Int J Health Geogr - Association of duration of residence in the southeastern United States with chronic kidney disease may differ by race: the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study.

Tópicos

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Resumo

CKGROUND: Prior evidence suggests that longer duration of residence in the southeastern United States is associated with higher prevalence of diabetes and hypertension. We postulated that a similar association would exist for chronic kidney disease (CKD).METHODS: In a national population-based cohort study that enrolled 30,239 men and women=45 years old (42% black/58% white; 56% residing in the Southeast) between 2003 and 2007, lifetime southeastern residence duration was calculated and categorized [none (0%), less than half (>0-<50%), half or more (=50-<100%), and all (100%)]. Prevalent albuminuria (single spot urinary albumin:creatinine ratio of =30 mg/g) and reduced kidney function (estimated glomerular filtration rate <60 ml/min/1.73 m2) were defined at enrollment. Incident end-stage renal disease (ESRD) during follow-up was identified through linkage to United States Renal Data System.RESULTS: White and black participants most often reported living their entire lives outside (35.7% and 27.0%, respectively) or inside (27.9% and 33.8%, respectively) the southeastern United States. The prevalence of neither albuminuria nor reduced kidney function was statistically significantly associated with southeastern residence duration, in either race. ESRD incidence was not statistically significantly associated with all vs. none southeastern residence duration (HR=0.50, 95% CI, 0.22-1.14) among whites, whereas blacks with all vs. none exposure showed increased risk of ESRD (HR=1.63, 95% CI, 1.02-2.63; PraceXduration=0.011).CONCLUSIONS: These data suggest that blacks but not whites who lived in the Southeast their entire lives were at increased risk of ESRD, but we found no clear geographic pattern for earlier-stage CKD.

Resumo Limpo

ckground prior evid suggest longer durat resid southeastern unit state associ higher preval diabet hypertens postul similar associ exist chronic kidney diseas ckdmethod nation populationbas cohort studi enrol men women year old black white resid southeast lifetim southeastern resid durat calcul categor none less half half preval albuminuria singl spot urinari albumincreatinin ratio mgg reduc kidney function estim glomerular filtrat rate mlmin m defin enrol incid endstag renal diseas esrd followup identifi linkag unit state renal data systemresult white black particip often report live entir live outsid respect insid respect southeastern unit state preval neither albuminuria reduc kidney function statist signific associ southeastern resid durat either race esrd incid statist signific associ vs none southeastern resid durat hr ci among white wherea black vs none exposur show increas risk esrd hr ci pracexdurationconclus data suggest black white live southeast entir live increas risk esrd found clear geograph pattern earlierstag ckd

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