Risk factors associated with the discordance in kidney function decline rate in identical twins

PLoS One. 2023 Apr 13;18(4):e0284154. doi: 10.1371/journal.pone.0284154. eCollection 2023.

Abstract

Background: The rate of kidney function decline is different for each individual regardless of any difference in the medical histories. This study set out to identify the risk factors for high discordance in kidney function decline in an identical twin cohort.

Methods: This study included 333 identical twins from the Korean Genome and Epidemiology Study who were categorized into two groups according to the estimated glomerular filtration rate (eGFR) decline: the slow and rapid progressor groups. The mean differences of variables were compared between the two groups. We calculated the difference in the annual eGFR change between twins and analyzed the risk factors associated with high discordance in twins who had > 5 mL/min/1.73 m2 /yr of the intra-twin difference in the annual eGFR decline. Identical twins with diabetes and baseline eGFR < 60 mL/min/1.73 m2 were excluded.

Results: The high discordance twins showed significant differences in body mass index; waist-to-hip ratio; total body fat percentage; and levels of blood hemoglobin, serum fasting glucose, albumin, triglyceride, and uric acid; however, there were no differences in low discordance twins. Multivariable logistic regression showed that blood hemoglobin level is the only significant factor associated with high discordance of eGFR decline in twins.

Conclusions: Blood hemoglobin level may play a role in the individual differences in kidney function decline.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Glomerular Filtration Rate
  • Humans
  • Kidney*
  • Risk Factors
  • Twins, Monozygotic*

Grants and funding

This study was supported by a grant from the KOREAN NEPHROLOGY RESEARCH FOUNDATION (Young Investigator Research Grant, 2022). The funders played no role in the conduct of the study, and the study was performed independently by the authors.