Risk Factors For Chronic Kidney Disease Research Articles

The liver-kidney axis: Is serum leptin a potential link in non-alcoholic fatty liver disease-associated chronic kidney disease?

Background and study aimsNon-alcoholic fatty liver disease (NAFLD) is an independent risk factor for chronic kidney disease (CKD). Previous studies argued that leptin levels increase significantly with the progression of CKD. But the association between leptin and CKD has not been investigated in patients with NAFLD. Therefore, we conducted this study to establish whether increased leptin level is associated with CKD in NAFLD patients. Patients and methodsIn our prospective study with a follow up period of six months thirty-five teetotaller biopsy-proven NAFLD patients were divided as groups with mild, versus advanced, fibrosis. Liver fibrosis was also assessed with Fibroscan. Serum leptin levels were measured by radioimmunoassay. For insulin resistance we used the homeostasis model assessment method (HOMA-IR). For the kidney function, we used the abbreviated formula Modification of Diet in Renal Disease (MDRD) formula, which estimates GFR. For statistical analysis, Student’s-t test, Mann-Whitney test, linear regression-binary logistic regression analyses and the ROC curve analysis were used. ResultsAdvanced fibrosis and increased HOMA-IR were risk factors for decreased eGFR. Leptin correlated inversely with advanced fibrosis (p: 0.03) and low leptin was a risk factor for CKD (p: 0.02). In ROC curve analysis, advanced fibrosis and low leptin were risk factors for decreased eGFR (p: 0.007 and 0.004, respectively). Low leptin level was dependently associated with decreased eGFR. ConclusionAdvanced fibrosis in NAFLD patients is a risk factor for CKD. Leptin correlated inversely with advanced fibrosis. Unlike the previous studies, which were not performed in NAFLD patients, we found decreased leptin in NAFLD patients with decreased eGFR. Low leptin level was found to be a dependent predictor for differentiating NAFLD patients with high risk for CKD.

Prevalence and risk factors of chronic kidney disease among patients with type 2 diabetes mellitus at a tertiary care hospital in Nepal: a cross-sectional study

ObjectiveTo estimate the prevalence of chronic kidney disease (CKD) among patients with type 2 diabetes mellitus (T2DM) and determine the sociodemographic and clinical risk factors associated with CKD.Design and settingsCross-sectional...

Evaluation of glomerular hyper filtration in obesity: Which formula to use?

Introduction: Obesity is a progressive chronic disease that is a renal risk factor. Renal hyperfiltration is an early stage in the development of chronic kidney disease (CKD). The objective of our study is to determine the prevalence of glomerular hyperfiltration in obese patients. Materials and Methods: This is a prospective and descriptive study conducted over a period of 4 months. All patients with BMI over 30 kg/m2 who do not have diabetes, hypertension or another apparent cause of CKD. Results: A total of 85 patients were included, the mean age was 41.96 years, with a female majority. The mean BMI was 38.24kg/m2 and the mean abdominal waist circumference was 114.57cm. Obesity was common in 55.88% and secondary in 44.11%. The prevalence of glomerular hyperfiltration was 85.18% by Cockcroft formula and 48.33% by MDRD formula. Discussion: Obesity is a risk factor for CKD, which promotes increased renal blood flow by vasodilation of the afferent glomerular arteriole, resulting in glomerular hyperfiltration that leads to a change in the glomerular barrier, increasing the risk of developing CKD. According to several studies, the Cockcroft formula is a better predictor of renal function in obese patients. A 51% increase in GFR in obese patients has been observed. In our study, the prevalence of glomerular hyperfiltration is 85.18% according to the Cockcroft formula. Conclusion: Obesity is a risk factor for CKD that needs to be carefully considered.

Long-term lithium therapy and risk of chronic kidney disease, hyperparathyroidism and hypercalcemia: a cohort study

BackgroundLithium is well recognized as the first-line maintenance treatment for bipolar disorder (BD). However, besides therapeutic benefits attributed to lithium therapy, the associated side effects including endocrinological and renal disorders constitute important parameters in prescribing patterns and patient adherence. The objectives of this study is to (i) determine whether long-term lithium therapy is associated with a decrease in renal function, hyperparathyroidism and hypercalcemia and (ii) identify risk factors for lithium-induced chronic kidney disease (CKD).MethodsWe conducted a single-centered cohort study of adult patients (≥ 18 years) treated with lithium, who were enrolled at Rennes University Hospital in France between January 1, 2018 and June 1, 2020. Required data were collected from the patient’s medical records: demographics characteristics (age, sex, body mass index), biologic parameters (GFR, lithium blood level, PTH and calcium), medical comorbidities (hypertension and diabetes), lithium treatment duration and dosage, and length of hospitalization.ResultsA total of 248 patients were included (mean age: 60.2 ± 16.5 years). Duration of lithium treatment correlated with (i) deterioration of renal function estimated at − 2.9 mL/min/year (p < 0.0001) and (ii) the development of hyperparathyroidism (p < 0.01) and hypercalcemia (p < 0.01). We also noted that patients with lithium blood level > 0.8 mEq/mL had significantly lower GFR than patients with lithium blood level < 0.8 mEq/mL (61.8 mL/min versus 77.6 mL/min, respectively, p = 0.0134). Neither diabetes mellitus nor hypertension was associated with more rapid deterioration of renal function.ConclusionThis study suggests that the duration of lithium treatment contribute to the deterioration of renal function, raising the question of reducing dosages in patients with a GFR < 60 mL/min. Overdoses has been identified as a risk factor for CKD, emphasizing the importance of regular re-evaluation of the lithium dose regimen. Also, long-term lithium therapy was associated with hyperparathyroidism and hypercalcemia. Particular vigilance is required on these points in order to limit the occurrence of endocrinological and renal lithium adverse effects.

Obesity-related kidney disease: Beyond hypertension and insulin-resistance.

Chronic kidney disease (CKD) causes considerable morbidity, mortality, and health expenditures worldwide. Obesity is a significant risk factor for CKD development, partially explained by the high prevalence of diabetes mellitus and hypertension in obese patients. However, adipocytes also possess potent endocrine functions, secreting a myriad of cytokines and adipokines that contribute to insulin resistance and induce a chronic low-grade inflammatory state thereby damaging the kidney. CKD development itself is associated with various metabolic alterations that exacerbate adipose tissue dysfunction and insulin resistance. This adipose-renal axis is a major focus of current research, given the rising incidence of CKD and obesity. Cellular senescence is a biologic hallmark of aging, and age is another significant risk factor for obesity and CKD. An elevated senescent cell burden in adipose tissue predicts renal dysfunction in animal models, and senotherapies may alleviate these phenotypes. In this review, we discuss the direct mechanisms by which adipose tissue contributes to CKD development, emphasizing the potential clinical importance of such pathways in augmenting the care of CKD.

Association Between CKD, Obesity, Cardiometabolic Risk Factors, and Severe COVID-19 Outcomes

Chronic kidney disease (CKD) is a risk factor for acquiring severe COVID-19, but underlying mechanisms are unknown. We aimed to study the risk associated with CKD for severe COVID-19 outcomes in relation to body mass index (BMI) and diabetes because they are common risk factors for both CKD and severe COVID-19. This nationwide case-control study with data from mandatory national registries included 4684 patients (cases) admitted to the intensive care units (ICUs) requiring mechanical ventilation and 46,840 population-based controls matched by age, sex, and district of residency. Logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs) for associations between severe COVID-19 and exposures with adjustment for confounders, in subgroups by BMI, and matched by type 2 diabetes. The median age was 64 years, and 27.7% were female. CKD was observed in 5.4% of the cases and 1.5% of the controls, whereas 1.9% and 0.3% had end-stage CKD, respectively. CKD was associated with severe COVID-19 (OR, 2.20 [95% CI, 1.85-2.62]), continuous renal replacement therapy (CRRT) in ICU (OR, 7.36 [95% CI, 5.39-10.05]), and death any time after ICU admission (OR, 2.51 [95% CI, 1.96-3.22]). The risk associated with CKD for severe COVID-19 did not differ significantly by weight but was higher in those without diabetes (OR, 2.76 [95% CI, 2.15-3.55]) than in those with diabetes (OR, 1.88 [95% CI, 1.37-2.59]). CKD, especially end-stage CKD, is an important risk factor for severe COVID-19 and death after ICU admission also in patients with normal BMI and without type 2 diabetes.

Association of a low ankle brachial index with progression to end-stage kidney disease in patients with advanced-stage diabetic kidney disease

Introductions The effect of a low ankle-brachial index (ABI) in patients with advanced-stage diabetic kidney disease is not fully understood. This study investigates the prevalence of a low ABI in patients with advanced-stage diabetic kidney disease, which was defined as a urinary albumin-to-creatinine ratio (UACR) ≥300 mg/g and an estimated glomerular filtration rate (eGFR) between 15–60 mL/min/1.73 m2. Furthermore, the association between a low ABI and end-stage kidney disease (ESKD) was determined. Methods This single-center, retrospective, cohort study included 529 patients with advanced-stage diabetic kidney disease who were stratified into groups according to the ABI: high (>1.3), normal (0.9–1.3), and low (<0.9). The Kaplan-Meier method and Cox proportional analysis were used to examine the association between the ABI and ESKD. Results A total of 42.5% of patients with a low ABI progressed to ESKD. A low ABI was associated with a greater risk of ESKD (hazard ratio (HR): 1.073). After adjusting for traditional chronic kidney disease risk factors, a low ABI remained associated with a greater risk of ESKD (HR: 1.758; 95% confidence interval: 1.243–2.487; p = 0.001). Conclusions These results indicate that patients with a low ABI should be monitored carefully. Furthermore, preventive therapy should be considered to improve the long-term kidney survival of patients with residual kidney function.

Prevalence and Geographic Distribution of Self-Reported Chronic Kidney Disease and Potential Risk Factors in Central America

Cases for chronic kidney disease of unknown etiology (CKDu) are increasing in specific disease hotspots located in rural agricultural communities over Central America. The goal of the study was to estimate the prevalence and geographic distribution of self-reported work-related CKD and associated risk factors for CKDu by industry sector in Central America. We calculated the prevalence and distribution of self-reported CKD, work-related CKD, and suspected CKDu risk factors among the 9032 workers in the Second Central American Survey of Working Conditions and Health (II ECCTS, 2018). We mapped the distribution of suspected CKDu risk factors to work-related CKDu and weather conditions using average annual temperatures. The primary and secondary industry sectors showed the highest proportion of males, suspected CKDu risk factors, and work-related CKD. Age (30-49 years: OR = 2.38, 95% CI 1.03-5.51), ethnicity (mestizo: OR, 7.44, 95% CI: 2.14-25.82), and exposure to high physical work demands (OR = 2.45, 95% CI: 1.18-5.09) were associated with work-related CKD. The majority of work-related CKD were reported in the western parts of Honduras and Nicaragua, in hot temperature regions, and overlapped with those areas with a high density of CKDu risk factors. Finally, some areas clustered CKDu risk factors without any work-related CKD points, mainly in the western part of Guatemala. Our findings supplement prior CKDu findings regarding a high prevalence of work-related CKD among 30- to 49-year-old mestizo males in the primary and secondary sectors, in hot temperature areas, in the central and western region, and overlapping with persons reporting two or more CKDu risk factors. Moreover, several geographic areas with CKDu risk factor clusters had no reported work-related CKD. These areas represent new industries and sectors to be monitored for possible future increases of CKDu cases.

Risk Factors of Chronic Kidney Disease (CKD) in Type 2 Diabetes Mellitus (DM) Patients at Dr. Soetomo General Academic Hospital, Surabaya

Highlights:1. The highest risk was a history of hypertension, followed by a history of low HDL levels.2. Patients with type 2 DM at Dr. Soetomo General Academic Hospital, Surabaya, had a greater risk of developing CKD for patients with a history of hypertension (3.801 times higher) and patients with a history of low HDL (3.356 times higher). AbstractIntroduction: Type 2 diabetes mellitus (DM), categorized as a non-communicable disease, has become a global health concern. This study aimed to identify the risk factors for chronic kidney disease (CKD) in type 2 DM patients at Dr. Soetomo General Academic Hospital, Surabaya.Methods: This was a case-control study. The samples were collected using consecutive sampling methods from the medical records Dr. Soetomo General Academic Hospital, Surabaya. The total samples were 158 patients consisting of 79 cases and 79 controls. Independent variables were a history of uncontrolled HbA1c levels; hypertension; high triglyceride (TG) levels; low high-density lipoprotein (HDL) levels, high low-density lipoprotein (LDL) levels, and being overweight. The dependent variable was CKD. Samples were analyzed using the Chi-Square test and logistic regression.Results: From six independent variables that were analyzed, two variables had significant results based on the Chi-Square test. Logistic regression was performed and showed the significant results between risk factors of CKD and type 2 DM patients at Dr. Soetomo General Academic Hospital, Surabaya, were a history of hypertension (OR = 3.801, 95% CI = 1.875-7.706) and a history of low HDL levels (OR = 3.356, 95% CI = 1.650-6.827). The highest risks were a history of hypertension followed by a history of low HDL levels.Conclusion: Type 2 DM patients at Dr. Soetomo General Academic Hospital, Surabaya, with a history of hypertension and a history of low HDL had a greater risk of developing CKD.

Late-onset Chronic Kidney Disease Over 2 Decades After Pediatric Liver Transplantation: A Single-center, Retrospective Study.

Although chronic kidney disease (CKD) after liver transplantation (LTx) is a common complication in adults, its long-term significance after pediatric LTx remains unclear. We examined the decades-long transition of renal function and revealed the risk factors for late-onset CKD after pediatric LTx in a single-center retrospective cohort of 117 pediatric LTx recipients who survived >5 y. The estimated glomerular filtration rate (eGFR) and CKD stages were calculated using serum creatinine. Risk factor analysis for late-onset CKD was performed in 41 patients whose eGFR could be evaluated at >20 y after LTx. The median age at LTx was 1.3 y, and most primary diagnoses were biliary atresia (77%). The mean pre-LTx and 1, 5, 10, 20, and >20 y post-LTx eGFRs were 180, 135, 131, 121, 106, and 95 mL/min/1.73 m 2 , respectively, with a median renal follow-up period of 15 y. The eGFR declined by 47% at >20 y after LTx ( P < 0.001). CKD was observed in 8%, 19%, and 39% of cases at 10, 20, and >20 y after LTx, respectively. In patients receiving cyclosporine, trough levels were 1.5 times higher in those with CKD up to 10 y after LTx. The multivariate analysis showed that older age at LTx (odds ratio, 1.3 by 1 y; P = 0.008) and episodes of repeated/refractory rejection (odds ratio, 16.2; P = 0.002) were independent risk factors of CKD >20 y after LTx. In conclusion, renal function deteriorates slowly yet steadily after pediatric LTx. Long-term careful surveillance is essential after pediatric LTx, especially in repeated/refractory rejection or long-term high trough-level use of cyclosporine cases.

Risk Factors for Incident CKD in Black and White Americans: The REGARDS Study

Little information exists on the incidence of and risk factors for chronic kidney disease (CKD) in contemporary US cohorts and whether risk factors differ by race, sex, or region in the United States. Observational cohort study. 4,198 Black and 7,799White participants aged at least 45years, recruited from 2003 through 2007across the continental United States,with baseline estimated glomerular filtration rate (eGFR)>60mL/min/1.73m2 and eGFRassessed again approximately 9 years later. Age, sex, race (Black or White), region ("stroke belt" or other), education, income, systolic blood pressure, body mass index, diabetes, coronary heart disease, hyperlipidemia, smoking, and albuminuria. (1) eGFR change and (2) incident CKD defined as eGFR<60mL/min/1.73m2 and≥40% decrease from baseline or kidney failure. Linear regression and modified Poisson regression were used to determine the association of risk factors with eGFR change and incident CKD overall and stratified by race, sex, and region. Mean age of participants was 63±8 (SD) years, 54% were female, and 35% were Black. After 9.4±1.0 years of follow-up, CKD developed in 9%. In an age-, sex-, and race-adjusted model, Black race (β=-0.13; P<0.001) was associated with higher risk of eGFR change, but this was attenuated in the fully adjusted model (β=0.02; P=0.5). Stroke belt residence was independently associated with eGFR change (β=-0.10; P<0.001) and incident CKD (relative risk, 1.14 [95% CI, 1.01-1.30]). Albuminuria was more strongly associated with eGFR change (β of-0.26 vs-0.17; P=0.01 for interaction) in Black compared with White participants. Results were similar for incident CKD. Persons of Hispanic ethnicity were excluded; unknown duration and/or severity of risk factors. Established CKD risk factors accounted for higher risk of incident CKD in Black versus White individuals. Albuminuria was a stronger risk factor for eGFR decrease and incident CKD in Black compared with White individuals. Living in the US stroke belt is a novel risk factor for CKD.

Racial and Ethnic Differences in Chronic Kidney Disease and Its Risk Factors among Asian-Americans and Pacific Islanders in Hawaii

Background: Several studies suggest that Asian-American and Native Hawaiian and Other Pacific Islander (NHOPI) racial/ethnic groups have a heightened risk of chronic kidney disease (CKD), but provide limited inference due to the aggregation of these groups into a single racial/ethnic category. We thus examined the association of granularly defined racial/ethnic groups with specific CKD indicators among a diverse group of participants from the National Kidney Foundation of Hawaii’s Kidney Early Detection Screening (KEDS) Program. Methods: Among 1,243 participants enrolled in 19 KEDS screening events over 2006–2009, we examined the association between Asian-American and NHOPI groups and specific CKD indicators, defined as self-reported CKD, microalbuminuria, and macroalbuminuria, using multivariable logistic regression. We then examined associations of race/ethnicity with various CKD risk factors. Results: The most predominant racial/ethnic groups were White (22.0%), Multiracial (18.9%), Japanese (19.2%), Filipino (13.4%), NHOPI (8.4%), and Chinese (4.5%) participants. NHOPI and Chinese participants had a higher risk of microalbuminuria (adjusted ORs [aORs] [95% CIs] 2.48 [1.25–4.91] and 2.37 [1.07–5.27], respectively), while point estimates for all other minority groups suggested higher risk (reference: Whites). NHOPI participants also had a higher risk of macroalbuminuria and self-reported CKD. While most minorities had a higher risk of diabetes and hypertension, NHOPI and Multiracial participants had a higher risk of obesity, whereas the East Asian groups had a lower risk. Conclusions: In this community-based cohort, compared with Whites, Asian-Americans had a higher risk of early CKD indicators, whereas NHOPIs had a higher risk of more severe CKD indicators. Further studies are needed to elucidate the distinct pathways leading to CKD across diverse racial/ethnic groups in Hawaii.

Knowledge and familiarity of chronic kidney disease risk factors among Saudi populations

Knowledge and familiarity of chronic kidney disease risk factors among Saudi populations

Assessment of Knowledge, Attitudes and Practices Regarding Chronic Kidney Disease in at-Risk Individuals

Background: Chronic kidney disease (CKD) is a global health problem, with a worldwide prevalence of around 9.1 per cent (as of 2017). In India, its prevalence was found to be around 17.2%. There are several risk factors of CKD, out of which the presence of underlying longstanding uncontrolled diabetes mellitus (DM) and hypertension are common. Certain previous studies have tried to assess the level of knowledge, attitudes and practices of such a ‘high risk’ group for developing CKD but there is a paucity of literature on it. Hence, this study was undertaken to assess these domains in individuals at risk for developing CKD. Patients and Methods: It is an observational cross-sectional study conducted from October 2020 to December 2021 at a tertiary care teaching and referral hospital in India. A total of 215 patients who were at risk of developing CKD, were enrolled and were given a CKD Screening Index questionnaire to fill and scoring was done for all three components-knowledge, attitudes and practices. Results: The mean age was found to be 49.21 ± 13.49 years with a male: female ratio of 1.4:1. Nearly three-a fourth of the patients were having DM while one-fourth of the participants had a previous history of hypertension. The mean scores on the knowledge, attitude and practices scales were found to be 11.80 ± 5.31, 50.18 ± 8.23 and 30.83 ± 7.53 respectively. The study results revealed that the majority of patients had ‘low’ levels of knowledge scores but ‘average’ levels of attitude and practice scores. A significant correlation was found amongst knowledge and attitude scores (r = 0.226, P = 0.001), knowledge and practice scores (r = 0.153, P = 0.025) and practice and attitude scores (r = 0.295, P = 0.000) of our patients. Conclusion: There is a need of improving awareness at least amongst the population at risk of getting CKD. Improving knowledge would help in inculcating positive attitudes and healthier practices amongst these, thus delaying the onset of this disease.

Prevalence of Chronic Kidney Disease of Uncertain Etiology Within Selected Farming Communities in Rural Sri Lanka.

Chronic kidney disease of uncertain etiology (CKDu) is an emergent health concern, particularly in tropical farming communities in several global hotspots, including Sri Lanka. This particular nephropathy is characterized by a progressive decline in kidney function in the absence of conventional chronic kidney disease (CKD) risk factors such as diabetes mellitus, hypertension, and other identifiable kidney disorders. As it is almost asymptomatic at early stages, CKDu is mostly diagnosed at late stages with significant kidney damage. Hence, the identification of disease susceptibility and vulnerable communities at the earliest possible instances is highly important for the management of the disease. We aimed to compare kidney health across three different farming communities in Sri Lanka to identify CKDu susceptibilities. A cross-sectional study was performed with three selected farming communities: paddy farmers (PF; N = 581), sugarcane farmers (SF; N = 550), and vegetable farmers (VF; N = 244) in comparison with an age-matched control group of nonfarming (NF; N = 225) individuals. A medical examination was performed to investigate health status and medical history, whereas a urinalysis was performed to determine creatinine and albumin contents. Estimated glomerular filtration rate (eGFR) and urinary albumin-creatinine ratio (ACR) were used for assessment of kidney function. CKDu susceptibility was determined based on eGFR, and urinary ACR adhering to the clinical practice guidelines in Sri Lanka. The median (interquartile range [IQR]) eGFR levels of PF (85 mL/min/1.73 m2 [72-97]) and SF (93 mL/min/1.73 m2 [73-112]) were significantly lower than that of the NF group (103 mL/min/1.73 m2 [87-125]) (P < .0001), whereas eGFR of VF (100 mL/min/1.73 m2 [80-111]) was not significantly different compared with NF. The median (IQR) urinary ACR levels of the study groups, PF, SF, VF, and NF, were 0.59 (0.26-1.45), 0.46 (0.28-0.88), 0.45 (0.34-0.90), and 0.44 (0.34-1.02) mg/mmol, respectively. However, urinary ACR did not differ significantly across the study groups (P > .05). The prevalence of CKDu within PF (13.60%), SF (12.54%), and VF (6.67%) communities was significantly higher (P < .05) compared with the NF (2.67%). Of the total CKD cases, CKDu susceptible cases represented 73%, 69%, 50%, and 25% in PF, SF, VF, and NF, respectively, indicating a high risk of CKDu susceptibility among farming communities. Moreover, a noteworthy association of CKDu was observed with agrochemical exposure (odds ratio [OR] = 3.11, 95% confidence interval [CI] = 1.36-7.09). Concerning the farming practices, sugarcane farming showed the highest association with CKDu prevalence (OR = 3.40, 95% CI = 1.49-7.78). Compared with the nonfarming group, a significant risk of CKDu was observed in the three farming communities, particularly among paddy and sugarcane farmers. Longitudinal epidemiological studies to identify vulnerable farming communities and associated risk factors are critically needed to develop effective management strategies against CKDu within farming communities.

PS-C27-11: HYPERTENSION AND LOW EGFR AMONG MALE OCCUPATIONAL AUTO-RICKSHAW DRIVERS FROM NORTH INDIA- SCREENING FOR CHRONIC KIDNEY DISEASE RISK FACTORS

Objective: To find out the prevalence of low estimated Glomerular Filtration Rate (eGFR) and major Chronic Kidney Disease (CKD) risk factors such as hypertension, Diabetes Mellitus, obesity among male occupational auto-rickshaw drivers as they are highly exposed to air pollution. Design and method: The study population included male auto-rickshaw drivers of more than or equal to 18 years of age and driving for at least one year. Participant's demography (height, weight, waist circumference), and blood pressure were measured and medical history, history of substance abuse, and occupation history was obtained in a structured questionnaire. Blood and urinalysis were performed for measurement of serum creatinine, uric acid, and proteinuria respectively. eGFR was measured using the CKD-EPI equation. Results: A total of 900 male auto-rickshaw drivers were enrolled in the study. Age varied from 19 to 75 (mean 39.56 ± 10.5 years). 59.6% had less than 15 years of experience in driving an auto-rickshaw (mean 13.1 ± 9.7 years) with daily working hours of 10.3 ± 2.1. Among 900 participants, 3.9% had low eGFR (less than 60 ml/min), and 8.7% had proteinuria (more than 30 mg/dl). Prevalence of CKD, hypertension, and diabetes was found to be 3.9% (stage - 1 to stage - 4; 6.4%, 1.3%, 3.4%, 0.5% respectively), 37% and 8.4% respectively. One-third (33.6%) of auto-rickshaw drivers were newly diagnosed with hypertension and 15 (2.7%) were new-onset diabetic. Around one-fourth (24.5%) of autorickshaw drivers were prevalent with hyperuricemia (serum uric acid more than 7 mg/dl) and 5% were anemic (Hb (less than 13 gm/dl). Approximately 42% of the participants were overweight or obese (BMI more than 25 kg/m2) and central obesity was found in 7.4% (more than 102 cm) participants. Tobacco products and alcohol use among auto/taxi drivers were high (63% and 23.5% respectively). Conclusion: High prevalence of CKD and associated risk factors such as hypertension, diabetes, obesity hyperuricemia, and anemia were observed in male occupational auto-rickshaw drivers. A routine screening program should be implemented for primary prevention and management of risk factors of CKD among such populations that are highly exposed to air pollution.

Prevalence of Chronic Kidney Disease and Associated Factors among HIV Patients in the Era of HAART in Ivory Coast: A Cross Sectional, Analytical Study

Background: Chronic kidney disease (CKD) may be common among HIV patients living in sub-saharan Africa due to the confluence of CKD risk factors and genetic predisposition. Preventive strategy through early detection and treatment has been advocated for CKD in Africa where majority of patients present late and cannot afford the cost of renal replacement therapy which is not widely available. The purpose of this study was to identify the prevalence and factors associated with CKD among HIV infected adults receiving HAART in a teaching hospital in Ivory Coast. Methods: This is a cross-sectional study of HIV patients on Highly Active Anti Retroviral Therapy followed at the HIV clinic of the medical out-patient department of the University teaching hospital of Bouaké from January to December 2021. CKD was defined as a serum creatinine-based estimated glomerular filtration rate ≤ 60 ml/min/1.73 m2. The collected data was analyzed by using Epi Info 2002 software. Results: Four hundred and two HIV-infected adults 18 years and over were recruited during the study period. We noticed 123 (30.6%) males. The mean age was 40 years. CKD was observed in 42 (10.44) patients infected-HIV. Eighty eight point three percent of patients had CD4 more than 500 cells. Low eGFR correlated with age more than 60 years old, worker in public sector, unemployed, no formal education and HIV type 2. Conclusion: Our study identified a prevalence of CKD of 10.44% by CKD EPI equations among HIV patients on HAART that attended the teaching hospital of Bouaké in Ivory Coast. Early screening and follow up of renal functions is important to minimize the risk of developing end stage kidney disease.

Prevalence of Chronic Kidney Disease Among Diabetes and Hypertensive Patients in a Teaching Hospital in Ekiti State, Southwest Nigeria

Introduction: Chronic kidney disease (CKD) is a growing public health problem associated with enormous economic burdens, reduced quality of life, and untimely deaths, predominantly in developing countries. Aims: The study determines the prevalence and risk factors for CKD among diabetes and hypertensive patients in a teaching hospital in Ekiti State. Methods: Descriptive and cross-sectional research designs were employed using a quantitative strategy. Two hundred (200) randomly selected participants participated in the study. Socio-demographic data, awareness, and risk factors for CKD were determined using a standardized questionnaire, while CKD prevalence was investigated with biophysical measurements and laboratory investigations. Descriptive analyses were used to answer the research questions, while inferential statistics were used to test hypotheses at a significant level of p &lt; 0.05. Results: Findings revealed that 50% and 57.1% of the diabetics and hypertensives were above 60 years, 36.7% of the people with diabetes had comorbidity, while only 2% and 3.1% of diabetics and hypertensives participants had a family history of CKD. The study revealed that the respondents' level of awareness of CKD was inadequate. Major risk factors of CKD identified among the respondents were already diagnosed with diabetes and hypertension, age above 60 years (50% and 57.1%), herbal concoction (77.7% and 73.5%), and NSAID (74.5% and 78.6%). The prevalence of CKD for people with diabetes was 39.8%, while 57.1% for hypertensives. There was a significant relationship between respondents’ level of education and awareness of CKD (X2 =44.20, p=&lt;0.001). The prevalence of CKD among the studied population was high. Conclusion: Efforts should be intensified by nurses and all other stakeholders on awareness and prevention programs for CKD. Furthermore, the promotion of patients’ satisfaction with the quality of healthcare services should be the goal to promote positive health outcomes.

Association of polypharmacy with incidence of CKD: a retrospective cohort study.

Polypharmacy is common in patients with chronic kidney disease (CKD) and is associated with a decline in kidney function. However, its impact on patients without CKD has not been adequately elucidated. Therefore, we aimed to investigate the association between polypharmacy and the incidence of CKD. We conducted retrospective cohort study using 1221 participants who were enrolled in the Fukushima Cohort Study with one or more risk factors of CKD, an estimated glomerular filtration rate (eGFR) of ≥ 60mL/min/1.73m2, and without proteinuria. Participants were categorized into three groups based on the number of medications: non-polypharmacy, 0-4 medications; polypharmacy, 5-9 medications; and hyper-polypharmacy, ≥ 10 medications. The median age was 62years, 49% were men, the median eGFR was 75.4ml/min/1.73m2, and the median number of medications was 5. Polypharmacy and hyper-polypharmacy were noted in 506 (41%) and 250 (20%) participants, respectively. During follow-up, 288 participants developed CKD and 67 cardiovascular events were observed. Compared to the non-polypharmacy group, the hyper-polypharmacy group had a higher risk of CKD and cardiovascular events. The adjusted hazard ratios were 1.41 (95% CI1.01-1.99) and 2.24 (95% CI1.05-4.78) for the incidence of CKD and cardiovascular events, respectively. Sensitivity analysesyielded similar findings for the restricted cubic spline function models. Hyper-polypharmacy is associated with a higher risk of CKD and cardiovascular events.

Nontraditional Risk Factors for Progression Through Chronic Kidney Disease Risk Categories: The Coronary Artery Risk Development in Young Adults Study

BackgroundThere may be nontraditional pathways of chronic kidney disease (CKD) progression that are complementary to classical pathways. Therefore, we aimed to examine nontraditional risk factors for incident CKD and its progression. MethodsWe used the generally healthy population (n = 4382) starting at age 27-41 years in the Coronary Artery Risk Development in Young Adults (CARDIA) cohort, which is an observational longitudinal study. Nontraditional risk factors included forced vital capacity, inflammation, serum urate, and serum carotenoids. CKD risk category was classified using the estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (UACR) measured in 1995-1996 and repeated every 5 years for 20 years: No CKD, low risk, moderate risk, high risk, and very high risk. ResultsAt baseline, 84.8% had no CKD (eGFR ≥60 mL/min/1.73 m2 and UACR <10 mg/g), 10.3% were in the low risk (eGFR ≥60 and UACR 10-29), and 4.9% had CKD (eGFR <60 and/or UACR ≥ 30). Nontraditional risk factors were significantly associated with the progression of CKD to higher categories. Hazard ratios per standard deviation of the predictor for incident CKD and its progression from the No CKD and low and moderate risk into CKD were inverse for forced vital capacity and serum carotenoids and positive for serum urate, GlycA, and C-reactive protein, the first 3 even after adjustment for conventional risk factors. ConclusionSeveral nontraditional markers were significantly associated with an increased risk of progression to higher CKD categories in generally healthy young to middle-aged adults.