The Epidemiological Investigation for the Associations between Pre-Hypertension/ Hypertension and Chronic Kidney Disease---An Community-Based Integrated Screening Program

Background: The Keelung Community-based Integrated Screening (KCIS) program was launched since 1999. The residents aged ＞=20 year old were invited to participate regular examination and repeated measurements, which were systematic implemented for Keelung city. The well established Health Information Management System also governed the administration and application for health information management. Health information management system based integrated screening which based on community family members offers an opportunity to develop fundaments of population-based and family-based associated researches. The dynamic algorithms for family construction and identification of relationship were developed for research and public health application from nuclear family to extended family. Study Aims: The aims were to investigate to (1)the risk of age onset of pre-hypertension/ hypertension history or not, (2) the prevalence rate and incidence rate of chronic kidney disease (CKD), (3) the mean sojourn time of each stage of CKD by using the P/I ratio (P:prevalence, I: Incidence) approach, (4)the assessment of risk factors for each stage progression of chronic kidney disease. Materials and Methods: Based on Keelung community-based integrated screening program, we investigated All participants were informed the data management for health care by Health Bureau of Keelung. We will perform this algorithm development on the computer server of Keelung office. All procedures are required on behave of statement of personal information security. The CKD was defined by both estimate GFR and proteinuria, which classify the stage according to the international criteria. The random sample with proband research was conducted for demonstration of dynamic algorithm for relationship identification. For the familial aggregation approach of hypertension, our study will conducted generalized estimation equation (GEE) to analyze the effect of family aggregation on hypertension adjusted other factors, especially for effect on different relationship. The longitudinal data on anthropometry measures, blood pressure measures, biochemical markers, dipstick spot urine analyses, and lifestyle factors were also collected at each visit. The concept of P/I ratio was applied to approximate the mean duration of proteinuria/severe proteinuria or stages of eGFR. Time-dependent Poisson regression models were conducted to estimate the effect of covariates (time-varying) on developing of event of interests. Expected outcome: According to our proposal aims, we expected to compare the age of onset of pre-hypertension and hypertension clarified by family history or not respectively. Based on the community-based integrated screening, both cross-sectional and longitudinal study designs will conduct for prevalence and incidence rates of CKD for general population, family history of hypertension, respectively. The mean sojourn time (mean duration) will calculated for each stage, classified by eGFR and proteinuria, using P/I ratio method. The effect covariates for CKD progression were assessed for each stage developing of outcome, such eGFR stage I􀃆stageII, or eGFR stageII 􀃆 stage III, etc. Those will be expected to clarify the significant effects for interesting baseline stage and developing stage.

Project ID:PC10101-2082
External Project ID:NSC100-2314-B182-042-MY2