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Objective To investigate the effects of hypertension, diabetes and the joint action of the two on the new chronic kidney disease (CKD). Methods This is a prospective cohort study. A total of 101,510 on job and retired Kailuan employees who participated in 2006-2007 annual physical examinations were as the research objects. Those without baseline data, and patients with CKD, cancer and history of cardiovascular and cerebrovascular diseases were excluded, and those with no physical examination during follow-up or missing follow-up data were also excluded, then 51,156 cases were included in the final analysis and divided into 4 groups: normal blood pressure (BP) and fasting blood glucose (FBG) group, hypertension group, diabetes group and hypertension+diabetes group. Multivariate COX risk proportional regression was performed to analyze the effect of hypertension, diabetes and the joint action of the two on the new CKD. Results After an average of 7.3±2.3 years follow-up, 8,179 participants were found to have developed CKD, the incidence density of CKD was 22.19 per 1000 person-year. The incidence density of CKD in the 4 groups above was 17.39, 27.78, 31.39 and 42.58 per 1000 person-year, respectively; while in males of the 4 groups was 18.20, 28.29, 32.77 and 44.37 per 1000 person-year, and in females of the 4 groups was 15.28, 25.37, 26.99 and 36.42 per 1000 person-year. Multivariate COX risk proportional regression analysis showed that, further adjusted by age, gender, physical exercise level, income level, smoking status, drinking status, body mass index (BMI), total cholesterol (TC), low density lipoprotein (LDL-C), high-density lipoprotein (HDL-C) and using of anti-hypertensive drugs and hypoglycemic drugs, and compared with the normal BP and FBG group, the HR and 95% CI in hypertension group, diabetes group and hypertension+diabetes group showed an increased risk of CKD as 1.57(1.49-1.66), 1.67(1.45-1.92) and 2.13(1.89-2.39), respectively. It generated similar results in different gender. Conclusion Hypertension and diabetes are the independent risk factors for new-onset CKD, and the combined effect of the two may significantly increase the risk of new-onset CKD. DOI: 10.11855/j.issn.0577-7402.2018.10.14 |
