Full
Outline
To investigate the longitudinal association of baseline chronic kidney disease (CKD) status and estimated glomerular filtration rate (eGFR) levels with the risk of incident knee osteoarthritis (KOA) among middle-aged and older Chinese adults, and to provide epidemiological evidence for the pathological crosstalk of the “kidney-bone axis”.
This study utilized longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS, 2011—2018). A total of 4 182 participants aged 45 years and older, free of KOA at baseline and with complete covariate data, were included. Missing data were handled using multiple imputation. The association between baseline CKD [defined as eGFR <60 ml/ (min·1.73m2) ] and incident KOA was analyzed using Kaplan-Meier survival curves and multivariatble Cox proportional hazards regression models. Restricted cubic spline (RCS) modeling was employed to examine the dose-response relationship between eGFR levels and KOA risk. Subgroup analyses and lag analyses were conducted to verify the robustness of the results.
During an average follow-up of 4 years, the cumulative incidence of incident KOA was significantly higher in the CKD group compared to the non-CKD group (Log-rank P<0.001). Multivariable Cox regression analysis demonstrated that, after adjusting for demographics, lifestyle factors, body mass index (BMI), and chronic comorbidities, baseline CKD remained an independent risk factor for incident KOA [hazard ratio (HR) =1.82, 95% confidence interval (CI) : 1.30-2.55, P<0.001]. RCS analysis revealed no significant linear or non-linear dose-response relationship between baseline eGFR levels and KOA risk in the total population (P for overall association =0.348), suggesting a pathological threshold effect of renal function on KOA. Sensitivity analyses confirmed the robustness of these findings.
CKD is an independent risk factor for incident KOA among middle-aged and older Chinese adults, characterized by a potential pathogenic threshold effect at an eGFR of <60 ml/ (min·1.73m2). Integrated management of joint health in CKD patients should be prioritized, employing early screening to achieve comprehensive prevention and treatment of “kidney-bone/joint” comorbidities.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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