Living in the Southeastern ‘stroke belt’ of the US can be a risk factor for CKD
Click Here to Manage Email Alerts
Among other risk factors, researchers identified living in the Southeastern “stroke belt” of the U.S. as an independent risk factor for chronic kidney disease, according to data published in the American Journal of Kidney Diseases.
Further, albuminuria showed a greater association with CKD in Black individuals compared with white individuals.
“Prior studies examined risk factors for incident CKD and/or longitudinal eGFR decline in large, population-based cohorts in the U.S.,” Katharine L. Cheung, MD, PhD, a nephrologist at the University of Vermont, and colleagues wrote. “However, few studies had substantial representation of Black individuals, and none had geographic diversity, limiting their ability to examine the extent to which standard CKD risk factors may differ by race, the degree to which race/ethnic differences in CKD incidence are explained by traditional CKD risk factors or the degree to which the risk of incident CKD differs by geographic region.”
In an observational cohort study, researchers examined 4,198 Black and 7,799 white participants at least 45 years old who were recruited between 2003 and 2007 to determine if risk factors differ by race, sex or region in the U.S. Participants recorded a baseline eGFR greater than 60 mL/min/1.73 m2.
Researchers followed patients and measured eGFR again around 9 years after enrollment. With eGFR change considered the primary outcome of the study, researchers assessed age, sex, race, region, education, income, systolic blood pressure, BMI, diabetes, coronary heart disease, hyperlipidemia, smoking and albuminuria as exposures.
Using linear regression and modified Poisson regression, researchers identified the relationship between risk factors and the primary outcomes stratified by race, sex and region.
Overall, 9% of participants developed CKD. Analyses revealed Southeastern stroke belt residence, which included living in Alabama, Arkansas,
Georgia, Louisiana, Mississippi, North Carolina, South Carolina and Tennessee, independently correlated with eGFR change and incident CKD. Further, Black patients were more likely to have albuminuria associated with eGFR change than white patients.
Researchers suggested that living in the Southeast stroke belt may expose patients to different environmental conditions, such as heat, air pollution or water quality.
“In summary, in this large cohort study of Black and white adults, traditional CKD risk factors accounted for the higher risk of incident CKD and eGFR decline in Black as compared to white adults, supporting the focus on addressing modifiable risk factors, such as diabetes, hypertension and obesity, in reducing disparities in CKD. Albuminuria was a more potent risk factor incident CKD and eGFR decline for Black participants and stroke belt residents, compared to white participants and those living outside the stroke belt,” Cheung and colleagues wrote. “In addition, residence in the U.S. stroke belt was an independent risk factor for incident CKD, an observation that will require further study to determine the key factors which underlie this finding.”
Collapse
Read more about
Click Here to Manage Email Alerts