Age-related Associations of Hypertension and Diabetes Mellitus with Chronic Kidney Disease

Tareq M Islam; Caroline S Fox; Devin Mann; Paul Muntner

Disclosures

BMC Nephrology 

In This Article

Results

Risk Factors for Stage 3–4 Chronic Kidney Disease by Age Grouping

Stage 3 or 4 CKD was progressively more common at older age with a prevalence of 1.4%, 9.9% and 38.3% among adults 20 to 49, 50 to 69 and ≥70 years of age, respectively. The age-specific prevalence of stage 3 or 4 CKD at 20 to 49, 50 to 69 and ≥70 years of age was 1.5%, 11.7%, and 39.0%, respectively, among individuals with diagnosed or undiagnosed diabetes mellitus or hypertension and 1.0%, 6.6% and 27.8%, respectively, among individuals without diabetes mellitus or hypertension.

Table S1 presents demographic characteristics and the prevalence and level of risk factors among individuals with and without stage 3 or 4 CKD stratified by age group [Additional file 1]. Within each age grouping, the difference in the prevalence of cigarette smoking was not significantly different among participants with and without CKD. Among participants 50 to 69 and ≥70 years of age but not their counterparts 20 to 49 years, obesity, hypertension, high cholesterol, and a history of cardiovascular disease were more common among those with compared to without stage 3 or 4 CKD. Within each age group, the prevalence of diagnosed diabetes mellitus was higher among participants with stage 3 or 4 CKD. Although undiagnosed diabetes mellitus was more common among adults with stage 3 or 4 CKD within each age group, this was not statistically significant after age-adjustment.

No patterns were present across age groups in the prevalence ratio of stage 3 or 4 CKD associated with gender, race-ethnicity, cigarette smoking, obesity, or high cholesterol [Additional file 2]. After adjustment for age, race-ethnicity, gender, and diagnosed diabetes mellitus, the prevalence ratio of stage 3 or 4 CKD associated with hypertension was lower at older age (p-trend = 0.038). Similarly, after adjustment for age, race-ethnicity, gender, hypertension, and diagnosed diabetes mellitus, the prevalence ratio of stage 3 or 4 CKD was lower at older age for cardiovascular disease (p-trend = 0.018). Although not statistically significant, a trend towards lower prevalence ratios of stage 3 or 4 CKD at older age were present at older age for diagnosed (p-trend = 0.067) and undiagnosed diabetes mellitus (p-trend = 0.369).

Risk Factors for Albuminuria by Age Grouping

Similar to stage 3 or 4 CKD, albuminuria was more common at older age (5.8%, 11.4% and 22.7% among adults 20 to 49, 50 to 69 and ≥70 years of age, respectively). Among individuals 20 to 49, 50 to 69 and ≥70 years of age, the prevalence of albuminuria was 14.0%, 14.9%, and 26.3%, respectively, among individuals with hypertension or diagnosed or undiagnosed diabetes mellitus and 3.7%, 6.9% and 14.0%, respectively, for those without diagnosed or undiagnosed diabetes mellitus or hypertension.

Although not statistically significant for all age groups, cigarette smoking and a history of cardiovascular disease were more common among participants with albuminuria within each age grouping [Additional file 3]. In contrast, among adults = 70 years of age, high cholesterol was less common among those with albuminuria. Among all age groups, the prevalence of obesity, hypertension, and diagnosed and undiagnosed diabetes mellitus was higher among those with, compared to without, albuminuria.

Although no patterns in the prevalence ratio of albuminuria associated with black race-ethnicity, cigarette smoking, and cardiovascular disease were present across age group, progressively weaker associations of albuminuria with female gender, obesity, and high cholesterol at older age groups were present [Additional file 4]. After adjustment for age, race-ethnicity, gender, and diagnosed diabetes mellitus, the prevalence ratio of albuminuria associated with hypertension was progressively lower in the older age groupings (p = 0.019). Similar patterns of lower prevalence ratios of albuminuria at older age groupings were present for diagnosed and undiagnosed diabetes mellitus (p < 0.001 and p = 0.003, respectively).

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