Chronic renal dysfunction, proteinuria, and risk of Parkinson's disease in the elderly

Ga Eun Nam, Nan Hee Kim, Kyungdo Han, Kyung Mook Choi, Hye Soo Chung, Jin Wook Kim, Byoungduck Han, Sung Jung Cho, Seung Jin Jung, Ji Hee Yu, Yong Gyu Park, Seon Mee Kim

Research output: Contribution to journalArticle

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Abstract

Background: The roles of chronic kidney disease and proteinuria in the development of Parkinson's disease have not been widely studied. The objective of this study was to examine the associations of chronic renal dysfunction and proteinuria with the risk of PD in older adults using cohort data of the whole South Korean population. Methods: We included 3,580,435 individuals aged ≥65 years who had undergone health checkups provided by the National Health Insurance Service of South Korea between 2009 and 2012 and were followed until 2015. Multivariable Cox proportional hazards regression models were performed. Results: During a mean follow-up of 5.2 ± 1.3 years, 30,813 individuals (0.86% of the total population) developed PD. Lower estimated glomerular filtration rate and a higher degree of proteinuria on a dipstick test were associated with higher incidence probability of PD (log-rank P < 0.001). In Cox regression models, chronic renal dysfunction graded by estimated glomerular filtration rate (mL/min/1.73 m 2 ) was associated with increased risk of PD after adjusting for potential confounding variables; hazard ratio (95% confidence interval) was 1.13 (1.10–1.17) for estimated glomerular filtration rate 60–90, 1.36 (1.31–1.42) for estimated glomerular filtration rate 30–60, and 1.47 (1.32–1.63) for estimated glomerular filtration rate <30 (P for trend <0.001). Proteinuria ≥1+ was also associated with increased risk of PD development (hazard ratio, 1.12; 95% confidence interval, 1.06–1.18). Coexistence of chronic kidney disease and proteinuria showed an increased hazard ratio of 1.33 (95% confidence interval, 1.23–1.45) for PD occurrence. Conclusions: Our findings suggest that chronic renal dysfunction and dipstick-positive proteinuria may be independent risk factors for the development of PD in older adults.

Original languageEnglish
JournalMovement Disorders
DOIs
Publication statusPublished - 2019 Jan 1

Fingerprint

Proteinuria
Parkinson Disease
Glomerular Filtration Rate
Kidney
National Health Programs
Confidence Intervals
Chronic Renal Insufficiency
Proportional Hazards Models
Republic of Korea
Confounding Factors (Epidemiology)
Population
Incidence
Health

Keywords

  • chronic kidney disease
  • estimated glomerular filtration rate
  • Parkinson's disease
  • proteinuria
  • urine dipstick test

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Chronic renal dysfunction, proteinuria, and risk of Parkinson's disease in the elderly. / Nam, Ga Eun; Kim, Nan Hee; Han, Kyungdo; Choi, Kyung Mook; Chung, Hye Soo; Kim, Jin Wook; Han, Byoungduck; Cho, Sung Jung; Jung, Seung Jin; Yu, Ji Hee; Park, Yong Gyu; Kim, Seon Mee.

In: Movement Disorders, 01.01.2019.

Research output: Contribution to journalArticle

Nam, Ga Eun ; Kim, Nan Hee ; Han, Kyungdo ; Choi, Kyung Mook ; Chung, Hye Soo ; Kim, Jin Wook ; Han, Byoungduck ; Cho, Sung Jung ; Jung, Seung Jin ; Yu, Ji Hee ; Park, Yong Gyu ; Kim, Seon Mee. / Chronic renal dysfunction, proteinuria, and risk of Parkinson's disease in the elderly. In: Movement Disorders. 2019.
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abstract = "Background: The roles of chronic kidney disease and proteinuria in the development of Parkinson's disease have not been widely studied. The objective of this study was to examine the associations of chronic renal dysfunction and proteinuria with the risk of PD in older adults using cohort data of the whole South Korean population. Methods: We included 3,580,435 individuals aged ≥65 years who had undergone health checkups provided by the National Health Insurance Service of South Korea between 2009 and 2012 and were followed until 2015. Multivariable Cox proportional hazards regression models were performed. Results: During a mean follow-up of 5.2 ± 1.3 years, 30,813 individuals (0.86{\%} of the total population) developed PD. Lower estimated glomerular filtration rate and a higher degree of proteinuria on a dipstick test were associated with higher incidence probability of PD (log-rank P < 0.001). In Cox regression models, chronic renal dysfunction graded by estimated glomerular filtration rate (mL/min/1.73 m 2 ) was associated with increased risk of PD after adjusting for potential confounding variables; hazard ratio (95{\%} confidence interval) was 1.13 (1.10–1.17) for estimated glomerular filtration rate 60–90, 1.36 (1.31–1.42) for estimated glomerular filtration rate 30–60, and 1.47 (1.32–1.63) for estimated glomerular filtration rate <30 (P for trend <0.001). Proteinuria ≥1+ was also associated with increased risk of PD development (hazard ratio, 1.12; 95{\%} confidence interval, 1.06–1.18). Coexistence of chronic kidney disease and proteinuria showed an increased hazard ratio of 1.33 (95{\%} confidence interval, 1.23–1.45) for PD occurrence. Conclusions: Our findings suggest that chronic renal dysfunction and dipstick-positive proteinuria may be independent risk factors for the development of PD in older adults.",
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author = "Nam, {Ga Eun} and Kim, {Nan Hee} and Kyungdo Han and Choi, {Kyung Mook} and Chung, {Hye Soo} and Kim, {Jin Wook} and Byoungduck Han and Cho, {Sung Jung} and Jung, {Seung Jin} and Yu, {Ji Hee} and Park, {Yong Gyu} and Kim, {Seon Mee}",
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AU - Nam, Ga Eun

AU - Kim, Nan Hee

AU - Han, Kyungdo

AU - Choi, Kyung Mook

AU - Chung, Hye Soo

AU - Kim, Jin Wook

AU - Han, Byoungduck

AU - Cho, Sung Jung

AU - Jung, Seung Jin

AU - Yu, Ji Hee

AU - Park, Yong Gyu

AU - Kim, Seon Mee

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N2 - Background: The roles of chronic kidney disease and proteinuria in the development of Parkinson's disease have not been widely studied. The objective of this study was to examine the associations of chronic renal dysfunction and proteinuria with the risk of PD in older adults using cohort data of the whole South Korean population. Methods: We included 3,580,435 individuals aged ≥65 years who had undergone health checkups provided by the National Health Insurance Service of South Korea between 2009 and 2012 and were followed until 2015. Multivariable Cox proportional hazards regression models were performed. Results: During a mean follow-up of 5.2 ± 1.3 years, 30,813 individuals (0.86% of the total population) developed PD. Lower estimated glomerular filtration rate and a higher degree of proteinuria on a dipstick test were associated with higher incidence probability of PD (log-rank P < 0.001). In Cox regression models, chronic renal dysfunction graded by estimated glomerular filtration rate (mL/min/1.73 m 2 ) was associated with increased risk of PD after adjusting for potential confounding variables; hazard ratio (95% confidence interval) was 1.13 (1.10–1.17) for estimated glomerular filtration rate 60–90, 1.36 (1.31–1.42) for estimated glomerular filtration rate 30–60, and 1.47 (1.32–1.63) for estimated glomerular filtration rate <30 (P for trend <0.001). Proteinuria ≥1+ was also associated with increased risk of PD development (hazard ratio, 1.12; 95% confidence interval, 1.06–1.18). Coexistence of chronic kidney disease and proteinuria showed an increased hazard ratio of 1.33 (95% confidence interval, 1.23–1.45) for PD occurrence. Conclusions: Our findings suggest that chronic renal dysfunction and dipstick-positive proteinuria may be independent risk factors for the development of PD in older adults.

AB - Background: The roles of chronic kidney disease and proteinuria in the development of Parkinson's disease have not been widely studied. The objective of this study was to examine the associations of chronic renal dysfunction and proteinuria with the risk of PD in older adults using cohort data of the whole South Korean population. Methods: We included 3,580,435 individuals aged ≥65 years who had undergone health checkups provided by the National Health Insurance Service of South Korea between 2009 and 2012 and were followed until 2015. Multivariable Cox proportional hazards regression models were performed. Results: During a mean follow-up of 5.2 ± 1.3 years, 30,813 individuals (0.86% of the total population) developed PD. Lower estimated glomerular filtration rate and a higher degree of proteinuria on a dipstick test were associated with higher incidence probability of PD (log-rank P < 0.001). In Cox regression models, chronic renal dysfunction graded by estimated glomerular filtration rate (mL/min/1.73 m 2 ) was associated with increased risk of PD after adjusting for potential confounding variables; hazard ratio (95% confidence interval) was 1.13 (1.10–1.17) for estimated glomerular filtration rate 60–90, 1.36 (1.31–1.42) for estimated glomerular filtration rate 30–60, and 1.47 (1.32–1.63) for estimated glomerular filtration rate <30 (P for trend <0.001). Proteinuria ≥1+ was also associated with increased risk of PD development (hazard ratio, 1.12; 95% confidence interval, 1.06–1.18). Coexistence of chronic kidney disease and proteinuria showed an increased hazard ratio of 1.33 (95% confidence interval, 1.23–1.45) for PD occurrence. Conclusions: Our findings suggest that chronic renal dysfunction and dipstick-positive proteinuria may be independent risk factors for the development of PD in older adults.

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