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American Journal of Kidney Diseases

Obesity, Smoking, and Physical Inactivity as Risk Factors for CKD: Are Men More Vulnerable?

  • Stein Hallan
    Correspondence
    Address reprint requests to Stein Hallan, MD, PhD, Department of Medicine, Division of Nephrology, St Olav’s Hospital, Olav Kyrres gt 17, N-7000 Trondheim, Norway
    Affiliations
    Department of Medicine, Division of Nephrology, and Department of Medicine, Division of Endocrinology, St Olavs Hospital

    Departments of Cancer Research and Molecular Medicine and Community Medicine and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim

    Health Survey of Nord-Trondelag County Research Center, Faculty of Medicine, Norwegian University of Science and Technology, Verdal, Norway

    Department of Epidemiology, Leiden University Medical Centre, Leiden

    European Renal Association–European Dialysis and Transplant Association Registry, Department of Medical Informatics, Academic Medical Center–University of Amsterdam, Amsterdam, The Netherlands
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  • Renée de Mutsert
    Affiliations
    Department of Medicine, Division of Nephrology, and Department of Medicine, Division of Endocrinology, St Olavs Hospital

    Departments of Cancer Research and Molecular Medicine and Community Medicine and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim

    Health Survey of Nord-Trondelag County Research Center, Faculty of Medicine, Norwegian University of Science and Technology, Verdal, Norway

    Department of Epidemiology, Leiden University Medical Centre, Leiden

    European Renal Association–European Dialysis and Transplant Association Registry, Department of Medical Informatics, Academic Medical Center–University of Amsterdam, Amsterdam, The Netherlands
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  • Sven Carlsen
    Affiliations
    Department of Medicine, Division of Nephrology, and Department of Medicine, Division of Endocrinology, St Olavs Hospital

    Departments of Cancer Research and Molecular Medicine and Community Medicine and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim

    Health Survey of Nord-Trondelag County Research Center, Faculty of Medicine, Norwegian University of Science and Technology, Verdal, Norway

    Department of Epidemiology, Leiden University Medical Centre, Leiden

    European Renal Association–European Dialysis and Transplant Association Registry, Department of Medical Informatics, Academic Medical Center–University of Amsterdam, Amsterdam, The Netherlands
    Search for articles by this author
  • Friedo W. Dekker
    Affiliations
    Department of Medicine, Division of Nephrology, and Department of Medicine, Division of Endocrinology, St Olavs Hospital

    Departments of Cancer Research and Molecular Medicine and Community Medicine and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim

    Health Survey of Nord-Trondelag County Research Center, Faculty of Medicine, Norwegian University of Science and Technology, Verdal, Norway

    Department of Epidemiology, Leiden University Medical Centre, Leiden

    European Renal Association–European Dialysis and Transplant Association Registry, Department of Medical Informatics, Academic Medical Center–University of Amsterdam, Amsterdam, The Netherlands
    Search for articles by this author
  • Knut Aasarød
    Affiliations
    Department of Medicine, Division of Nephrology, and Department of Medicine, Division of Endocrinology, St Olavs Hospital

    Departments of Cancer Research and Molecular Medicine and Community Medicine and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim

    Health Survey of Nord-Trondelag County Research Center, Faculty of Medicine, Norwegian University of Science and Technology, Verdal, Norway

    Department of Epidemiology, Leiden University Medical Centre, Leiden

    European Renal Association–European Dialysis and Transplant Association Registry, Department of Medical Informatics, Academic Medical Center–University of Amsterdam, Amsterdam, The Netherlands
    Search for articles by this author
  • Jostein Holmen
    Affiliations
    Department of Medicine, Division of Nephrology, and Department of Medicine, Division of Endocrinology, St Olavs Hospital

    Departments of Cancer Research and Molecular Medicine and Community Medicine and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim

    Health Survey of Nord-Trondelag County Research Center, Faculty of Medicine, Norwegian University of Science and Technology, Verdal, Norway

    Department of Epidemiology, Leiden University Medical Centre, Leiden

    European Renal Association–European Dialysis and Transplant Association Registry, Department of Medical Informatics, Academic Medical Center–University of Amsterdam, Amsterdam, The Netherlands
    Search for articles by this author
Published:February 06, 2006DOI:https://doi.org/10.1053/j.ajkd.2005.11.027
      Background: The incidence of end-stage renal disease is especially high in men, and some studies indicated that smoking is a risk factor for men only. We investigated associations between obesity, smoking, and physical inactivity and chronic kidney disease (CKD) in the general population and whether risk for CKD was restricted to men. Methods: This was a cross-sectional health survey of the entire adult population of Nord-Trondelag County, Norway, 1995 to 1997, with a 70.6% participation rate. Glomerular filtration rate (GFR) was estimated in all subjects 20 years and older from calibrated serum creatinine levels by using the simplified Modification of Diet in Renal Disease Study formula, and CKD cases are defined as those with a GFR less than 45 mL/min/1.73 m2 (<0.75 mL/s). Results: A total of 30,485 men and 34,708 women were included, and prevalences of GFR less than 45 mL/min/1.73 m2 (<0.75 mL/s) were 0.8% and 1.1%, respectively. Age- and sex-adjusted logistic regression analyses showed dose-response relations for body mass index, smoking history, and physical activity. Relative risks were 1.77 (95% confidence interval [CI], 1.47 to 2.14) for obesity (body mass index ≥ 30 kg/m2), 1.52 (95% CI, 1.13 to 2.06) for smoking (>25 pack-years), and 2.14 (95% CI, 1.39 to 3.30) for physical inactivity (no or some physical activity in leisure time). For subjects with all these risk factors, relative risk was 5.10 (95% CI, 2.36 to 11.01). These results remained significant after adjusting for other known risk factors. No biological interactions between sex and obesity, smoking, or physical activity were found. Conclusion: Obesity, smoking, and physical inactivity were associated significantly with CKD. Men were not more susceptible to these risk factors than women.

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