Oxidative Balance Score and Chronic Kidney Disease Público

Ilori, Titilayo Omolara (2015)

Permanent URL: https://etd.library.emory.edu/concern/etds/5t34sk048?locale=es
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Abstract

Background and Objectives: The Oxidative balance score (OBS) is a composite estimate of the overall pro- and antioxidant exposure status in an individual. The aim of this study was to determine the association between OBS and renal disease: albuminuria, chronic kidney disease (CKD) and End Stage Renal Disease (ESRD).

Design, Setting, Participants and Measurements: The study was conducted with data from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study. Data were collected from 2003 to 2007 by phone questionnaire and in-home examination. OBS was calculated by combining 13 a priori-defined pro- and antioxidant factors using baseline dietary and lifestyle assessment. The OBS was divided into quartiles (Q1-Q4) with the lowest, Q1 (predominance of pro-oxidants) as the reference. Multivariable logistic regression and cox proportional hazards models were used to estimate adjusted odds ratios (ORs) for albuminuria defined as urine albumin/creatinine ratio > 30mg/g and CKD defined as estimated glomerular filtration rate < 60ml/min as calculated by the CKD-EPI equation and hazard ratios (HRs) for ESRD, respectively.

Results: Of the 19,461 participants analyzed, 2,519 (12.9%) had albuminuria and 1,957 (10.1%) had CKD defined as estimated glomerular filtration rate (eGFR) < 60ml/min/1.73m2 at baseline; over a median follow-up of 3.5 years (range 2.14-4.32 years), 90 (0.46%) developed ESRD. Higher OBS quartiles were associated with lower prevalence of CKD (OR vs. Q1: Q2=0.93, (95% CI, 0.80-1.08); Q3=0.90, (95% CI, 0.77-1.04; and Q4= 0.79, (95% C.I 0.67-0.92), p for trend <0.01). The associations between OBS and albuminuria (p for trend 0.31) and incident ESRD (p for trend 0.56) were not significant in the fully adjusted models.

Conclusions: These findings suggest that higher OBS is associated with lower prevalence of CKD. Lack of association with ESRD incidence in the multivariable analyses indicates that temporal relation between OBS and renal damage remains unclear.

Table of Contents

INTRODUCTION……………………………………………… 1
BACKGROUND………………………………………………… 3
METHODS……………………………………………………… 6
RESULTS………………………………………………………... 11
DISCUSSION……………………………………………………. 14
REFERENCES………………………………………………….. 17
TABLES AND FIGURES………………………………………. 23

LIST OF TABLES AND FIGURES

Tables

Table 1. Oxidative balance score (OBS) components...23

Table 2. Characteristics of the Participants in the REGARDS Cohort by OBS quartiles at baseline...24

Table 3. Crude Models Showing the Association between OBS: Albuminuria and ESRD...25

Table 4. Adjusted Association between OBS: Albuminuria, CKD, AND ESRD...26

Table 5. Supplemental Table: Distribution of Individual OBS components by OBS quartile...27


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