The association between waist circumference and renal insufficiency among hypertensive patients
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The Association between Waist Circumference and Renal Insufficiency among Hypertensive Patients. Mrs. Watcharasa Pitug ID. 567110011-2. Contents. Background/Rationale Objective Methods Results Discussion &Conclusions. Background/Rationale.

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The association between waist circumference and renal insufficiency among hypertensive patients

The Association between Waist Circumference and Renal Insufficiency among Hypertensive Patients

Mrs. Watcharasa Pitug

ID. 567110011-2


Contents
Contents Insufficiency among Hypertensive Patients

  • Background/Rationale

  • Objective

  • Methods

  • Results

  • Discussion &Conclusions


Background rationale
Background/Rationale Insufficiency among Hypertensive Patients

Chronic kidney disease (CKD) has become a global public health problem and is a common condition in the United States

(Alejandro et al.,2009 ; Essam et al.,2008 ; Adam et al., 2007)

In 2004, there were approximately 472,000 patients with treated ESRD (Alejandro et al.,2009 )

By 2030, expected to increase to more than 2 million. The estimated prevalence of earlier CKD stages (stages 1 through 4) in US adults was 24 to 28 million based on the 2000

(Adam et al., 2007)


Chronic kidney disease classification and clinical consequences
Chronic kidney disease: classification and clinical consequences

Relative risk of death in relation to kidney function

(N=1,120,295 pts)

CKD -KDOQI classification

Go AS et., 2004


Modification of diet in renal disease mdrd in thailand
Modification of Diet in Renal Disease (MDRD consequences) in Thailand

In 2007 : Chronic Renal Insufficiency patients 13.2% in state 3 and 0.61% in state 4

(ThaweeSiriwong, 2007)

In 2008 : Chronic Renal Insufficiency patients in Thailand 17.5% (สมาคมโรคไตแห่งประเทศไทย, 2008)


Clinical complications of renal failure
Clinical complications of renal failure consequences

Loss of erythropoietin –anaemia

Parathyroid gland disturbances –renal bone disease

Myocardial fibrosis and cardiomyopathy

Active vitamin D

deficiency

Immunodeficiency

Atherosclerosis

and

arteriosclerosis

Malnutrition/wasting

..and many others

Polyneuropathy

No diuresis –overhydration


Gab of knowledge
Gab of knowledge consequences

  • The relationship of obesity to Renal insufficiency is somewhat controversial. While it is established that obesity increases the risk of hypertension, diabetes and dyslipidemia

  • it is not clear if excess waist circumference influences Renal insufficiency independently

Correlation between waist circumference and (A) visceral and (B) subcutaneous fat areas assessed by using computed tomography in 75 men (open circle; dotted lines) and 47 women (filled triangle; solid lines) with prevalent chronic kidney disease.

Fabiana et al.,2008


Objective consequences

  • To investigate the association between waist circumference and Renal insufficiency among hypertensive patients

Methods

  • Analytic study was conducted all information were collected from medical records of all patients diagnosed with Hypertension during 2012. The type of hypertension complications was based on Renal insufficiency was the main outcome of this study.


The inclusion flow chart

Methods consequences

The inclusion flow chart

Sampling frame

DM, HT & DMHT

N=61,706

Exclude DM & DMHT

(n=28,938)

Sample

only HT patients

(n=32,768)

Exclude if not estimate waist circumference

(n=23,287)

Study participants

(n=9,481)


Modification of diet in renal disease mdrd in thailand1

Methods consequences

Modification of Diet in Renal Disease (MDRD) in Thailand

Go AS et., 2004


Variables and measurements

Methods consequences

Variables and measurements


Variables and measurements1

Methods consequences

Variables and measurements


Statistic analysis

Methods consequences

Statistic Analysis

  • Demographic characteristics were described using frequency and percentage for categorical data such as gender, age group,WC group, BMI group, Cigarette smoking use, fasting plasma glucose group, total cholesterol group, triglyceride group, HDL cholesterol group, LDL cholesterol group, hemoglobin group and hematocrit group.

  • Using mean, standard deviation, median, minimum, and maximum to described continuous data such as age, BMI, fasting plasma glucose level, total cholesterol level, triglyceride level, HDL cholesterol level, LDL cholesterol level, hemoglobin level and hematocrit level.

  • To investigate factors that associated with chronic renal insufficiency, adjusted odds ratios (ORs) and their 95% confidence intervals (95%CIs) were estimated using multiple logistic regression.

  • All test statistics were p-value of less than 0.05 was considered statistical significant.

  • All analyses were performed by using STATA version 12.0 (AtataCorp, College Station, TX).


Results
Results consequences

Basic characteristic of the individual included in the study


Results1
Results consequences

Basic characteristic of the individual included in the study


Results consequences

Basic characteristic of the individual included in the study


Crude odds ratios of having renal insufficiency and their 95 confidence intervals for each factor
Crude consequencesodds ratios of having Renal Insufficiency and their 95% confidence intervals for each factor


Odds ratios (ORs) of having Renal Insufficiency and their 95% confidence intervals for each factor adjusted for all other factors presented in the table using logistic regression (n=13151)


Odds ratios (ORs) of having Renal Insufficiency and their 95% confidence intervals for each factor adjusted for all other factors presented in the table using logistic regression (n=13151)


Forest plot 95% confidence intervals for each factor adjusted for all other factors presented in the table using logistic regression (n=13151)was compare for each factors affecting chronic renal insufficiency, presented as odds ratio adjusted for waist circumference, age, gender, BMI, smoking, triglyceride, and Hemoglobin, using multiple logistic regression


Discussion conclusions
Discussion & 95% confidence intervals for each factor adjusted for all other factors presented in the table using logistic regression (n=13151)Conclusions

1

2

1

2


Discussion conclusions1
Discussion & 95% confidence intervals for each factor adjusted for all other factors presented in the table using logistic regression (n=13151)Conclusions


Discussion conclusions2
Discussion & 95% confidence intervals for each factor adjusted for all other factors presented in the table using logistic regression (n=13151)Conclusions


Discussion conclusions3
Discussion & 95% confidence intervals for each factor adjusted for all other factors presented in the table using logistic regression (n=13151)Conclusions

In summary, in agreement with the findings in the general population, the present study shows that WC is not associated with Chronic Renal Insufficiency in individuals. In previous study, associations found between WC and some CVD risk factors were similar to those observed for visceral fat, suggesting that WC is a simple and economic tool to be used more often in epidemiological research also involving patients with CKD. Prospective studies are necessary to evaluate the reproducibility of WC and the ability of this method to predict outcomes in patients with CKD.


Thanks for your attention 95% confidence intervals for each factor adjusted for all other factors presented in the table using logistic regression (n=13151)


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