Journal article
Urbanization and Altitude Are Associated with Low Kidney Function in Peru
High altitude medicine & biology, Vol.20(2), pp.133-140
06/2019
DOI: 10.1089/ham.2018.0106
PMCID: PMC6602110
PMID: 31063411
Abstract
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.
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).
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, β = -8.07 (95% confidence interval [CI]: -10.90 to -5.24). Intermediate (β = -8.60; 95% CI: -10.55 to -6.66) and high (β = -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: β = -1.09 (95% CI: -2.22 to 0.04).
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.
Details
- Title: Subtitle
- Urbanization and Altitude Are Associated with Low Kidney Function in Peru
- Creators
- Rodrigo M Carrillo-Larco - Universidad Peruana Cayetano HerediaJ Jaime Miranda - Universidad Peruana Cayetano HerediaRobert H Gilman - Johns Hopkins UniversityOffdan Narvaez-Guerra - 6 Department of Preventive Medicine, Integral Occupational Medicine Center CEMOIN, Arequipa, PeruKarela Herrera-Enriquez - 6 Department of Preventive Medicine, Integral Occupational Medicine Center CEMOIN, Arequipa, PeruJosefina Medina-Lezama - Catholic University of Santa MaríaLiam Smeeth - London School of Hygiene & Tropical MedicineWilliam Checkley - Universidad Peruana Cayetano HerediaAntonio Bernabe-Ortiz - Johns Hopkins UniversityCRONICAS Cohort Study Group
- Resource Type
- Journal article
- Publication Details
- High altitude medicine & biology, Vol.20(2), pp.133-140
- DOI
- 10.1089/ham.2018.0106
- PMID
- 31063411
- PMCID
- PMC6602110
- NLM abbreviation
- High Alt Med Biol
- ISSN
- 1557-8682
- eISSN
- 1557-8682
- Grant note
- HHSN268200900033C / NHLBI NIH HHS 100693/Z/12/Z / Wellcome Trust 214185/Z/18/Z / Wellcome Trust 103994/Z/14/Z / Wellcome Trust Wellcome Trust 294834/Z/16/Z ISSF ICL / Wellcome Trust
- Language
- English
- Date published
- 06/2019
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984845467602771
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