Prevalence and Risk Factors of Renal Insufficiency in Elderly Population / 대한신장학회잡지

BACKGROUND: The effects of aging on kidney are anatomic and physiologic abnormality. The most important abnormality is the decreased GFR. Hypertension, diabetes and glomerular disease are the most important risk factors of renal damage. Previous evidence suggested that obesity, smoking and hyperlipidemia progress the renal disease in diabetic nephropathy and glomerular disease. However, it is unclear whether these factors are independently associated with renal insufficiency (GFR<60 mL/min/1.73m2). METHODS: A total of 1, 014 elderly (over 65 years) who participated in health screening examinations in Seoul, Korea was eligible for study. Those who had hypertension, diabetes, urinary abnormality and major disease (cardiovascular disease, cancer, etc) were excluded. Finally, a total of 632 elderly population (age 68.8+/-3.9 yr, M: F=362: 270) was included in the analysis for the present study. Estimated GFR was calculated using the abbreviated MDRD equation. Body mass index (BMI), blood pressure, fasting blood sugar, lipid study, Lp (a), hs CRP and smoking habit were measured. Logistic regression analysis was used to examine the risk factors of renal insufficiency. RESULTS: The mean serum creatinine value was 1.04+/-0.16 mg/dL (male 1.12+/-0.13, female 0.94+/-0.13) and mean estimated GFR was 68.0+/-12.5 mL/min/ 1.73m2 (male 69.7+/-12.5, female 65.8+/-12.0). The prevalence of renal insufficiency was 26%. In renal insufficiency group (n=165), age, BMI, systolic blood pressure, total cholesterol, LDL-cholesterol, Lp (a) and hs CRP were greater than normal renal function group (n=467). After adjusting for potential confounding factor, age (odds ratio=1.12, CI 1.04-1.21, p<0.01), BMI (odds ratio=1.17, CI 1.04-1.31, p=0.01) and smoking in man (odds ratio=4.03, CI 1.04-16.04, p=0.04) were significantly associated with renal insufficiency. CONCLUSION: Mean estimated GFR was 68.0+/-12.5 mL/min/1.73m2 (male 69.7+/-12.5, female 65.8+/-12.0) in elderly population. The prevalence of renal insufficiency was 26%. This study suggests overweight and smoking may be associated with renal insufficiency in the elderly population.

The comparison of bacterial infection rate in the patients with alcoholic and viral cirrhosis / 대한내과학회지

BACKGROUND: Liver cirrhosis may be considered one of the most common cause of acquired immunodeficiency. Alcohol abuse may be predisposing factor to infections in patients with liver cirrhosis, so we compared the rate of spontaneous bacterial peritonitis (SBP) and other bacterial infections in alcoholic and viral liver cirrhosis. METHODS: We studied 188 patients who had been diagnosed with liver cirrhosis from January 1995 to June 2000 and evaluated the frequency of bacterial infections (SBP, pneumonia, urinary track infection, bacteremia, infectious colitis) retrospectively according to cause and degree of cirrhosis. RESULTS: Among 188 patients (alcoholic 76, viral 112), 64 patients (34%) presented with bacterial infection at hospitalization, 33 (43%;33/76) of 64 subjects were alcoholic and 31 (28%;31/112) of 64 subjects were viral liver cirrhosis. The rate of bacterial infections was higher in alcoholic liver cirrhosis than viral cirrhosis (p0.05). CONCLUSION: This results suggest that the rate of bacterial infections are more common in alcoholic than viral liver cirrhosis in relatively early stage and it may be influence the prognosis of liver cirrhosis.