Trends in renal function in Northern Sweden 1986–2014: data from the seven cross-sectional surveys within the Northern Sweden MONICA study

• Published in: BMJ Open
• Main Authors: de Man Lapidoth, Julia, Hultdin, Johan, Jonsson, P Andreas, Eriksson Svensson, Maria, Wennberg, Maria, Zeller, Tanja, Söderberg, Stefan
• Other Authors: Umeå Universitet, the European Union Seventh Framework Programme, Västerbotten Läns Landsting, Norrbottens Läns Landsting
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMJ 2023
• Subjects: General Medicine; Northern Sweden
• Online Access: http://dx.doi.org/10.1136/bmjopen-2023-072664; https://syndication.highwire.org/content/doi/10.1136/bmjopen-2023-072664

Objective The prevalence of chronic kidney disease (CKD) is increasing globally, and CKD is closely related to cardiovascular disease (CVD). CKD and CVD share several risk factors (RF), such as diabetes, hypertension, obesity and smoking, and the prevalence of these RF has changed during the last decades, and we aimed to study the effect on renal function over time. Design Repeated cross-sectional population-based studies. Setting The two Northern counties (Norr- and Västerbotten) in Sweden. Participants Within the MONitoring Trends and Determinants of CArdiovascular Disease (MONICA) study, seven surveys were performed between 1986 and 2014, including participants aged 25–64 years (n=10 185). Interventions None. Measures Information on anthropometry, blood pressure and cardiovascular risk factors was collected. Creatinine and cystatin C were analysed in stored blood samples and the estimated glomerular filtration rate (eGFR) calculated using the creatinine-based Lund–Malmö revised and Chronic Kidney Disease Epidemiology Collaboration (eGFR crea ) equations as well as the cystatin C-based Caucasian, Asian, Paediatric and Adult cohort (CAPA) equation (eGFR cysC ). Renal function over time was analysed using univariable and multivariable linear regression models. Results Renal function, both eGFR crea and eGFR cysC , decreased over time (both p<0.001) and differed between counties and sexes. In a multivariable analysis, study year remained inversely associated with both eGFR crea and eGFR cysC (both p<0.001) after adjustment for classical cardiovascular RF. Conclusion Renal function has deteriorated in Northern Sweden between 1986 and 2014.