Mendelian randomization analysis revealed that albuminuria is the key factor affecting socioeconomic status in CKD patients.

IF 3 3区 医学 Q1 UROLOGY & NEPHROLOGY Renal Failure Pub Date : 2024-12-01 Epub Date: 2024-07-16 DOI:10.1080/0886022X.2024.2367705
Jianbo Qing, Lijuan Zhang, Changqun Li, Yafeng Li
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Abstract

Previous studies indicate a strong correlation between the incidence of chronic kidney disease (CKD) and lower economic status. However, these studies often struggle to delineate a clear cause-effect relationship, leaving healthcare providers uncertain about how to manage kidney disease in a way that improves patients' financial outcomes. Our study aimed to explore and establish a causal relationship between CKD and socioeconomic status, identifying critical influencing factors. We utilized summary meta-analysis data from the CKDGen Consortium and UK Biobank. Genetic variants identified from these sources served as instrumental variables (IVs) to estimate the association between CKD and socioeconomic status. The presence or absence of CKD, estimated glomerular filtration rate (eGFR), and albuminuria were used as exposures, while income and regional deprivation were analyzed as outcomes. We employed the R packages 'TwoSampleMR' and 'Mendelianrandomization' to conduct both univariable and multivariable Mendelian randomization (MR) analyses, assessing for potential pleiotropy and heterogeneity. Our univariable MR analysis revealed a significant causal relationship between high levels of albuminuria and lower income (OR = 0.84, 95% CI: 0.73-0.96, p = 0.013), with no significant pleiotropy detected. In the multivariable MR analysis, both CKD (OR = 0.867, 95% CI: 0.786-0.957, p = 0.0045) and eGFR (OR = 0.065, 95% CI: 0.010-0.437, p = 0.0049) exhibited significant effects on income. This study underscores that higher albuminuria levels in CKD patients are associated with decreased income and emphasizes the importance of effective management and treatment of albuminuria in CKD patients to mitigate both social and personal economic burdens.

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孟德尔随机分析显示,白蛋白尿是影响慢性肾脏病患者社会经济地位的关键因素。
以往的研究表明,慢性肾脏病(CKD)的发病率与较低的经济状况之间存在密切的相关性。然而,这些研究往往难以界定明确的因果关系,使医疗服务提供者无法确定如何管理肾脏疾病以改善患者的经济状况。我们的研究旨在探索并确立慢性肾脏病与社会经济地位之间的因果关系,找出关键的影响因素。我们利用了 CKDGen 联合会和英国生物库的汇总荟萃分析数据。从这些数据中确定的基因变异作为工具变量(IV)来估计 CKD 与社会经济地位之间的关联。是否患有 CKD、估计肾小球滤过率 (eGFR) 和白蛋白尿作为暴露变量,而收入和地区贫困作为结果进行分析。我们使用 R 软件包 "TwoSampleMR "和 "Mendelianrandomization "进行单变量和多变量孟德尔随机化(MR)分析,评估潜在的多义性和异质性。我们的单变量 MR 分析表明,白蛋白尿水平高与收入低之间存在显著的因果关系(OR = 0.84,95% CI:0.73-0.96,p = 0.013),未发现明显的多重效应。在多变量 MR 分析中,CKD(OR = 0.867,95% CI:0.786-0.957,p = 0.0045)和 eGFR(OR = 0.065,95% CI:0.010-0.437,p = 0.0049)对收入均有显著影响。这项研究强调,慢性肾脏病患者的白蛋白尿水平越高,收入越低,并强调了有效管理和治疗慢性肾脏病患者白蛋白尿以减轻社会和个人经济负担的重要性。
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来源期刊
Renal Failure
Renal Failure 医学-泌尿学与肾脏学
CiteScore
3.90
自引率
13.30%
发文量
374
审稿时长
1 months
期刊介绍: Renal Failure primarily concentrates on acute renal injury and its consequence, but also addresses advances in the fields of chronic renal failure, hypertension, and renal transplantation. Bringing together both clinical and experimental aspects of renal failure, this publication presents timely, practical information on pathology and pathophysiology of acute renal failure; nephrotoxicity of drugs and other substances; prevention, treatment, and therapy of renal failure; renal failure in association with transplantation, hypertension, and diabetes mellitus.
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