Long-term predictive models of risk factors for early chronic kidney disease: a longitudinal study
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Wen-Chih Wu1,2, Po-Chien Hsieh1, Fu-Kang Hu3, Jen-Chun Kuan4,5, Chi-Ming Chu1, Chien-An Sun6,7, Tsan Yang8, Sui-Lung Su1 and Yu-Ching Chou1
1School of Public Health, National Defense Medical Center, Taipei, Taiwan
2Department of Surgery, Suao and Yuanshan branches of Taipei Veterans General Hospital, Yilan, Taiwan
3Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
4Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
5Department of Biostatistics, Firma Clinical Research, Hunt Valley, MD, USA
6Department of Public Health, College of Medicine, Fu-Jen Catholic University, New Taipei, Taiwan
7Big Data Research Center, College of Medicine, Fu-Jen Catholic University, New Taipei, Taiwan
8Department of Health Business Administration, Meiho University, Pingtung, Taiwan
Yu-Ching Chou, email: [email protected]
Keywords: predictor; chronic kidney disease (CKD); aircrew; early detection; longitudinal study
Received: August 02, 2017 Accepted: February 27, 2018 Published: April 13, 2018
Background: The high incidence and prevalence of chronic kidney disease (CKD) in Taiwan have produced tremendous burdens on health care resources. The work environment of air force special operations personnel engenders high psychological stress, and the resulting increased blood pressure can lead to glomerular hypertension and accelerated glomerular injury in the long term. The aim of the study was to establish the predictive models to define the predictors of CKD.
Results: The results indicated that the prevalence of CKD over 4 consecutive years was 3.8%, 9.4%, 9.0%, and 9.4%. The capability of using occult blood in urine to predict the risk of CKD after 1, 2, and 3 years was statistically significant. The age-adjusted odds ratio (OR) and 95% confidence interval (CI) were 7.94 (95% CI: 2.61–24.14), 12.35 (95% CI: 4.02–37.94) and 4.25 (95% CI: 1.32–13.70), respectively.
Discussion: The predictive power of occult blood in urine for the risk of CKD in each model was statistically significant. Future investigations can explore the feasibility of implementing simple and accurate urine dipsticks for preliminary testing besides annual aircrew physical examinations to facilitate early detection and treatment.
Methods: This study was a longitudinal study, in which air force special operations personnel who received physical examinations at military hospitals between 2004 and 2010 were selected. CKD was determined based on the definition provided by the US National Kidney Foundation. Overall, 212 participants that could be followed continuously for 4 years were analyzed.
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