Predictors of new-onset decline in kidney function in a general middle-european population

Background. Limited epidemiological data are available on predictors of new-onset kidney disease. Methods. In this longitudinal cohort study, 17 375 apparently healthy volunteers of the general Viennese population (46.4% women, age range 20–84 years, men 20–89 years) performed a baseline examination at some time within the study period (1990–2005) and completed a median of two follow-up examinations [interquartile range (IQR) 1 to 4]; the median follow-up period was 7 years (IQR 4 to 11). The outcome of interest was the development of kidney disease, defined as a decrease of the glomerular filtration rate (GFR) <60 ml/min/1.73 m 2 at the follow-up examinations [calculated by the abbreviated modification of diet in renal disease (MDRD) equation]. Logistic generalized estimating equations were used to analyse the relationship between the covariates and the outcome variable. Results. The following parameters [odds ratios (OR) with 95% confidence intervals] predicted new-onset kidney disease: Age (increase by 5 years), OR = 1.36 (1.34–1.40); NationalKidneyFoundation-chronickidneydisease(NKFCKD)stage1withproteinuria(+),OR =1.39(1.10–1.75); NKF-CKD stage 1 with proteinuria (≥++), OR = 2.07 (1.11–3.87);NKF-CKDstage2withproteinuria(+),OR = 2.71 (2.10–3.51); NKF-CKD stage 2 with proteinuria (≥++), OR = 3.80 (2.29–6.31); body mass index, OR = 1.04 (1.02–1.06); current-smoker, OR = 1.20 (1.01– 1.43); performing no sports, OR = 1.57 (1.27–1.95); uric acid (increase by 2 mg/dl), OR = 1.69 (1.59–1.80); HDLcholesterol(decreaseby10mg/dl),OR =1.12(1.07–1.17); hypertension stage 1, OR = 1.35 (1.08–1.67); hypertension