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Association of clustering of major cardiovascular risk factors with chronic kidney disease in the adult population.

BACKGROUND
The prevalence of chronic kidney disease (CKD) is high in China, as is the clustering of major cardiovascular (CVD) risk factors. We aimed to explore the association of clustering of CVD risk factors with CKD in the adult population.


METHODS
A total of 3,287 adults who visited the Health Checkup Clinic were consecutively enrolled in the study. We investigated the clustering of four CVD risk factors (defined as two or more of the following: hypertension, diabetes, dyslipidemia, and overweight) and their association with CKD. CKD was defined as decreased estimated glomerular filtration rate (eGFR < 60 mL/min/1.73 m2) or the presence of albuminuria (urinary albumin-to-creatinine >= 30 mg/g).


RESULTS
Among the total participants in this study, only 27.4% were free of any pre-defined CVD risk factors, and 46% of them had clustering of CVD risk factors. The prevalence of decreased eGFR, albuminuria, and the overall prevalence of CKD in the group of clustering of CVD risk factors was higher than in the group of none or in the group of single CVD risk factors, which were 4.9% vs. 1.0% and 1.8% (p < 0.001), 9.0% vs. 4.1% and 4.0% (p < 0.001), 12.8% vs. 5.1% and 5.8% (p < 0.001), respectively. After being adjusted for potential confounders, the clustering of CVD risk factors was positively associated with either albuminuria or CKD,with odds ratio of 1.93 (95% confidence interval [CI], 1.39 - 2.68) and 1.72 (95%CI, 1.29 - 2.28).


CONCLUSIONS
Clustering of CVD risk factors was positively associated with CKD, which further confirms the importance of modifying lifestyle to reduce the burden of CKD. *contributed equally to this work.