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Urbanization and Altitude Are Associated with Low Kidney Function in Peru.

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dc.contributor.author Carrillo-Larco, Rodrigo M.
dc.contributor.author Miranda, J. Jaime
dc.contributor.author Gilman, Robert H.
dc.contributor.author Narvaez-Guerra, Offdan
dc.contributor.author Herrera-Enriquez, Karela
dc.contributor.author Medina-Lezama, Josefina
dc.contributor.author Smeeth, Liam
dc.contributor.author Checkley, William
dc.contributor.author Bernabe-Ortiz, Antonio
dc.date.accessioned 2019-12-06T20:57:49Z
dc.date.available 2019-12-06T20:57:49Z
dc.date.issued 2019
dc.identifier.uri https://hdl.handle.net/20.500.12866/7439
dc.description.abstract Background: Kidney health needs to be studied in low- and middle-income countries with populations living at high altitude and undergoing urbanization. We studied whether greater level of urbanization was associated with worse kidney function and higher hemoglobin was associated with worse kidney function at high altitude. Methods: Cross-sectional analysis of population-based studies in Peru including five sites at different altitude above the sea level and urbanization level (in decreasing order of urbanization): Lima (sea level), Arequipa (2335 m), urban Puno (3825 m), Tumbes (sea level), and rural Puno (3825 m). The exposures were urbanization and altitude as per study site, and hemoglobin (g/dL). The outcome was the estimated glomerular filtration rate (eGFR). Results: Four thousand two hundred eight people were studied: mean age was 57.4 years (standard deviation: 12.4) and 51.9% were women. In comparison to rural Puno, eGFR was similar in Lima; in comparison to rural Puno, Arequipa, urban Puno, and Tumbes had worse eGFR, for example, in Arequipa, beta = -8.07 (95% confidence interval [CI]: -10.90 to -5.24). Intermediate (beta = -8.60; 95% CI: -10.55 to -6.66) and high (beta = -11.21; 95% CI: -14.19 to -8.24) altitude were negatively correlated with eGFR when only urban places were analyzed. At high altitude, there was a trend for a negative association between hemoglobin and eGFR: beta = -1.09 (95% CI: -2.22 to 0.04). Conclusions: Apparently, higher altitude and level of urbanization, except for one highly urbanized site, were associated with worse kidney function. Our findings suggest that some of the adverse impact of high altitude on kidney function has been balanced by the lower risk conferred by rural environments. en_US
dc.language.iso eng
dc.publisher Mary Ann Liebert
dc.relation.ispartof urn:issn:1557-8682
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject adult en_US
dc.subject aged en_US
dc.subject altitude en_US
dc.subject Altitude en_US
dc.subject Article en_US
dc.subject chronic kidney disease en_US
dc.subject controlled study en_US
dc.subject cross-sectional study en_US
dc.subject estimated glomerular filtration rate en_US
dc.subject female en_US
dc.subject glomerular filtration en_US
dc.subject hemoglobin en_US
dc.subject human en_US
dc.subject kidney dysfunction en_US
dc.subject kidney function en_US
dc.subject major clinical study en_US
dc.subject male en_US
dc.subject Peru en_US
dc.subject priority journal en_US
dc.subject rural area en_US
dc.subject sea level en_US
dc.subject urban area en_US
dc.subject urbanization en_US
dc.title Urbanization and Altitude Are Associated with Low Kidney Function in Peru. en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1089/ham.2018.0106
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00 es_PE
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.01.08
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.11
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.05


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