The Effect of Health-Related Behaviors on Disease Progression and Mortality in Early Stages of Chronic Kidney Disease: A Korean Nationwide Population-Based Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Source
2.2. Study Cohort for Early Stages of CKD
2.3. Health-Related Behaviors
2.4. ESRD and Mortality
2.5. Covariate Data
2.6. Statistical Analysis
3. Results
3.1. Baseline Characteristics
3.2. Health-Related Behaviors and Risk of ESRD and Death
3.2.1. Physical Activity
3.2.2. Smoking
3.2.3. Alcohol Consumption
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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n | Total | Death | ESRD | ||||
---|---|---|---|---|---|---|---|
No | Yes | p Value | No | Yes | p Value | ||
83,470 | 81,664 | 1,806 | 83,237 | 233 | |||
Age, years, mean ± SD | 48.43 ± 13.34 | 48.09 ± 13.16 | 64.05 ± 12.02 | <0.001 | 48.41 ± 13.33 | 57.24 ± 12.97 | <0.001 |
Male, n, (%) | 45,108(54.04) | 43,835(53.68) | 1,273(70.49) | <0.001 | 44,935(53.98) | 173(74.25) | <0.001 |
Urban residence, n, (%) | 37,732(45.2) | 37,064(45.39) | 668(36.99) | <0.001 | 37,652(45.23) | 80(34.33) | <0.001 |
Low Income, n, (%) | 12,956(15.52) | 12,562(15.38) | 394(21.82) | <0.001 | 12,893(15.49) | 63(27.04) | <0.001 |
Diabetes Mellitus, n, (%) | 13,047(15.63) | 12,383(15.16) | 664(36.77) | <0.001 | 12,931(15.54) | 116(49.79) | <0.001 |
Hypertension, n, (%) | 27,346(32.76) | 26,275(32.17) | 1,071(59.3) | <0.001 | 27,188(32.66) | 158(67.81) | <0.001 |
Dyslipidemia, n, (%) | 21,377(25.61) | 20,801(25.47) | 576(31.89) | <0.001 | 21,275(25.56) | 102(43.78) | <0.001 |
History of CVD, n, (%) | 1,326(1.59) | 1,198(1.47) | 128(7.09) | <0.001 | 1,312(1.58) | 14(6.01) | <0.001 |
CCI, n, (%) | <0.001 | <0.001 | |||||
0 | 42,039(50.36) | 41,654(51.01) | 385(21.32) | 41,994(50.45) | 45(19.31) | ||
1 | 20,782(24.9) | 20,452(25.04) | 330(18.27) | 20,751(24.93) | 31(13.3) | ||
2 or more | 20,649(24.74) | 19,558(23.95) | 1,091(60.41) | 20,492(24.62) | 157(67.38) | ||
Sufficient physical activity, n, (%) | 16,854(20.19) | 16,550(20.27) | 304(16.83) | <0.001 | 16,810(20.2) | 44(18.88) | 0.619 |
Smoking, n, (%) | <0.001 | <0.001 | |||||
No | 49,476(59.27) | 48,590(59.5) | 886(49.06) | 49,367(59.31) | 109(46.78) | ||
Ex | 13,451(16.11) | 13,086(16.02) | 365(20.21) | 13,405(16.1) | 46(19.74) | ||
Current | 20,543(24.61) | 19,988(24.48) | 555(30.73) | 20,465(24.59) | 78(33.48) | ||
Alcohol consumption, n, (%) | <0.001 | 0.007 | |||||
No | 41,602(49.84) | 40,533(49.63) | 1,069(59.19) | 41,466(49.82) | 136(58.37) | ||
Mild | 34,622(41.48) | 34,102(41.76) | 520(28.79) | 34,549(41.51) | 73(31.33) | ||
Heavy | 7,246(8.68) | 7,029(8.61) | 217(12.02) | 7,222(8.68) | 24(10.3) | ||
eGFR, ml/min/1.73 m2, n, (%) | <0.001 | <0.001 | |||||
30–59 | 16,365(19.61) | 15,760(19.3) | 605(33.5) | 16,269(19.55) | 96(41.2) | ||
60–89 | 25,042(30) | 24,508(30.01) | 534(29.57) | 24,963(29.99) | 79(33.91) | ||
90- | 42,063(50.39) | 41,396(50.69) | 667(36.93) | 42,005(50.46) | 58(24.89) | ||
Urine Dipstick, n, (%) | <0.001 | <0.001 | |||||
Negative | 15,344(18.38) | 14,820(18.15) | 524(29.01) | 15,284(18.36) | 60(25.75) | ||
Trace | 39,384(47.18) | 38,822(47.54) | 562(31.12) | 39,341(47.26) | 43(18.45) | ||
1+ or more | 28,742(34.43) | 28,022(34.31) | 720(39.87) | 28,612(34.37) | 130(55.79) | ||
Fasting Glucose, n, (%) | <0.001 | <0.001 | |||||
<90 | 27,850(33.37) | 27,508(33.68) | 342(18.94) | 27,798(33.4) | 52(22.32) | ||
90–130 | 46,947(56.24) | 45,909(56.22) | 1,038(57.48) | 46,837(56.27) | 110(47.21) | ||
>130 | 8,673(10.39) | 8,247(10.1) | 426(23.59) | 8,602(10.33) | 71(30.47) | ||
LDL, mg/dL, n, (%) | <0.001 | 0.059 | |||||
<70 | 7,924(9.49) | 7,596(9.3) | 328(18.16) | 7,894(9.48) | 30(12.88) | ||
70–100 | 22,478(26.93) | 21,992(26.93) | 486(26.91) | 22,407(26.92) | 71(30.47) | ||
>100 | 53068(63.58) | 52076(63.77) | 992(54.93) | 52,936(63.6) | 132(56.65) | ||
BMI, n, (%) | <0.001 | 0.631 | |||||
<20 | 10,247(12.28) | 9,960(12.2) | 287(15.89) | 10,223(12.28) | 24(10.3) | ||
20–25 | 43,758(52.42) | 42,774(52.38) | 984(54.49) | 43,635(52.42) | 123(52.79) | ||
>25 | 29,465(35.3) | 28,930(35.43) | 535(29.62) | 27,379(35.3) | 86(36.91) | ||
BP > 130/80 mmHg, n, (%) | 44,645(53.49) | 43,452(53.21) | 1,193(66.06) | <0.001 | 44,481(53.44) | 164(70.39) | <0.001 |
N | ESRD | Follow-up Duration (Person × Year) | Crude HR (95%CI) | Adjusted HR (95%CI) a | Death | Follow-up Duration (Person × Year) | Crude HR (95%CI) | Adjusted HR (95%CI) a | |
---|---|---|---|---|---|---|---|---|---|
Smoking | |||||||||
Non, Ex | 62,927 | 155 | 336,424.23 | 1(ref.) | 1(ref.) | 1,251 | 336,675.06 | 1(ref.) | 1(ref.) |
Current | 20,543 | 78 | 108,623.67 | 1.41 (1.04,1.90) | 1.44 (1.06,1.95) | 555 | 108,733.86 | 1.7 (1.52,1.90) | 1.61 (1.44,1.80) |
p-value | 0.03 | 0.02 | <0.001 | <0.001 | |||||
Alcohol | |||||||||
Non | 41,602 | 136 | 222,490.34 | 1(ref.) | 1(ref.) | 1,069 | 222,719.88 | 1(ref.) | 1(ref.) |
<30 g/day or >30 g/day | 41,868 | 97 | 222,557.55 | 0.60 (0.45,0.80) | 0.59 (0.44,0.79) | 737 | 222,689.04 | 0.87 (0.79,0.97) | 0.83 (0.74,0.93) |
p-value | <0.001 | <0.001 | 0.01 | <0.001 | |||||
Physical Activity | |||||||||
Insufficient | 66,616 | 189 | 354,888.68 | 1(ref.) | 1(ref.) | 1,502 | 355,182.57 | 1(ref.) | 1(ref.) |
Sufficient | 16,854 | 44 | 90,159.22 | 0.79 (0.57,1.1) | 0.84 (0.60,1.17) | 304 | 90,226.35 | 0.69 (0.61,0.78) | 0.73 (0.64,0.83) |
p-value | 0.16 | 0.30 | <0.001 | <0.001 |
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Lee, Y.; Kwon, S.; Moon, J.J.; Han, K.; Paik, N.-J.; Kim, W.-S. The Effect of Health-Related Behaviors on Disease Progression and Mortality in Early Stages of Chronic Kidney Disease: A Korean Nationwide Population-Based Study. J. Clin. Med. 2019, 8, 1100. https://doi.org/10.3390/jcm8081100
Lee Y, Kwon S, Moon JJ, Han K, Paik N-J, Kim W-S. The Effect of Health-Related Behaviors on Disease Progression and Mortality in Early Stages of Chronic Kidney Disease: A Korean Nationwide Population-Based Study. Journal of Clinical Medicine. 2019; 8(8):1100. https://doi.org/10.3390/jcm8081100
Chicago/Turabian StyleLee, Yookyung, SuYeon Kwon, Jong Joo Moon, Kyungdo Han, Nam-Jong Paik, and Won-Seok Kim. 2019. "The Effect of Health-Related Behaviors on Disease Progression and Mortality in Early Stages of Chronic Kidney Disease: A Korean Nationwide Population-Based Study" Journal of Clinical Medicine 8, no. 8: 1100. https://doi.org/10.3390/jcm8081100