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Am J Kidney Dis. 2017 Nov;70(5):619-626. doi: 10.1053/j.ajkd.2017.05.007. Epub 2017 Jun 26.

Family Aggregation and Heritability of ESRD in Taiwan: A Population-Based Study.

Author information

1
Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Medicine, Chang Gung University, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan.
2
Department of Rheumatology, Allergy, and Immunology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan; Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
3
Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Medicine, Chang Gung University, Taoyuan, Taiwan.
4
Department of Rheumatology, Allergy, and Immunology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
5
Biostatistics Core Laboratory, Molecular Medicine Research Centre, Chang Gung University, Taoyuan, Taiwan.
6
Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
7
Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address: dryctian@cgmh.org.tw.

Abstract

BACKGROUND:

Aggregation of end-stage renal disease (ESRD) has been observed in families of European origin, as well as those of African origin. However, it is not well documented if this disease aggregates in Asian families. Furthermore, the contribution of genetic factors and shared environmental factors to family aggregation remains unclear.

STUDY DESIGN:

Population-based cross-sectional cohort study.

SETTING & PARTICIPANTS:

All 23,422,955 individuals registered in the Taiwan National Health Insurance Research Database in 2013. Among these, 47.45%, 57.45%, 47.29%, and 1.51% had a known parent, child, sibling, or twin, respectively. We identified 87,849 patients who had a diagnosis of ESRD.

PREDICTOR:

Family history of ESRD.

OUTCOMES & MEASUREMENTS:

ESRD and heritability defined as the proportion of phenotypic variance attributable to genetic factors.

RESULTS:

Having an affected first-degree relative with ESRD was associated with an adjusted relative risk of 2.46 (95% CI, 2.32-2.62). Relative risks were 96.38 (95% CI, 48.3-192.34) for twins of patients with ESRD, 2.15 (95% CI, 2.02-2.29) for parents, 2.78 (95% CI, 2.53-3.05) for offspring, 4.96 (95% CI, 4.19-5.88) for siblings, and 1.66 (95% CI, 1.54-1.78) for spouses without genetic similarities. Heritability in this study was 31.1% to 11.4% for shared environmental factors and 57.5% for nonshared environmental factors.

LIMITATIONS:

This was a registry database study and we did not have detailed information about clinical findings or the definite causes of ESRD.

CONCLUSIONS:

This whole population-based family study in Asia confirmed, in a Taiwanese population, that a family history of ESRD is a strong risk factor for this disease. Moderate heritability was noted and environmental factors were related to disease. Family history of ESRD is an important piece of clinical information.

KEYWORDS:

Asia; End stage renal disease (ESRD); Taiwan; environmental risk factors; family aggregation; family history of ESRD; family transmission; heritability; risk factor

PMID:
28663061
DOI:
10.1053/j.ajkd.2017.05.007
[Indexed for MEDLINE]
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