The effects of hypertension and diabetes on new-onset chronic kidney disease: A prospective cohort study.

Abstract

The study aimed to determine the different status of hypertension and diabetes on the risk of new-onset chronic kidney disease (CKD) events in Kailuan Study. A total of 21 905 individuals were enrolled in the study. The new-onset incidents of CKD, hypertension, and diabetes were collected in the follow-ups. All the individuals were divided into five groups according to baseline and follow-up hypertension and diabetes status: baseline hypertension (BH), baseline hypertension and incidence of diabetes (BHID), baseline diabetes (BD), baseline diabetes and incidence of hypertension (BDIH), and baseline hypertension and diabetes (BHD). The risk of new-onset CKD of the five groups was calculated using the Cox regression analysis. In the median follow-up of 7.05±2.59years, the prevalence of new-onset CKD in the group of BH, BHID, BD, BDIH, and BHD were 27.1, 43.79, 25.4, 36.6, and 45.1 per 1000years, respectively. When adjusted possible confounders, the hazard ratios (HRs) and 95% confidence intervals (CIs) of new-onset CKD were 1.50 (95% CI: 1.38-1.63), 1.25(95% CI: 1.07-1.47), and 1.52 (95% CI: 1.35-1.7) in the group of BHID, BDIH, and BHD, respectively, as referred to the BH group (P<.001). No obvious difference was observed in the group of BH and BD for the incidence of new-onset CKD. Sensitivityanalysis still showed the similar results among the five groups. The study showed that the effect of simple hypertension or simple diabetes on new-onset CKD was not significantly different, but the incidence of new-onset hypertension or diabetes increased the risk of new-onset CKD. Hypertension and diabetes had a synergistic influence on the risk of new-onset CKD.