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Prevalence of renal impairment and its association with cardiovascular risk factors in a general population: results of the Swiss SAPALDIA study

Nitsch, Dorothea ; Dietrich, Denise Felber ; von Eckardstein, Arnold ; Gaspoz, Jean-Michel ; Downs, Sara H. ; Leuenberger, Philippe ; Tschopp, Jean-Marie ; Brändli, Otto ; Keller, Roland ; Gerbase, Margaret W. ; Probst-Hensch, Nicole M. ; Stutz, Elisabeth Zemp ; Ackermann-Liebrich, Ursula

In: Nephrology Dialysis Transplantation, 2006, vol. 21, no. 4, p. 935-944

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    Title
    • Prevalence of renal impairment and its association with cardiovascular risk factors in a general population: results of the Swiss SAPALDIA study
    Author
    • Nitsch, Dorothea. 1Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK, 2Institute of Social and Preventive Medicine, University of Basel, 3Institute of Clinical Chemistry, University Hospital Zurich, 4Division of General Internal Medicine and Cardiology Division, University Hospitals, Geneva, 5Service of Pulmonology, University Hospital of Lausanne, CHUV, 6Centre Valaisan de Pneumonology, Montana, 7Zuercher Hoehenklinik, Wald, 8Hirslanden Hospital, Aarau, 9Pulmonology Service, University Hospitals, Geneva and 10Molecular Epidemiology/Cancer Registry, Institute of Social and Preventive Medicine/Department of Pathology, University of Zurich, Switzerland
    • Dietrich, Denise Felber. 1Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK, 2Institute of Social and Preventive Medicine, University of Basel, 3Institute of Clinical Chemistry, University Hospital Zurich, 4Division of General Internal Medicine and Cardiology Division, University Hospitals, Geneva, 5Service of Pulmonology, University Hospital of Lausanne, CHUV, 6Centre Valaisan de Pneumonology, Montana, 7Zuercher Hoehenklinik, Wald, 8Hirslanden Hospital, Aarau, 9Pulmonology Service, University Hospitals, Geneva and 10Molecular Epidemiology/Cancer Registry, Institute of Social and Preventive Medicine/Department of Pathology, University of Zurich, Switzerland
    • von Eckardstein, Arnold. 1Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK, 2Institute of Social and Preventive Medicine, University of Basel, 3Institute of Clinical Chemistry, University Hospital Zurich, 4Division of General Internal Medicine and Cardiology Division, University Hospitals, Geneva, 5Service of Pulmonology, University Hospital of Lausanne, CHUV, 6Centre Valaisan de Pneumonology, Montana, 7Zuercher Hoehenklinik, Wald, 8Hirslanden Hospital, Aarau, 9Pulmonology Service, University Hospitals, Geneva and 10Molecular Epidemiology/Cancer Registry, Institute of Social and Preventive Medicine/Department of Pathology, University of Zurich, Switzerland
    • Gaspoz, Jean-Michel. 1Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK, 2Institute of Social and Preventive Medicine, University of Basel, 3Institute of Clinical Chemistry, University Hospital Zurich, 4Division of General Internal Medicine and Cardiology Division, University Hospitals, Geneva, 5Service of Pulmonology, University Hospital of Lausanne, CHUV, 6Centre Valaisan de Pneumonology, Montana, 7Zuercher Hoehenklinik, Wald, 8Hirslanden Hospital, Aarau, 9Pulmonology Service, University Hospitals, Geneva and 10Molecular Epidemiology/Cancer Registry, Institute of Social and Preventive Medicine/Department of Pathology, University of Zurich, Switzerland
    • Downs, Sara H.. 1Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK, 2Institute of Social and Preventive Medicine, University of Basel, 3Institute of Clinical Chemistry, University Hospital Zurich, 4Division of General Internal Medicine and Cardiology Division, University Hospitals, Geneva, 5Service of Pulmonology, University Hospital of Lausanne, CHUV, 6Centre Valaisan de Pneumonology, Montana, 7Zuercher Hoehenklinik, Wald, 8Hirslanden Hospital, Aarau, 9Pulmonology Service, University Hospitals, Geneva and 10Molecular Epidemiology/Cancer Registry, Institute of Social and Preventive Medicine/Department of Pathology, University of Zurich, Switzerland
    • Leuenberger, Philippe. 1Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK, 2Institute of Social and Preventive Medicine, University of Basel, 3Institute of Clinical Chemistry, University Hospital Zurich, 4Division of General Internal Medicine and Cardiology Division, University Hospitals, Geneva, 5Service of Pulmonology, University Hospital of Lausanne, CHUV, 6Centre Valaisan de Pneumonology, Montana, 7Zuercher Hoehenklinik, Wald, 8Hirslanden Hospital, Aarau, 9Pulmonology Service, University Hospitals, Geneva and 10Molecular Epidemiology/Cancer Registry, Institute of Social and Preventive Medicine/Department of Pathology, University of Zurich, Switzerland
    • Tschopp, Jean-Marie. 1Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK, 2Institute of Social and Preventive Medicine, University of Basel, 3Institute of Clinical Chemistry, University Hospital Zurich, 4Division of General Internal Medicine and Cardiology Division, University Hospitals, Geneva, 5Service of Pulmonology, University Hospital of Lausanne, CHUV, 6Centre Valaisan de Pneumonology, Montana, 7Zuercher Hoehenklinik, Wald, 8Hirslanden Hospital, Aarau, 9Pulmonology Service, University Hospitals, Geneva and 10Molecular Epidemiology/Cancer Registry, Institute of Social and Preventive Medicine/Department of Pathology, University of Zurich, Switzerland
    • Brändli, Otto. 1Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK, 2Institute of Social and Preventive Medicine, University of Basel, 3Institute of Clinical Chemistry, University Hospital Zurich, 4Division of General Internal Medicine and Cardiology Division, University Hospitals, Geneva, 5Service of Pulmonology, University Hospital of Lausanne, CHUV, 6Centre Valaisan de Pneumonology, Montana, 7Zuercher Hoehenklinik, Wald, 8Hirslanden Hospital, Aarau, 9Pulmonology Service, University Hospitals, Geneva and 10Molecular Epidemiology/Cancer Registry, Institute of Social and Preventive Medicine/Department of Pathology, University of Zurich, Switzerland
    • Keller, Roland. 1Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK, 2Institute of Social and Preventive Medicine, University of Basel, 3Institute of Clinical Chemistry, University Hospital Zurich, 4Division of General Internal Medicine and Cardiology Division, University Hospitals, Geneva, 5Service of Pulmonology, University Hospital of Lausanne, CHUV, 6Centre Valaisan de Pneumonology, Montana, 7Zuercher Hoehenklinik, Wald, 8Hirslanden Hospital, Aarau, 9Pulmonology Service, University Hospitals, Geneva and 10Molecular Epidemiology/Cancer Registry, Institute of Social and Preventive Medicine/Department of Pathology, University of Zurich, Switzerland
    • Gerbase, Margaret W.. 1Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK, 2Institute of Social and Preventive Medicine, University of Basel, 3Institute of Clinical Chemistry, University Hospital Zurich, 4Division of General Internal Medicine and Cardiology Division, University Hospitals, Geneva, 5Service of Pulmonology, University Hospital of Lausanne, CHUV, 6Centre Valaisan de Pneumonology, Montana, 7Zuercher Hoehenklinik, Wald, 8Hirslanden Hospital, Aarau, 9Pulmonology Service, University Hospitals, Geneva and 10Molecular Epidemiology/Cancer Registry, Institute of Social and Preventive Medicine/Department of Pathology, University of Zurich, Switzerland
    • Probst-Hensch, Nicole M.. 1Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK, 2Institute of Social and Preventive Medicine, University of Basel, 3Institute of Clinical Chemistry, University Hospital Zurich, 4Division of General Internal Medicine and Cardiology Division, University Hospitals, Geneva, 5Service of Pulmonology, University Hospital of Lausanne, CHUV, 6Centre Valaisan de Pneumonology, Montana, 7Zuercher Hoehenklinik, Wald, 8Hirslanden Hospital, Aarau, 9Pulmonology Service, University Hospitals, Geneva and 10Molecular Epidemiology/Cancer Registry, Institute of Social and Preventive Medicine/Department of Pathology, University of Zurich, Switzerland
    • Stutz, Elisabeth Zemp. 1Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK, 2Institute of Social and Preventive Medicine, University of Basel, 3Institute of Clinical Chemistry, University Hospital Zurich, 4Division of General Internal Medicine and Cardiology Division, University Hospitals, Geneva, 5Service of Pulmonology, University Hospital of Lausanne, CHUV, 6Centre Valaisan de Pneumonology, Montana, 7Zuercher Hoehenklinik, Wald, 8Hirslanden Hospital, Aarau, 9Pulmonology Service, University Hospitals, Geneva and 10Molecular Epidemiology/Cancer Registry, Institute of Social and Preventive Medicine/Department of Pathology, University of Zurich, Switzerland
    • Ackermann-Liebrich, Ursula. 1Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK, 2Institute of Social and Preventive Medicine, University of Basel, 3Institute of Clinical Chemistry, University Hospital Zurich, 4Division of General Internal Medicine and Cardiology Division, University Hospitals, Geneva, 5Service of Pulmonology, University Hospital of Lausanne, CHUV, 6Centre Valaisan de Pneumonology, Montana, 7Zuercher Hoehenklinik, Wald, 8Hirslanden Hospital, Aarau, 9Pulmonology Service, University Hospitals, Geneva and 10Molecular Epidemiology/Cancer Registry, Institute of Social and Preventive Medicine/Department of Pathology, University of Zurich, Switzerland
    Document Type
    • Postprint
    Language
    • English
    Published in
    • Nephrology Dialysis Transplantation, 2006, vol. 21, no. 4, p. 935-944. Oxford University Press
    Other Version
    OAI-PMH Identifier
    • oai:doc.rero.ch:294064
    Summary
    Background. Impaired renal function is evolving as an independent marker of the risk of cardiovascular morbidity and mortality. Little is known about the prevalence of impaired renal function and its relationship to cardiovascular risk factors in the Swiss general population. Methods. SAPALDIA comprises a random sample of the Swiss population established in 1991, originally to investigate the health effects of long-term exposure to air pollution. Participants were reassessed in 2002/3 and blood measurements were obtained (n = 6317). Renal function was estimated using the Cockcroft-Gault equation and the modified MDRD (four-component) equation incorporating age, race, gender and serum creatinine level. Results. The estimated prevalence of impaired renal function [estimated glomerular filtration rate <60 ml/min/1.73 m2] differed substantially between men and women, particularly at higher ages, and amounted to 13% [95% confidence interval (CI) 10-16%] and 36% (95% CI 32-40%) in men and women, respectively, of 65 years or older. Smoking, obesity, blood lipid levels, high systolic blood pressure and hyperuricaemia were all more common in men when compared with women. These cardiovascular risk factors were also associated independently with creatinine in both women and men. Women were less likely to receive cardiovascular drugs, in particular angiotensin-converting enzyme inhibitors and β-blockers, when compared with men of the same age. Conclusion. Moderate renal impairment seems to be prevalent in the general population, with an apparent excess in females which is not explained by conventional cardiovascular risk factors. The unexpected finding questions the validity of the prediction equations, in particular in females