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Renal functional impairment in the elderly, the importance of fasting plasma glucose: the Northern Shanghai Study

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Abstract

Background

Chronic kidney disease is a global health problem that is closely related to the aging population. Although plasma glucose levels have been shown to be related to renal dysfunction, risk factors for renal functional impairment in the geriatric population are unknown. The authors therefore aimed to investigate the determinants of renal functional impairment in an elderly population.

Methods

From June 2014 to August 2015, 912 participants (aged > 65 years) were recruited. Renal function was assessed at baseline; follow-up was conducted in 2016. Within the framework of comprehensive cardiovascular examinations, all conventional cardiovascular risk factors, fasting plasma glucose (FPG), and renal function were assessed. Renal function was evaluated by the estimated glomerular filtration rate (e-GFR) using a modified Modification of Diet in Renal Disease formula. Rapid decline in e-GFR was defined as an e-GFR slope > 5 mL/min per 1.73 m2 per year.

Results

We observed that FPG levels were significantly higher in participants with (6.15 ± 2.76 mmol/L) than in those without (5.56 ± 1.61 mmol/L) a rapid decline in e-GFR (p = 0.02). The average decline in e-GFR was 0.149 mL/min/1.73m2 per year in this elderly population, and the increasing risk of having rapid decline in e-GFR was 0.44-fold each year. In the full adjustment model, decline in e-GFR (p = 0.02) and rapid decline in e-GFR (OR1.33, 95% CI 1.03–1.72) were significantly associated with FPG, independent of other conventional cardiovascular risk factors. Using the same models, decline in e-GFR (p = 0.04) and rapid decline in e-GFR (OR 1.57, 95% CI 1.05–2.35) were also significantly associated with FPG in diabetic population, but they were not in non-diabetic population.

Conclusions

In community-dwelling elderly Chinese, the average decline in e-GFR was 0.149 mL/min/1.73m2 per year. FPG control is important for delaying renal functional impairment in elderly population.

Trial registration NSS, NCT02368938

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Funding

This study was authorized and financially supported by the Shanghai Municipal Government (15GWZK1002) and the National Key Technology R&D Program during the Thirteenth Five-year Plan Period (2017YFC0111800). Dr. Yi Zhang was supported by the National Nature Science Foundation of China (81670377) and the Shanghai Excellent Young Scholars Program (2017YQ065).

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Author notes

  1. Ximin Fan and Jiadela Teliewubai contributed equally to this work.

Authors and Affiliations

  1. Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, 301 Yanchang Middle Road, Shanghai, 200072, China

    Ximin Fan, Jiadela Teliewubai, Jing Xiong, Chen Chi, Yuyan Lu, Mengyun Zhu, Yi Zhang & Yawei Xu

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  1. Ximin Fan
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  2. Jiadela Teliewubai
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  7. Yi Zhang
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  8. Yawei Xu
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Contributions

XF and JT have contributed equally to this work. XF wrote the manuscript. JT designed the study. CC provided purely technical help. JX and MZ collated data. YL revised the manuscript. YX and YZ acquired the funding.

Corresponding authors

Correspondence to Yi Zhang or Yawei Xu.

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Conflict of interest

The authors declared they do not have anything to disclose regarding conflict of interest with respect to this manuscript.

Ethical approval

This study acquired approval of the Ethics Committee of Shanghai Tenth People’s Hospital. All procedures were performed in accordance with ethical standards. The registration ID on Clinical Trial is NCT02368938 (ClinicalTrials.gov).

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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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Fan, X., Teliewubai, J., Xiong, J. et al. Renal functional impairment in the elderly, the importance of fasting plasma glucose: the Northern Shanghai Study. Aging Clin Exp Res 33, 353–360 (2021). https://doi.org/10.1007/s40520-020-01527-x

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