/dL). Results After adjusting for socio-demographic (e.g., age, education and household income), a sex-stratified multilevel logistic model revealed that living in a more urbanized community was associated with higher odds of reduced eGFR (odds ratio [OR] = 1.38 per one-standard deviation [SD] increase in the CHNS specific urbanization index, 95% confidence interval [CI] = 1.11–1.73 for men; OR = 1.35, 95% CI = 1.11–1.62 for women). After adjusting for behavioral variables (i.e., alcohol consumption, smoking, physical activity and diet), as well as obesity and cardiometabolic risk factors, the association was attenuated in men (OR = 1.25, 95% CI = 0.98–1.59), but remained statistically significant in women (OR = 1.24, 95% CI = 1.01–1.52). Conclusion Our findings suggest that living in an urban environment is linked with higher odds of reduced renal function independently of behavioral and cardiometabolic risk factors, which have been shown to increase along with urbanization.http://link.springer.com/article/10.1186/s12882-017-0577-7Glomerular filtration rateCreatinineRenal insufficiencyChinaUrbanization |
| spellingShingle | Yosuke Inoue Annie Green Howard Amanda L. Thompson Michelle A. Mendez Amy H. Herring Penny Gordon-Larsen The association between urbanization and reduced renal function: findings from the China Health and Nutrition Survey BMC Nephrology Glomerular filtration rate Creatinine Renal insufficiency China Urbanization |
| title | The association between urbanization and reduced renal function: findings from the China Health and Nutrition Survey |
| title_full | The association between urbanization and reduced renal function: findings from the China Health and Nutrition Survey |
| title_fullStr | The association between urbanization and reduced renal function: findings from the China Health and Nutrition Survey |
| title_full_unstemmed | The association between urbanization and reduced renal function: findings from the China Health and Nutrition Survey |
| title_short | The association between urbanization and reduced renal function: findings from the China Health and Nutrition Survey |
| title_sort | association between urbanization and reduced renal function findings from the china health and nutrition survey |
| topic | Glomerular filtration rate Creatinine Renal insufficiency China Urbanization |
| url | http://link.springer.com/article/10.1186/s12882-017-0577-7 |
| work_keys_str_mv | AT yosukeinoue theassociationbetweenurbanizationandreducedrenalfunctionfindingsfromthechinahealthandnutritionsurvey AT anniegreenhoward theassociationbetweenurbanizationandreducedrenalfunctionfindingsfromthechinahealthandnutritionsurvey AT amandalthompson theassociationbetweenurbanizationandreducedrenalfunctionfindingsfromthechinahealthandnutritionsurvey AT michelleamendez theassociationbetweenurbanizationandreducedrenalfunctionfindingsfromthechinahealthandnutritionsurvey AT amyhherring theassociationbetweenurbanizationandreducedrenalfunctionfindingsfromthechinahealthandnutritionsurvey AT pennygordonlarsen theassociationbetweenurbanizationandreducedrenalfunctionfindingsfromthechinahealthandnutritionsurvey AT yosukeinoue associationbetweenurbanizationandreducedrenalfunctionfindingsfromthechinahealthandnutritionsurvey AT anniegreenhoward associationbetweenurbanizationandreducedrenalfunctionfindingsfromthechinahealthandnutritionsurvey AT amandalthompson associationbetweenurbanizationandreducedrenalfunctionfindingsfromthechinahealthandnutritionsurvey AT michelleamendez associationbetweenurbanizationandreducedrenalfunctionfindingsfromthechinahealthandnutritionsurvey AT amyhherring associationbetweenurbanizationandreducedrenalfunctionfindingsfromthechinahealthandnutritionsurvey AT pennygordonlarsen associationbetweenurbanizationandreducedrenalfunctionfindingsfromthechinahealthandnutritionsurvey |