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18. Polypharmacy, hospitalization, and mortality risk: a nationwide cohort study.

Author

Chang, Tae Ik, Park, Haeyong, Kim, Dong Wook, Jeon, Eun Kyung, Rhee, Connie M, Kalantar-Zadeh, Kamyar, Kang, Ea Wha, Kang, Shin-Wook, and Han, Seung Hyeok

Abstract

Polypharmacy is a growing and major public health issue, particularly in the geriatric population. This study aimed to examine the association between polypharmacy and the risk of hospitalization and mortality. We included 3,007,620 elderly individuals aged ≥ 65 years who had at least one routinely-prescribed medication but had no prior hospitalization within a year. The primary exposures of interest were number of daily prescribed medications (1-2, 3-4, 5-6, 7-8, 9-10, and ≥ 11) and presence of polypharmacy (≥ 5 prescription drugs per day). The corresponding comparators were the lowest number of medications (1-2) and absence of polypharmacy. The study outcomes were hospitalization and all-cause death. The median age of participants was 72 years and 39.5% were men. Approximately, 46.6% of participants experienced polypharmacy. Over a median follow-up of 5.0 years, 2,028,062 (67.4%) hospitalizations and 459,076 (15.3%) all-cause deaths were observed. An incrementally higher number of daily prescribed medications was found to be associated with increasingly higher risk for hospitalization and mortality. These associations were consistent across subgroups of age, sex, residential area, and comorbidities. Furthermore, polypharmacy was associated with greater risk of hospitalization and death: adjusted HRs (95% CIs) were 1.18 (1.18-1.19) and 1.25 (1.24-1.25) in the overall and 1.16 (1.16-1.17) and 1.25 (1.24-1.25) in the matched cohorts, respectively. Hence, polypharmacy was associated with a higher risk of hospitalization and all-cause death among elderly individuals.

Published
2020

21. Associations of Systolic Blood Pressure With Incident CKD G3-G5: A Cohort Study of South Korean Adults

Author

Chang, Tae Ik, Lim, Hyunsun, Park, Cheol Ho, Rhee, Connie M, Moradi, Hamid, Kalantar-Zadeh, Kamyar, Kang, Ea Wha, Kang, Shin-Wook, and Han, Seung Hyeok

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Kidney Disease, Prevention, Clinical Research, Good Health and Well Being, Adult, Aged, Antihypertensive Agents, Blood Pressure, Cohort Studies, Female, Glomerular Filtration Rate, Humans, Hypertension, Incidence, Male, Middle Aged, Proportional Hazards Models, Renal Insufficiency, Chronic, Republic of Korea, Retrospective Studies, Risk Factors, Systole, BP target, Systolic blood pressure, blood pressure, chronic kidney disease, estimated glomerular filtration rate, healthy adults, hypertension, incident CKD, national cohort, renal function, Public Health and Health Services, Urology & Nephrology, Clinical sciences
Abstract

RATIONALE & OBJECTIVE:Clinical practice guidelines recommend a target blood pressure (BP)

Published
2020

22. Association Between Income Disparities and Risk of Chronic Kidney Disease: A Nationwide Cohort Study of Seven Million Adults in Korea.

Author

Kang, Ea, Kang, Shin-Wook, Han, Seung, Chang, Tae, Lim, Hyunsun, Park, Cheol, Kalantar-Zadeh, Kamyar, and Rhee, Connie

Subjects
Adult, Comorbidity, Female, Glomerular Filtration Rate, Humans, Incidence, Income, Male, Middle Aged, Renal Insufficiency, Chronic, Republic of Korea, Risk
Abstract

OBJECTIVE: To examine the association between income level and incident chronic kidney disease (CKD) in adults with normal baseline kidney function. PATIENT AND METHODS: We studied the association between income level categorized into deciles and incident CKD in a national cohort comprised of 7,405,715 adults who underwent National Health Insurance Service health examinations during January 1, 2009, to December 31, 2015, with baseline estimated glomerular filtration rates (eGFRs) ≥60 mL/min/1.73 m2. Incident CKD was defined as de novo development of eGFR

Published
2020

23. Association Between Income Disparities and Risk of Chronic Kidney Disease A Nationwide Cohort Study of Seven Million Adults in Korea

Author

Chang, Tae Ik, Lim, Hyunsun, Park, Cheol Ho, Rhee, Connie M, Kalantar-Zadeh, Kamyar, Kang, Ea Wha, Kang, Shin-Wook, and Han, Seung Hyeok

Subjects
Biomedical and Clinical Sciences, Prevention, Kidney Disease, Clinical Research, Renal and urogenital, Good Health and Well Being, Adult, Comorbidity, Female, Glomerular Filtration Rate, Humans, Incidence, Income, Male, Middle Aged, Renal Insufficiency, Chronic, Republic of Korea, Risk, Medical and Health Sciences, Biomedical and clinical sciences
Abstract

ObjectiveTo examine the association between income level and incident chronic kidney disease (CKD) in adults with normal baseline kidney function.Patient and methodsWe studied the association between income level categorized into deciles and incident CKD in a national cohort comprised of 7,405,715 adults who underwent National Health Insurance Service health examinations during January 1, 2009, to December 31, 2015, with baseline estimated glomerular filtration rates (eGFRs) ≥60 mL/min/1.73 m2. Incident CKD was defined as de novo development of eGFR

Published
2020

48. Coronary Artery Calcification Score and the Progression of Chronic Kidney Disease

Author

Yun, Hae-Ryong, Joo, Young Su, Kim, Hyung Woo, Park, Jung Tak, Chang, Tae Ik, Son, Nak-Hoon, Yoo, Tae-Hyun, Kang, Shin-Wook, Sung, Suah, Lee, Kyu-Beck, Lee, Joongyub, Oh, Kook-Hwan, Han, Seung Hyeok, Ahn, Curie, Oh, Kook-Hwan, Han, Seung Seok, Lee, Hajeong, Koh, Young Ok, So, Jeongok, Ko, Seonui, Lee, Aram, Chae, Dong Wan, Jeong, Jong Cheol, Cho, Hyun Jin, Oh, Jung Eun, Lee, Kyu Jin, Yoo, Tae-Hyun, Choi, Kyu Hun, Han, Seung Hyeok, Park, Jung Tak, Hong, Hui Kyung, You, Ji Young, Lee, Kyu-Beck, Hyun, Young Youl, Kim, Hyun Jung, Kim, Yong-Soo, Kim, Yaeni, Kim, Sol Ji, Chung, Wookyung, Jung, Ji Yong, Jin, Kwon Eun, Sung, Suah, Min, Hyang Ki, Ku, Ja Yung, Kim, Soo Wan, Kwon, Seong, Bae, Eun Hui, Kim, Chang Seong, Kim, Ha Yeon, Oh, Tae Ryom, Choi, Hong Sang, Kim, Minah, Myeong, Chana, Lee, Jeong Ho, Lee, Ji Seon, Kim, Yeong Hoon, Kang, Sun Woo, Kim, Tae Hee, Kim, Yunmi, Oh, Young Eun, Koo, Ja Ryong, Seo, Jang Won, Baek, Seon Ha, Kim, Myung Sun, Chang, Tae Ik, Park, Kyoung Sook, Choi, Aei Kyung, Oh, Yun Kyu, Lee, Jung Pyo, Lee, Jeong Hwan, Park, Jeong Mi, Seong, Eun Young, Heon, Song Sang, Rhee, Harin, Kim, Hyo Jin, Woon, Kim Da, Ji, Seung Hee, Kim, Young Taek, Na, Ki Ryang, Choi, Dae Eun, Ham, Young Rok, Lee, Eu Jin, and Cha, Yoon Jung

Published
2022
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49. Insomnia in patients on incident maintenance dialysis and the risk of major acute cardio-cerebrovascular events and all-cause mortality.

Author

Kim, Hyung Woo, Heo, Ga Young, Kim, Hyo Jeong, Kang, Shin-Wook, Park, Jung Tak, and Lee, Eun

Subjects
MORTALITY, CHRONIC kidney failure, INSOMNIACS, HEALTH insurance claims, DIALYSIS (Chemistry)
Abstract

Background Insomnia is a known risk factor for cardio-cerebrovascular disease in the general population; however, its effect on cardio-cerebrovascular outcomes in end-stage kidney disease patients is unclear. Therefore, this study aimed to investigate the association between cardio-cerebrovascular outcomes and insomnia in patients who initiated maintenance dialysis. Methods This study used nationwide Korean health insurance claims data to analyze 79   420 patients who initiated maintenance dialysis from January 2009 to December 2017. Insomnia was defined using claim codes and sleep medication prescription data. Patients were categorized according to the presence of insomnia before and after dialysis initiation: (i) no insomnia, (ii) insomnia before dialysis only (improved insomnia), (iii) insomnia after dialysis only (developed insomnia) and (iv) insomnia in both periods (persistent insomnia). The primary and secondary outcomes were major adverse cardiac and cerebrovascular events (MACCE) and all-cause mortality, respectively. The outcome risks were estimated by Cox regression models with inverse probability of treatment weighting. Results The mean age was 61.4 ± 13.4 years, and 39.7% were women. During the transition period from pre-dialysis to maintenance dialysis, 13.2% experienced insomnia. The insomnia groups showed significantly higher risks for MACCE [weighted hazard ratios (95% confidence intervals): developed insomnia, 1.26 (1.25–1.28); improved insomnia, 1.31 (1.29–1.33); persistent insomnia, 1.39 (1.37–1.41)] and higher all-cause mortality risks than the no insomnia group. The insomnia-related cardio-cerebrovascular disease risk elevation was more prominent in younger and male patients. Conclusions Insomnia may increase cardio-cerebrovascular disease and all-cause mortality risk among end-stage kidney disease patients who initiate maintenance dialysis. [ABSTRACT FROM AUTHOR]

Published
2024
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50. Presence of periodontal disease and the incidence of inflammatory arthritides in the general population: data from the UK Biobank.

Author

Yun, Hae-Ryong, Koh, Hee Byung, Park, Jung Tak, Han, Seung Hyeok, Kang, Shin-Wook, Yoo, Tae-Hyun, and Ahn, Sung Soo

Subjects
RHEUMATOID arthritis risk factors, RISK assessment, RESEARCH funding, PERIODONTAL disease, FUNCTIONAL status, MULTIVARIATE analysis, DESCRIPTIVE statistics, AGE distribution, KAPLAN-Meier estimator, QUALITY of life, EARLY diagnosis, CONFIDENCE intervals, BIOMARKERS, PROPORTIONAL hazards models, DISEASE complications
Abstract

Objectives To investigate the association between periodontal disease and the development of inflammatory arthritides in the general population. Methods In total, 489 125 participants from the UK Biobank without a previous history of RA, AS and PsA were enrolled. The primary outcome was the incidence of inflammatory arthritides, which was a composite of RA, AS and PsA according to the presence of periodontal disease based on self-reported oral health indicators. Multivariate Cox proportional hazard regression analyses using four different models were performed to assess the association between periodontal disease and inflammatory arthritides development. Results In all, 86 905 and 402 220 individuals were categorized as with and without periodontal disease, respectively. Cox hazard analysis indicated that the presence of periodontal disease was an independent predictor of the occurrence of composite outcomes of inflammatory arthritides, which was also consistent for RA and AS. Significant associations were found to be consistent in the four Cox models and were replicated even when different criteria were used to define periodontal disease. Subgroup analyses indicated that periodontal disease was associated with an increased RA risk in those aged <60 years, and this risk was persistent for both male and female patients and for patients with seropositive/seronegative RA. Conclusion Self-reported periodontal disease is associated with inflammatory arthritides incidence in participants included in the UK Biobank, particularly for RA and AS. Higher clinical attention and optimal dental care in patients with signs of periodontal disease may be recommended for early disease detection and for reducing this risk. [ABSTRACT FROM AUTHOR]

Published
2024
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