RESUMO
BACKGROUND AND OBJECTIVES: Chronic kidney disease (CKD) significantly contributes to the socio-economic burden both in China and worldwide. Previous research has shown that experiencing childhood famine is linked to various chronic conditions like diabetes, hypertension, and proteinuria. However, the long-term effects of early life famine exposure on adult kidney function remain unclear. This study investigates whether exposure to the Chinese Great Famine (1959-1962) is associated with a decline in glomerular filtration rate (GFR) later in life. MATERIALS AND METHODS: CHARLS is a population-based observational study. We analyzed data from 8,828 participants in the 2011-2012 baseline survey, updated in 2014. Participants were categorized based on their birth year into fetal-exposed (1959-1962), childhood-exposed (1949-1958), adolescence/adult-exposed (1912-1948), and non-exposed (1963-1989) groups. The estimated GFR (eGFR) was calculated using the CKD-EPI-Cr-Cys equation (2021), with CKD defined as an eGFR below 60 mL/min/1.73 m2. RESULTS: Average eGFR values were 103.0, 96.8, 91.2, and 76.3 mL/min/1.73 m2 for the fetal-exposed, childhood-exposed, adolescence/adult-exposed, and non-exposed groups, respectively. The eGFR in the exposed groups was significantly lower compared to the non-exposed group. Specifically, famine exposure correlated with a lower eGFR (CE -9.14, 95%CI -9.46, -8.82), with the strongest association observed in the adolescence/adult-exposed group (CE -26.74, 95%CI -27.75, -25.74). Adjusting for variables such as demographics, physical and laboratory tests, complications, and personal habits like smoking and drinking did not qualitatively alter this association (CE -1.38, 95%CI -1.72, -1.04). Further stratification by sex, body mass index (BMI), alcohol consumption history, hypertension, diabetes, CESD score, and education level showed that the association remained consistent. CONCLUSIONS: Exposure to famine during different life stages can have enduring effects on GFR decline in humans.