Title of article :
Diabetes, Hypertension, and Incidence of Chronic Kidney Disease: Is There any Multiplicative or Additive Interaction?
Author/Authors :
Erfanpoor, Saeed Department of Epidemiology - School of Public Health - Iran University of Medical Sciences, Tehran, Iran , Etemad, Koorosh Department of Epidemiology - School of Public Health - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Kazempour, Sara Endocrinology and Metabolism Research Institute - Tehran University of Medical Sciences, Tehran, Iran , Hadaegh, Farzad Prevention of Metabolic Disorders Research Center - Research Institute for Endocrine Sciences - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Hasani, Jalil Kashmar School of Nursing - Mashhad University of Medical Sciences, Mashhad, Iran , Azizi, Fereidoun Endocrine Research Center - Research Institute for Endocrine Sciences - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Parizadeh, Donna Prevention of Metabolic Disorders Research Center - Research Institute for Endocrine Sciences - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Khalili, Davood Prevention of Metabolic Disorders Research Center - Research Institute for Endocrine Sciences - Shahid Beheshti University of Medical Sciences, Tehran, Iran
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 :
Interaction , Chronic Kidney Disease , Hypertension , Diabetes
