Association between famine exposure during infancy and childhood and the risk of chronic kidney disease in adulthood

Xiao Liu; Junhui Sun; Bing Ge; Chi Pan; Hongxuan Yan; Xiaohui Sun; Jiahui Peng; Weijing Wang; Yongfeng Lin; Dongfeng Zhang; Feng Ning

doi:10.1111/imj.16367

Association between famine exposure during infancy and childhood and the risk of chronic kidney disease in adulthood

Intern Med J. 2024 Mar 11. doi: 10.1111/imj.16367. Online ahead of print.

Authors

Xiao Liu¹, Junhui Sun², Bing Ge³, Chi Pan⁴, Hongxuan Yan¹, Xiaohui Sun³, Jiahui Peng³, Weijing Wang¹, Yongfeng Lin³, Dongfeng Zhang¹, Feng Ning³

Affiliations

¹ Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, Shandong, China.
² The Second People's Hospital of Jimo, Qingdao, Shandong, China.
³ Qingdao Centers for Disease Control and Prevention, Qingdao, Shandong, China.
⁴ Huangdao District Centers for Disease Control and Prevention, Qingdao, Shandong, China.

PMID: 38465389
DOI: 10.1111/imj.16367

Abstract

Background: Famine exposure in childhood is proven to be associated with multiple chornic disease in adult but has not been studied with chronic kidney disease (CKD).

Aims: This study was conducted to identify the relationship between famine exposure during infancy and childhood - specifically, the Chinese famine of 1959-1961 - and the risk of adult-onset chronic kidney disease (CKD) among Chinese individuals.

Methods: This study included 2937 individuals from the Qingdao Diabetes Prevention Program. They were stratified by birth year into infancy-exposed (1956-1958), childhood-exposed (1950-1955) and unexposed (1963-1971) groups. The estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. CKD was defined as an eGFR of <90 mL/min/1.73 m² .

Results: The mean eGFR values for the infancy-exposed and childhood-exposed groups were 107.23 ± 12.53 and 103.23 ± 12.44 mL/min/1.73 m² , respectively, both of which were lower than that of the unexposed group (114.82 ± 13.39 mL/min/1.73 m² ; P < 0.05). In the crude model, the odds ratio (OR) for CKD was 2.00 (95% confidence interval (CI): 1.39-2.88) in the infancy-exposed group and 2.92 (95% CI: 2.17-3.93) in the childhood-exposed group. Further adjustments for urban/rural residence, body mass index, age, current smoking, type 2 diabetes, systolic blood pressure, diastolic blood pressure and total cholesterol did not significantly alter the association between famine exposure and CKD. The corresponding ORs were 1.71 (95% CI: 1.17-2.50) and 2.48 (95% CI: 1.81-3.40) for the infancy-exposed and childhood-exposed groups respectively.

Conclusions: Famine exposure during infancy and childhood is associated with a long-term decline in eGFR and an increased adult-onset CKD risk. Early intervention for high-risk individuals may mitigate the risk of adult-onset CKD.

Keywords: adulthood; chronic kidney disease; cross-sectional study; estimated glomerular filtration rate; famine exposure.

Abstract

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