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

Herrera-Enriquez, Karela; Gilman, Robert Hugh; Medina-Lezama, Josefina; Miranda, J. Jaime; Checkley, William; Carrillo Larco, Rodrigo Martín; Narvaez-Guerra, Offdan; Smeeth, Liam; Bernabé Ortiz, Antonio

dc.contributor.author	Carrillo Larco, Rodrigo Martín
dc.contributor.author	Miranda, J. Jaime
dc.contributor.author	Gilman, Robert Hugh
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	Bernabé 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.ispartofseries	High Altitude Medicine and Biology
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#3.01.08
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
dc.relation.issn	1557-8682