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Chronic Kidney Disease in Older Women: Association with Reproductive History

Khoury, Jane Caroline
http://rave.ohiolink.edu/etdc/view?acc_num=ucin1147968863

Abstract Details

2006, PhD, University of Cincinnati, Medicine : Epidemiology (Environmental Health).
In the last ten years the prevalence of end-stage renal disease (ESRD) in women has risen from 281 to 485 per million. Chronic kidney disease (CKD) increases with age and is the precursor to ESRD. In this study, it was hypothesized that in women 50 years and older there is an association between reproductive factors and CKD. The National Health and Nutrition Examination Survey (NHANES) III and NHANES 1999-2002 datasets were used to examine this association. The reproductive portion of the NHANES gathered information on number of pregnancies and live births, having had a hysterectomy and age at first and last menses. After consideration of six estimating equations, the one published by Levey et al., adjusting for gender and race, was selected as optimum and used to estimate glomerular filtration rate (eGFR). An eGFR of <60 mL /min/1.73 m2, as recommended by the National Kidney Foundation, defined CKD. The association between CKD and the independent reproductive variables of interest was modeled using multiple logistic regression. Analyses involved combining two NHANES datasets requiring application of re-weighting techniques for correct point and variance estimation. The number of live births and the interactions of age at interview with age at last period as well as hysterectomy were associated with CKD. Specifically, added risk for CKD was seen in women having zero, or one to three live births, compared to four or more, odds ratio (95% confidence interval) 1.5 (1.1, 2.2) and odds ratio 1.4 (1.1, 1.8), respectively. Menopause by age 40 was associated with increased risk for CKD in the 50 to 69 year age group; odds ratio 2.3 (1.2, 4.6). Having had a hysterectomy was associated with reduced risk for CKD in the 50 to 69 year age group; odds ratio 0.5 (0.3, 0.7). Contrary to postulation that pregnancy may have an adverse effect on CKD, having four or more pregnancies was associated with decreased risk of CKD. In addition, continuing menses to an older age and hysterectomy were indicators associated with decreased risk of CKD in women aged 50 to 69 years.
Dr. Grace LeMasters (Advisor)
124 p.
chronic kidney disease; reproductive history; hysterectomy; menopause; NHANES

Recommended Citations

Citations

  • Khoury, J. C. (2006). Chronic Kidney Disease in Older Women: Association with Reproductive History [Doctoral dissertation, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1147968863

    APA Style (7th edition)

  • Khoury, Jane. Chronic Kidney Disease in Older Women: Association with Reproductive History. 2006. University of Cincinnati, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1147968863.

    MLA Style (8th edition)

  • Khoury, Jane. "Chronic Kidney Disease in Older Women: Association with Reproductive History." Doctoral dissertation, University of Cincinnati, 2006. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1147968863

    Chicago Manual of Style (17th edition)

ucin1147968863
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© 2006, all rights reserved.
This open access ETD is published by University of Cincinnati and OhioLINK.