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. 2020 Nov 2;19(1):e101061.
doi: 10.5812/ijem.101061. eCollection 2021 Jan.

Diabetes, Hypertension, and Incidence of Chronic Kidney Disease: Is There any Multiplicative or Additive Interaction?

Saeed Erfanpoor  1 , Koorosh Etemad  2 , Sara Kazempour  3 , Farzad Hadaegh  4 , Jalil Hasani  5 , Fereidoun Azizi  6 , Donna Parizadeh  4 , Davood Khalili  4
Affiliations

Diabetes, Hypertension, and Incidence of Chronic Kidney Disease: Is There any Multiplicative or Additive Interaction?

Saeed Erfanpoor et al. Int J Endocrinol Metab. .

Abstract

Background: The burden of chronic kidney disease (CKD) is on the rise worldwide; diabetes and hypertension are mentioned as the main contributors.

Objectives: The current study aimed to investigate the multiplicative and additive interaction of diabetes and hypertension in the incidence of CKD.

Methods: In this population-based cohort study, 7342 subjects aged 20 years or above (46.8% male) were divided into four groups: no diabetes and hypertension; diabetes and no hypertension; hypertension and no diabetes; and both diabetes and hypertension. The multivariable Cox regression was used to determine the effect of diabetes, hypertension, and their multiplicative interaction on CKD. The following indices were used to determine the additive interaction of diabetes and hypertension: the relative excess risk of interaction, the attributable proportion due to interaction, and the synergism index.

Results: Diabetes and hypertension had no significant multiplicative interaction in men (hazard ratio of 0.93, P value: 0.764) and women (hazard ratio of 0.79, P value: 0.198); furthermore, no additive interaction was found in men (relative excess risk due to interaction of 0.79, P value: 0.199; attributable proportion due to interaction of 0.22, P value: 0.130; synergy index of 1.44, P value: 0.183) and women (relative excess risk due to interaction of -0.26, P value: 0.233, attributable proportion due to interaction of -0.21, P value: 0.266; synergy index of 0.48, P value: 0.254).

Conclusions: This study demonstrated no synergic effect between diabetes and hypertension on the incidence of CKD.

Keywords: Chronic Kidney Disease; Diabetes; Hypertension; Interaction.

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Conflict of interest statement

Conflict of Interests: The authors declare no conflict of interest.

Figures

Figure 1.
Figure 1.. Incidence of CKD in females and males with and without diabetes and/or hypertension. CKD, Chronic Kidney Disease; DM, Diabetes Mellitus; HTN, Hypertension.
See this image and copyright information in PMC

References

    1. Hosseinpanah F, Kasraei F, Nassiri AA, Azizi F. High prevalence of chronic kidney disease in Iran: a large population-based study. BMC Public Health. 2009;9:44. doi: 10.1186/1471-2458-9-44. - DOI - PMC - PubMed
    1. James MT, Hemmelgarn BR, Tonelli M. Early recognition and prevention of chronic kidney disease. The Lancet. 2010;375(9722):1296–309. doi: 10.1016/s0140-6736(09)62004-3. - DOI - PubMed
    1. Tohidi M, Hasheminia M, Mohebi R, Khalili D, Hosseinpanah F, Yazdani B, et al. Incidence of chronic kidney disease and its risk factors, results of over 10 year follow up in an Iranian cohort. PLoS One. 2012;7(9):e45304. doi: 10.1371/journal.pone.0045304. - DOI - PMC - PubMed
    1. Long AN, Dagogo-Jack S. Comorbidities of diabetes and hypertension: mechanisms and approach to target organ protection. J Clin Hypertens (Greenwich). 2011;13(4):244–51. doi: 10.1111/j.1751-7176.2011.00434.x. - DOI - PMC - PubMed
    1. Hay SI, Abajobir AA, Abate KH, Abbafati C, Abbas KM, Abd-Allah F, et al. Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet. 2017;390(10100):1260–344. doi: 10.1016/s0140-6736(17)32130-x. - DOI - PMC - PubMed

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