: Publication 13530

Publication 13530

Title:	Navigating the Complexities of End-Stage Renal Disease (ESRD) from Risk Factors to Outcome: Insights from the UK Biobank Cohort
Journal:	-
Published:	1 Sep 2024
DOI:	https://doi.org/10.2139/ssrn.4955291

Abstract

Background: The prevalence of end-stage renal disease (ESRD) is rising worldwide. Hyperglycaemia, hypertension, and dyslipidaemia are known risk factors. However, despite managing these risk factors optimally, ESRD cases are increasing. This study aims to explore the relationship between different cardiorenal risk factors and ESRD to address this global challenge.Methods: This cross-sectional study used data from participants recruited between 2006 and 2010 in UK Biobank. Seven multivariable logistic regression models were fitted to analyse the risk factors for ESRD. Results are presented as adjusted odds ratio (aOR) and 95% confidence intervals (95% CI).Findings: Among 502,408 study participants, 1191 (0.2%) were diagnosed with ESRD. Individuals diagnosed with diabetes before 40 had more than twice, and those with hypertension had 73% higher odds of ESRD, compared to those who were diagnosed between 40 and 60 years [aOR 2.26 (1.57 - 3.24)], and [aOR 1.73 (1.21 - 2.44)], respectively. In contrast to those without any cardiovascular disease (CVD), those with stroke, hypertension, myocardial infarction, and angina had higher odds of ESRD [aOR 5.97 (3.99 - 8.72), 5.35 (4.38 - 6.56), 4.94 (3.56 - 6.78), and 4.89 (3.47 - 6.81)], respectively. Each additional year of diabetes duration increased ESRD odds by 2% [aOR 1.02 (1.01 - 1.03)]. Non-white ethnicity was linked to a 70% higher ESRD risk compared to white ethnicity [aOR 1.70 (1.23 -2.31)], and individuals with diabetes had a 62% higher ESRD odds compared to those without [aOR 1.62 (1.36 - 1.93)]. The most socioeconomically deprived quintile had 83% higher ESRD risk [aOR 1.83 (1.48 - 2.26)] than the least deprived. Elevated HbA1c levels were also associated with higher ESRD risk [aOR 1.03 (1.02 - 1.03)], while each unit increase in high-density lipoprotein (HDL) decreased ESRD risk by 55% [aOR 0.45 (0.35 - 0.57)]. Proteinuria increased the ESRD odds 11-fold compared to microalbuminuria [aOR 11.0 (9.25 - 13.07), while normoalbuminuria reduced the odds by 76% [aOR 0.24 (0.20 - 0.28)].Interpretation: Early onset of diabetes and hypertension is linked to higher odds of ESRD. Male gender, non-white ethnicity, higher HbA1c levels and prolonged hyperglycaemia are independently associated with ESRD. Microalbuminuria serves as a reliable early indicator of ESRD risk.Funding: This project received no external funding.Declaration of Interest: The NIHR funds lead author DK. He worked as a specialist adviser for the Quality Standard Advisory Committee (QSAC) of the National Institute for Health and Care Excellence (NICE). SdeL is the Director of RCGP, RSC and is the lead at the Clinical Informatics and Health Outcomes Research Group at the University of Oxford. He has received research funding through his University from AstraZeneca, GSK, Eli Lily, Moderna, MSD, Sanofi, Seqirus, and Takeda. He also served as an advisory board member for AstraZeneca, GSK, Sanofi, Seqirus, and Pfizer. Other authors declare no conflict of interest.Ethical Approval: This research was conducted using the UK Biobank resource under application No 61894. The UK Biobank received ethical approval from the National Information Governance Board for Health and Social Care (NIGB) and the Northwest Multicentre Research Ethics Committee. There was no formal involvement of the public and patients in this study.</p>

Application ID	Title
61894	Predictors of incident albuminuria in people with newly diagnosed Type 2 diabetes mellitus and prediabetes depending on smoking status and cardiometabolic profile.

Application ID

Title

61894

Predictors of incident albuminuria in people with newly diagnosed Type 2 diabetes mellitus and prediabetes depending on smoking status and cardiometabolic profile.

Abstract

18 Authors

1 Application