CONSEQUENCES of EXPOSURE to FAMINE EXPOSURE on the eGFR DECLINE and LATER LIFE CKD RISK AMONG SURVIVORS of the GREAT CHINESE FAMINE: a RETROSPECTIVE STUDY

E-Poster

Abstract Title

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Zhu

Co-author 1

Ruichun Meng mengrch@mail2.sysu.edu.cn the fifth affiliated hospital of Sun Yat-sen University Nephrology Zhuhai

Co-author 2

Xuefeng Pei zdwy01pxfhhh@163.com the fifth affiliated hospital of Sun Yat-sen University Intensive Care Unit Zhuhai

Co-author 3

Dongliang Yang yangdl@hbczmc.edu.cn Cangzhou Medical College Mathematics Cangzhou

Co-author 4

Juanjuan Shang hahajuanjuan@163.com Cangzhou Medical College Nursing Cangzhou

Co-author 5

Yangjian Cao caoyj33@mail2.sysu.edu.cn the fifth affiliated hospital of Sun Yat-sen University Nephrology Zhuhai

Co-author 6

Co-author 7

Co-author 8

Co-author 9

Co-author 10

Co-author 11

Co-author 12

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Introduction

Chronic kidney disease (CKD) is an increasing contributor to the socio-economic burdendisease burden in China and globally. Previous findings indicated that the experience of exposure to childhood famine is associated with various chronic illnesses diseases such as diabetes, hypertension high blood pressure, and proteinuriaurinary protein levels. However, no clear conclusions were drawn about the long term consequences of human early life famine exposure on adulthood kidney function. In this study, we aimed to explore whether exposure to the Chinese Great Famine (from 1959 to 1962) was associated with the later life glomerular filtration rate (GFR) decline and the CKD risk.

Methods

CHARLS was a population-based observational study. We selected 8,828 participants from the 2011-2012 baseline survey (updated in 2014). Based on the birth year, they were divided into fetal-exposed (1959-1962), childhood-exposed (1949-1958), adolescence/adult-exposed (1912–1948), and non-exposed (1963–1989) groups. The estimated glomerular filtration rate (eGFR) was calculated according to the CKD-EPI-Cr-Cys equation (2021), and CKD was defined as eGFR less than 60 mL/min/ per 1.73 m2.

Results

The mean value of eGFR in non-exposed, fetal-exposed, childhood-exposed and adolescence/adult-exposed groups was 103.0, 96.8, 91.2 and 76.3 (mL/min per /1.73 m2), respectively. The value of eGFR in fetal-exposed, childhood-exposed and adolescence/adult-exposed groups was significantly lower than the non-exposed group. In addition, compared with the non-exposed, exposure to famine was significantly associated with eGFR reduction (OR -9.14, 95%CI −9.46, −8.82), this kind of association was strongest in adolescence/adult-exposed group (OR -26.74, 95%CI -27.75, -25.74). Further adjustment for covariates such as demographic variables, physical examination index, laboratory test, various complications and personal history of smoking, drinking, education level, etc, did not change the association qualitatively (OR -1.38, 95%CI -1.72, -1.04). After stratification by sexsex, BMI, smoke, drink, hypertension, degree of depression , education, CKD, we found that the association still remains stable.

Conclusions

Exposure to famine at various life stages may have long-term effects on the decline of GFR and progression to CKD in humans.

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