Higher prevalence of unrecognized kidney disease at high altitude
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High altitude renal syndrome has been described in populations with excessive erythrocytosis. We evaluated whether high altitude (HA) dwellers might be at increased risk for kidney disease.
We performed a cross-sectional study to investigate differences in prevalence of kidney function and metabolic syndrome in healthy subjects living at HA vs. sea level (SL) without any known history of hypertension, diabetes or chronic kidney disease.
We examined 293 subjects, aged 40 to 60 years: 125 SL (154 m) and 168 HA (3640 m) dwellers. HA dwellers had higher serum creatinine, lower estimated glomerular function rate (eGFR) (69.5 ± 15.2 vs. 102.1 ± 17.8 ml/min/1.73 m2, p < 0.0001), more proteinuria and higher hemoglobin concentrations compared to SL subjects. HA subjects had a lower prevalence of metabolic syndrome. Hemoglobin concentrations correlated inversely with eGFR in female (p = 0.001) and male (p = 0.03) HA dwellers. Using logistic regression analysis to compare subjects with eGFR < 90 vs. > 90 ml/min/1.73 m2, a lower eGFR was associated with female gender (odds ratio adjusted: 5.65 [95% confidence interval: 2.43–13.13]; p = 0.001), high altitude (14.78 [6.46–33.79]; p = 0.001), hemoglobin (1.68 [1.16–2.43]; p = 0.001) and uric acid (1.93 [1.36–2.72]; p = 0.001).
Dwellers at high altitude who are considered healthy have worse kidney function, a higher prevalence of proteinuria and a lower prevalence of metabolic syndrome compared to people living at SL.
KeywordsCardiovascular risk High altitude Kidney function Proteinuria
We thank to Ronald Guillen MD, Marco Antonio Pariente MD, Claudia Ferrer MD Griselda Calisaya from Instituto de Nefrología, La Paz-Bolivia. Raquel Cancino MD, Luis Gonzales MD, Enrique Hernandez MD, Ivan Seminario MD, Jose Luis León MD from Hospital Nacional Arzobispo Loayza, Lima-Peru for their contribution for this work. This study was partially supported by a Grant no. 03-018 from the “International Society of Nephrology (ISN) Global Outreach Research and Prevention Committee”.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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