Familial clustering of ESRD in the Norwegian population

Rannveig Skrunes; Einar Svarstad; Anna Varberg Reisæter; Bjørn Egil Vikse

doi:10.2215/CJN.01680214

Familial clustering of ESRD in the Norwegian population

Clin J Am Soc Nephrol. 2014 Oct 7;9(10):1692-700. doi: 10.2215/CJN.01680214. Epub 2014 Aug 4.

Authors

Rannveig Skrunes¹, Einar Svarstad², Anna Varberg Reisæter³, Bjørn Egil Vikse⁴

Affiliations

¹ Department of Medicine, Haukeland University Hospital, Bergen, Norway; rannveig.skrunes@helse-bergen.no.
² Department of Medicine, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, University of Bergen, Bergen, Norway;
³ Department of Transplantation Medicine, Rikshospitalet, Oslo University Hospital, Oslo, Norway; and.
⁴ Department of Clinical Medicine, University of Bergen, Bergen, Norway; Department of Medicine, Haugesund Hospital, Haugesund, Norway.

Abstract

Background and objectives: Studies and clinical experience suggest that kidney disease clusters in families, but few population-based studies have been performed. This study investigates risks and causes of ESRD in Norwegians with and without a first-degree relative with ESRD.

Design, setting, participants, & measurements: On the basis of data from the Norwegian Population Registry, first-degree relatives for most Norwegians were identified. All Norwegians with ESRD (defined as chronic RRT) since 1980 have been registered in the Norwegian Renal Registry. All Norwegians born in Norway who were alive in 1980 and had at least one registered relative were included. For this study, data on ESRD were available through 2009, and individuals without ESRD were censored at December 31, 2009. Data were analyzed in a cohort design, with ESRD in a first-degree relative of the included person as the main explanatory variable. Risks of ESRD and different causes of ESRD were analyzed using Cox regression statistics.

Results: In total, 5,119,134 individuals were included, of whom 8203 individuals developed ESRD during follow-up and 27,046 individuals had a first-degree relative with ESRD. Compared with individuals without a first-degree relative with ESRD, individuals with a first-degree relative with ESRD had a relative risk of ESRD of 7.2 (95% confidence interval, 6.5 to 8.1). Similar analyses showed that relative risk of ESRD caused by nonhereditary causes was 3.7 (95% confidence interval, 3.1 to 4.4), relative risk of ESRD caused by glomerular disease was 5.2 (95% confidence interval, 4.1 to 6.6), relative risk of ESRD caused by interstitial disease was 4.7 (95% confidence interval, 3.1 to 7.3), relative risk of ESRD caused by diabetic nephropathy was 2.6 (95% confidence interval, 1.6 to 4.1), and relative risk of ESRD caused by hypertensive nephrosclerosis was 2.6 (95% confidence interval, 1.6 to 4.1). Relative risk of nonhereditary parenchymal renal disease was 3.8 (95% confidence interval, 3.1 to 4.7).

Conclusions: As expected, ESRD clusters in families. Interestingly, ESRD without known hereditary cause also clusters in families.

Keywords: ESRD; family history; nephrology.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Child
Cluster Analysis
Female
Genetic Predisposition to Disease
Heredity
Humans
Kidney Failure, Chronic / diagnosis
Kidney Failure, Chronic / epidemiology*
Kidney Failure, Chronic / genetics*
Male
Middle Aged
Norway / epidemiology
Pedigree
Phenotype
Proportional Hazards Models
Registries
Risk Assessment
Risk Factors
Time Factors
Young Adult