Incidence Of Chronic Kidney Disease Research Articles

Incidence and predictors of chronic kidney disease among patients with diabetes treated at governmental hospitals of Harari Region, eastern Ethiopia, 2022.

Chronic kidney disease (CKD) is the leading cause of morbidity and mortality in diabetic patients. However, limited evidence is available about its incidence and predictors in Ethiopia, specifically in the Harari region. A retrospective follow-up study was conducted among 520 diabetes patients who followed their treatment at governmental hospitals in the Harari region between 1 September 2012, and 30 May 2022. The risk of developing CKD was calculated with a 95% CI, and the risk was stratified by type of diabetes mellitus. Predictors of CKD were determined using the Gompertz regression model with the baseline Cox model. Data from 494 patients were included in the final analysis with 26 (5%) excluded. A total of 51 patients (10.32%) developed CKD over the 10-year follow-up period with an incidence rate of 2.16 cases (95% CI 1.64-2.84) per 100 person-years of observation. The risk of CKD was increased by three times (AHR: 3.09, 45 95% CI: 1.56, 6.14) among patients older than 60 years and by more than three times (AHR: 3.53, 95% CI: 1.43, 8.71) among patients with diabetes mellitus for longer than 5 years of stay with the diabetes mellitus. Moreover, the risk of CKD was increased four-fold among patients with high-density lipoprotein cholesterol (HDL-C) levels <40 mg/dL (AHR: 3.84, 95% CI, 1.80-8.18) and those with positive baseline proteinuria (AHR: 3.77, 95% CI: 1.43-8.71). We found that one in ten diabetic patients had developed CKD within 10 years of the diabetes mellitus diagnosis. Advanced age, longer duration of diabetes, lower baseline HDL-C level, and proteinuria had increased the hazards of developing CKD. We recommend a more focused follow-up of older adult patients with advanced disease status at baseline for optimal control of diabetes mellitus that prevents its furthering to CKD.

Association of long-term triglyceride-glucose index patterns with the incidence of chronic kidney disease among non-diabetic population: evidence from a functional community cohort

BackgroundThe triglyceride-glucose (TyG) index is a reliable surrogate marker of insulin resistance and previous studies have confirmed the association of TyG index with incident chronic kidney disease (CKD). However, the impact of longitudinal patterns of TyG index on CKD risk among non-diabetic population is still unknown. Therefore, this study aimed to investigate the association of longitudinal patterns of TyG index with incident CKD among non-diabetic population.MethodsA total of 5484 non-diabetic participants who underwent one health examination per year from 2015 to 2017 were included in this prospective study. TyG index variability and cumulative TyG index were calculated to assess the longitudinal patterns of TyG index. Cox proportional hazard models were performed to estimate the association of TyG index variability or cumulative TyG index with incident CKD.ResultsDuring a median of 3.82 years follow-up, 879 participants developed CKD. Compared with participants in the lowest quartile, the hazard ratio (HR) and 95% confidence interval (CI) of incident CKD were 1.772 (95% CI: 1.453, 2.162) for the highest TyG index variability quartile and 2.091 (95% CI: 1.646, 2.655) for the highest cumulative TyG index quartile in the fully adjusted models. The best discrimination and reclassification improvement were observed after adding baseline TyG, TyG index variability and cumulative TyG index to the clinical risk model for CKD.ConclusionsBoth TyG index variability and cumulative TyG index can independently predict incident CKD among non-diabetic population. Monitoring longitudinal patterns of TyG index may assist with prediction and prevention of incident CKD.

A Therapeutic Approach in the Management of Chronic Kidney Disease: Plant-Based Dietary Models and Associated Parameters.

Chronic kidney disease is one of the leading causes of death worldwide today. Nutrition and nutrition-related factors have a very important role in both the prevention and management of the disease. Plant-based dietary practices are one of the promising approaches to chronic kidney disease. This review aims to examine the potential benefits and risks of plant-based diet models on symptoms and indices used in diet quality in chronic kidney disease. Recently, a growing body of evidence has shown that, unlike animal-based diets, diets rich in plant-based nutrients may play an active role in the incidence of chronic kidney disease in many ways and the management of common symptoms, such as metabolic acidosis, uremic toxicity, and hyperphosphatemia. Implementation of existing plant-based dietary patterns in patients with chronic kidney disease may increase the efficacy of the diet and improve patients' quality of life by expanding their food choices. While there are concerns about creatine deficiency, dietary adequacy, and accessibility regarding plant-based diets, available information is limited.

Mortality and mode of dialysis: meta-analysis and systematic review

BackgroundThe global use of kidney replacement therapy (KRT) has increased, mirroring the incidence of acute kidney injury and chronic kidney disease. Despite its growing clinical usage, patient outcomes with KRT modalities remain controversial. In this meta-analysis, we sought to compare the mortality outcomes of patients with any kidney disease requiring peritoneal dialysis (PD), hemodialysis (HD), or continuous renal replacement therapy (CRRT).MethodsThe investigation was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). PubMed (MEDLINE), Cochrane Library, and Embase databases were screened for randomized trials and observational studies comparing mortality rates with different KRT modalities in patients with acute or chronic kidney failure. A random-effects model was applied to compute the risk ratio (RR) and 95% confidence intervals (95%CI) with CRRT vs. HD, CRRT vs. PD, and HD vs. PD. Heterogeneity was assessed using I2 statistics, and sensitivity using leave-one-out analysis.ResultsFifteen eligible studies were identified, allowing comparisons of mortality risk with different dialytic modalities. The relative risk was non-significant in CRRT vs. PD [RR = 0.95, (95%CI 0.53, 1.73), p = 0.92 from 4 studies] and HD vs. CRRT [RR = 1.10, (95%CI 0.95, 1.27), p = 0.21 from five studies] comparisons. The findings remained unchanged in the leave-one-out sensitivity analysis. Although PD was associated with lower mortality risk than HD [RR = 0.78, (95%CI 0.62, 0.97), p = 0.03], the significance was lost with the exclusion of 4 out of 5 included studies.ConclusionThe current evidence indicates that while patients receiving CRRT may have similar mortality risks compared to those receiving HD or PD, PD may be associated with lower mortality risk compared to HD. However, high heterogeneity among the included studies limits the generalizability of our findings. High-quality studies comparing mortality outcomes with different dialytic modalities in CKD are necessary for a more robust safety and efficacy evaluation.

Risk factor analysis for a rapid progression of chronic kidney disease.

Chronic kidney disease (CKD) is a growing global health concern. Identifying individuals in routine clinical care with new onset CKD at high risk of rapid progression of the disease is imperative to guide allocation of prophylactic interventions, but community-based data are limited. We aimed to examine the risk of rapid progression, kidney failure, hospitalisation and death among adults with incident CKD stage G3 and to clarify the association between predefined risk markers and rapid CKD progression. Using plasma creatinine measurements for the entire Danish population from both hospitals and primary care, we conducted a nationwide, population-based cohort study, including adults in Denmark with incident CKD stage G3 in 2017-2020. We estimated 3-year risks of rapid progression (defined by a confirmed decline in estimated glomerular filtration rate of ≥5ml/min/1.73 m2/year), kidney failure, all-cause hospitalisation and death. To examine risk markers, we constructed a heat map showing the risk of rapid progression based on predefined markers: albuminuria, sex, diabetes and hypertension/cardiovascular disease. Among 133443 individuals with incident CKD stage G3, the 3-year risk of rapid progression was 14.6% (95% confidence interval (CI): 14.4-14.8). The 3-year risks of kidney failure, hospitalisation and death were 0.3% (95% CI: 0.3-0.4), 53.3% (95% CI: 53.0-53.6) and 18.1% (95% CI: 17.9-18.4), respectively. In the heat map, the 3-year risk of rapid progression ranged from 7% in females without albuminuria, hypertension/cardiovascular disease or diabetes, to 46-47% in males and females with severe albuminuria, hypertension/cardiovascular disease and diabetes. This population-based study shows that CKD stage G3 is associated with considerable morbidity in a community-based setting and underscores the need for optimised prophylactic interventions among such patients. Moreover, our data highlight the potential of using easily accessible markers in routine clinical care to identify individuals who are at high risk of rapid progression.

Association between dietary intake of selenium and chronic kidney disease in US adults: a cross-sectional study of NHANES 2015-2018.

Chronic kidney disease (CKD) is currently a widespread chronic illness, and its development is influenced by nutrients. Selenium plays a crucial role in the intervention and therapy of various chronic illness. In this study, we aimed to investigate the connection between dietary selenium intake and CKD in adults in the United States. We included 6,390 individuals from the datasets of the National Health and Nutrition Examination Survey (NHANES) between 2015 and 2018. We used multiple logistic regression, restricted cubic spline regression, and forest plots to investigate the connection between dietary selenium intake and CKD. After fully adjusting the data of 6,390 individuals from NHANES between 2015 and 2018, 1,523 (23.83%) of the individuals were identified as having chronic kidney disease (CKD). The rates of CKD in participants with average selenium intakes of ≤0.072, 0.072-0.103, 0.103-0.144, and > 0.144 mg/day were 27.53, 25.11, 22.42, and 19.96%, respectively. After adjusting for potential confounding factors, the fully adjusted odds ratio (OR) values for CKD according to dietary selenium intake were 1 (reference), 0.94 (95% confidence interval (CI): 0.79-1.12, p = 0.466), 0.82 (95% CI:0.68-0.98, p = 0.033), and 0.77 (95% CI:0.63-0.95, p = 0.016) for the four selenium intake levels, respectively, with P trend = 0.007. The dietary selenium intake was negatively associated with the incidence of CKD, after adjusting for other confounding factors. The risk of CKD decreased by 7.7% for every additional 0.1 mg of dietary selenium intake. A higher dietary selenium intake correlates significantly and negatively with the incidence of CKD.

Association of high vibration perception threshold with reduced renal function in patients with type 2 diabetes.

To investigate the correlation between vibration sensory threshold (VPT) and renal function, including glomerulus and renal tubule, in patients with type 2 diabetes mellitus (T2DM). A total of 1274 patients with T2DM who were enrolled in the Department of Endocrinology of the First Affiliated Hospital of Fujian Medical University between January 2017 and June 2020 were included. Patients were grouped according to VPT levels and divided into three groups, including the normal VPT group (VPT<15V), the mild-moderate elevated VPT group (VPT15~25V), and the severely elevated VPT group (VPT≥25 V). Linear correlation analysis was used to analyze the correlation between VPT and renal functions, including glomerulus markers urine microalbumin (MA) and urinary immunoglobulin G (U-IgG), and renal tubule marker α1-microglobulin (α1-MG). Chronic kidney disease (CKD) was defined according to Kidney Disease Improving Global Outcomes (KDIGO) criteria. The binary logistic regression of the relation between VPT and CKD, eGFR<60 ml/min, and UACR >30 mg/g were expressed. In the mild-moderate and severely elevated VPT group, injury biomarkers of glomerulus (MA and U-IgG), renal tubule (α1-MG), and the incidence of CKD, eGFR<60 ml/min, and UACR > 30 mg/g were gradually increased compared with the normal VPT group. Furthermore, patients with diabetes and severely elevated VPT had significantly higher levels of MA (β=197.54, p=0.042) and α1-MG (β=11.69, p=0.023) compared to those with normal VPT. Also, patients with mild-moderate elevated VPT demonstrate significantly higher levels of MA (β=229.02, p=0.005). Patients in mild-moderate elevated VPT group (OR=1.463, 95% CI 1.005-2.127; OR=1.816, 95% CI 1.212-2.721) and severely elevated VPT group (OR=1.704, 95% CI 1.113-2.611; OR=2.027, 95% CI 1.248-3.294) are at a higher incidence of CKD and elevated levels of UACR>30mg/g compared to those in the VPT normal group. Moreover, the incidence of positive Upro was notably higher in the severely elevated VPT group (OR=1.738, 95% CI 1.182-2.556). However, this phenomenon was not observed in the incidence of eGFR <60 ml/min. A higher VPT is positively associated with the incidence of CKD in patients with T2DM, particularly with elevated UACR. VPT may serve as a marker for glomerulus and renal tubule injury.

Association between dietary protein intake and risk of chronic kidney disease: a systematic review and meta-analysis.

There is suggestive data indicating a correlation among dietary protein intake and the progression of chronic kidney disease (CKD). Nonetheless, the exact associations between dietary protein intake and the incidence of CKD have remained uncertain. We performed the first meta-analysis to explore the correlation among total protein, plant protein, animal protein intake and CKD risk. The study conformed the PRISMA statement guidelines. We comprehensively searched PubMed, Web of Science, and Embase until to December 2023. The retrieved studies underwent rigorous evaluation for eligibility, and relevant data were meticulously extracted. The Newcastle-Ottawa Scale (NOS) tool was applied to evaluate the risk of bias. Subsequently, relevant data were extracted and pooled to evaluate the relations among dietary protein intake and CKD incidence. Totally, 6,191 articles were identified, six studies were eligible. A total of 148,051 participants with 8,746 CKD cases were included. All studies had a low overall risk of bias. Higher total, plant and animal protein intake were all correlated with decreased CKD incidence, pooled risk ratios (RRs) and 95% confidence intervals (CIs) were as follows: (RR = 0.82, 95% CI = 0.71-0.94, p = 0.005; I2 = 38%, p = 0.17); (RR = 0.77, 95% CI = 0.61-0.97, p = 0.03; I2 = 77%, p = 0.001); (RR = 0.86, 95% CI = 0.76-0.97, p = 0.02; I2 = 0%, p = 0.59), respectively. For fish and seafood within animal protein: RR = 0.84, 95% CI = 0.74-0.94. Subgroup analysis showed that geographical region, sample size, follow-up time, not assessing protein by food frequency questionnaire, using %energy as the measurement index, not adjusting for several covariates may be the sources of heterogeneity for plant protein. A significant non-linear relation among plant protein and incident CKD was observed by dose-response analysis. The data showed a lower CKD risk significantly associated higher-level dietary total, plant or animal protein (especially for fish and seafood) intake. Further prospective studies demonstrating the correlations of precise sources, intake and duration of dietary protein and incident CKD are warranted.

Diabetes and chronic kidney disease in Chinese adults: a population-based cohort study

IntroductionCohort evidence of the association of diabetes mellitus (DM) with chronic kidney disease (CKD) is limited. Previous studies often describe patients with kidney disease and diabetes as diabetic kidney disease...

Non-indicated initiation of proton pump inhibitor and risk of adverse outcomes in patients with underlying chronic kidney disease: a nationwide, retrospective, cohort study

ObjectiveEvidence related to the risk of kidney damage by proton pump inhibitor (PPI) initiation in patients with ‘underlying’ chronic kidney disease (CKD) remains scarce, although PPI use is generally associated...

Association of Smoking with Chronic Kidney Disease Stages 3 to 5: A Mendelian Randomization Study.

Background: Previous studies suggested that smoking behavior (e.g., smoking status) was associated with an elevated risk of chronic kidney disease (CKD), yet whether this association is causal remains uncertain. Methods: We used data for half million participants aged 40 to 69 years from the UK Biobank cohort. In the traditional observational study, we used Cox proportional hazards models to calculate the associations between 2 smoking indices-smoking status and lifetime smoking index and incident CKD stages 3 to 5. Mendelian randomization (MR) approaches were used to estimate a potential causal effect. In one-sample MR, genetic variants associated with lifetime smoking index were used as instrument variables to examine the causal associations with CKD stages 3 to 5, among 344,255 UK Biobank participants with white British ancestry. We further validated our findings by a two-sample MR analysis using information from the Chronic Kidney Disease Genetics Consortium genome-wide association study. Results: In the traditional observational study, both smoking status [hazard ratio (HR): 1.26, 95% confidence interval (CI): 1.22 to 1.30] and lifetime smoking index (HR: 1.22, 95% CI: 1.20 to 1.24) were positively associated with a higher risk of incident CKD. However, both our one-sample and two-sample MR analyses showed no causal association between lifetime smoking index and CKD (all P > 0.05). The genetic instruments were validated by several statistical tests, and all sensitivity analyses showed similar results with the main model. Conclusion: Evidence from our analyses does not suggest a causal effect of smoking behavior on CKD risk. The positive association presented in the traditional observational study is possibly a result of confounding.

Sugar types, genetic predictors of the gut microbiome, and the risk of chronic kidney disease: a prospective cohort study.

Background: Emerging studies suggest that focusing on the intake of specific types or sources of sugars may yield greater benefits in preventing chronic kidney disease (CKD). Objective: We aimed to investigate the associations between free and non-free sugar intakes and CKD risk as well as the potential sugar type-gut microbiome interactions. Methods: A total of 138 064 participants from the UK Biobank were included in this prospective study. The free and non-free sugar intakes were assessed using repeated web-based 24-hour dietary recalls. A cause-specific competing risk model was used to estimate hazard ratios (HRs) and the corresponding confidence intervals (CIs) of incident CKD, treating deaths before incident CKD as competing events. Results: During a median follow-up of 10.5 years, 2,923 participants (2.1%) developed CKD. The free sugar intake was positively associated with the risk of CKD (HRquartile 4 vs. quartile 1 = 1.32, 95% CI = 1.18, 1.47), with a nonlinear relationship (P for nonlinearity = 0.01, the risk increased rapidly after free sugars made up 10% of the total energy). The non-free sugar intake was inversely associated with CKD risk (HRquartile 4 vs. quartile 1 = 0.68, 95% CI = 0.60, 0.77), with an L-shaped nonlinear curve (p for nonlinearity = 0.01, the turning point was at 13.5% of the total energy). We found that the associations between free sugar and non-free sugar intakes and CKD risk were more pronounced in participants with high genetically predicted gut microbial abundance. Furthermore, a significant interaction was observed between the genetically predicted gut microbial abundance and non-free sugar intake (P for interaction = 0.04). Conclusion: A higher intake of free sugars was associated with an elevated risk of CKD, whereas a higher intake of non-free sugars was associated with a reduced risk of CKD. The impact of free sugar intake and non-free sugar intake may be modified by the gut microbial abundance.

Particulate Matter and Incident Chronic Kidney Disease in Japan: The Ibaraki Prefectural Health Study (IPHS).

Global health hazards caused by air pollution, such as chronic kidney disease (CKD), have been gaining attention; however, air pollution-associated CKD has not been explored in Japan. We examined 77,770 men and women with estimated glomerular filtration rate (eGFR) ≥60 ml/min/1.73 m2 in the Ibaraki Prefecture who participated in annual community-based health checkups from 1993 at 40-75 years old and were followed up through December 2020. The outcome was newly developed kidney dysfunction with eGFR of <60 ml/min/1.73 m2 during follow-up. To assess air pollution, a PM2.5 exposure model was employed to estimate yearly means at 1 × 1-km resolution, converted into means at the municipal level. Hazard modeling was employed to examine PM2.5 concentrations in residential areas as a risk factor for outcomes. Participants were distributed across 23 municipalities in the Ibaraki Prefecture, with PM2.5 concentrations between 16.2 and 33.4 μg/m3 (mean, 22.7 μg/m3) in 1987-1995 as the exposure period. There were 942 newly developed kidney dysfunctions during follow-up. Based on 1987-1995 PM2.5 concentrations as the baseline exposure, the multivariate-adjusted hazard ratio per 10-μg/m3 increase in PM2.5 for newly developed kidney dysfunction was 1.02 (95%CI, 0.80-1.24) in men and 1.19 (95%CI, 0.95-1.44) in women. Elevated PM2.5 did not represent a significant risk factor for incident CKD in a prefecture in Japan.

A Crosssectional Observational Research on Assessment of Patterns of Discharge Medications in Patients with Chronic Kidney Disease Associated with Diabetes Mellitus and Hypertension

Abstract Background: Chronic kidney disease (CKD), also known as chronic renal insufficiency, progressive kidney deterioration, or nephropathy, is an illness, in which the kidneys fail to function properly. When prescription and over-the-counter medications are combined, the risk of adverse drug reactions and interactions increases, which are the main causes of hospitalizations and mortality. The aims and strategies for reducing the incidence, morbidity, mortality, and health costs of CKD in India are outlined in this new chapter. Aim: A cross-sectional observational study to estimate the pattern of discharge prescription pattern in patients of CKD associated with hypertension and diabetes mellitus. Methodology: 100 patients with CKD and comorbidities of hypertension, diabetes, or both were included in observational cross-sectional research done at the Nephrology Department of Dhiraj Hospital. The laboratory findings, as well as their comorbidity, discharge prescription medicines, and comorbidity, were all documented and examined. Results: Calcium channel blockers (CCBs) were the most often recommended antihypertensive medication for hypertensive patients with CKD. Diuretics were the least often given class of antihypertensive medicine. In antidiabetic medication, class sulfonylurea and dipeptidyl peptidase-4 inhibitors had similar prescription rates which are the highest prescribing medication for diabetes mellitus with CKD. Biguanides were the least prescribed class of drugs. Conclusion: Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers are widely used to treat hypertensive patients with CKD; but due to chances of arrhythmia, CCBs are prescribed. This research might aid in the identification of educational and quality-improvement opportunities to minimize medication-related errors and increase benefits in this population.

Risk Factors Associated with Pyogenic Spinal Infections among Intravenous Drug Users and Nonusers.

To identify the differences in patient factors, presentation, treatment course, and outcomes of intravenous drug users (IVDA) vs. nonusers (non-IVDA) presenting with pyogenic spinal infections. Study Design/Setting. Retrospective case series. We identified all cases involving spinal infections at our institution between May 2017 and January 2023. Postsurgical infections were excluded, and patients were separated into IVDA and non-IVDA groups. The patient charts were reviewed and analyzed for statistical or clinically significant differences using RStudio (2019 version 3.6.2). Our institutional review board approved this study, IRB# 2020-277, iRISID-2023-1384. Fifty patients (29 males and 21 females) with primary pyogenic spinal infections were included in our study. There were fourteen patients (28.0%) in the IVDA group. The mean age in the IVDA group was 50.6 vs. 61.9 years (p < 0.05) in the non-IVDA group. The average length of stay (LOS) in the IVDA group was 15.8 vs. 14.0 days (p = 0.54) in the non-IVDA group, with no significant difference in readmissions or disposition. Twenty-three non-IVDA patients were diagnosed with diabetes, while eight IVDA patients had a psychiatric diagnosis (other than substance abuse). There were no significant differences in microbial isolate or the duration of antibiotics. In our study population, there is a high incidence of intravenous drug abuse (IVDA), psychiatric disease, diabetes, and chronic kidney disease. Analysis shows a trend of two distinct patient populations. Patients without a history of IVDA were significantly older than those with IVDA and significantly more likely to have medical comorbidities including hyperlipidemia, diabetes, chronic kidney disease, and malignancy than those with IVDA history. Patients with IVDA were younger with significantly higher rates of smoking and psychiatric disorders. IVDA patients struggled to receive continued psychiatric/addiction treatment after discharge, an area for significant improvement. Due to a small sample size and single urban institution setting, this study may be underpowered to demonstrate differences in healthcare resource consumption.

Impact of Thyroid Status on Incident Kidney Dysfunction and Chronic Kidney Disease Progression in a Nationally Representative Cohort

ObjectiveTo examine the relationship between thyroid status and incident kidney dysfunction/chronic kidney disease (CKD) progression. Patients and MethodsWe examined incident thyroid status, ascertained by serum thyrotropin (TSH) levels measured from January 1, 2007, through December 31, 2018, among 4,152,830 patients from the Optum Labs Data Warehouse, containing deidentified retrospective administrative claims data from a large national health insurance plan and electronic health record data from a nationwide network of provider groups. Associations of thyroid status, categorized as hypothyroidism, euthyroidism, or hyperthyroidism (TSH levels >5.0, 0.5-5.0, and <0.5 mIU/L, respectively), with the composite end point of incident kidney dysfunction in patients without baseline kidney dysfunction and CKD progression in those with baseline CKD were examined using Cox models. ResultsPatients with hypothyroidism and hyperthyroidism had higher risk of incident kidney dysfunction/CKD progression in expanded case-mix analyses (reference: euthyroidism): adjusted hazard ratios (aHRs) (95% CIs) were 1.37 (1.34 to 1.40) and 1.42 (1.39 to 1.45), respectively. Incrementally higher TSH levels in the upper reference range and TSH ranges for subclinical, mild overt, and overt hypothyroidism (≥3.0-5.0, >5.0-10.0, >10.0-20.0, and >20.0 mIU/L, respectively) were associated with increasingly higher risk of the composite end point (reference: TSH level, 0.5 to <3.0 mIU/L): aHRs (95% CIs) were 1.10 (1.09 to 1.11), 1.37 (1.34 to 1.40), 1.70 (1.59 to 1.83), and 1.70 (1.50 to 1.93), respectively. Incrementally lower TSH levels in the subclinical (<0.5 mIU/L) and overt (<0.1 mIU/L) hyperthyroid ranges were also associated with the composite end point: aHRs (95% CIs) were 1.44 (1.41 to 1.47) and 1.48 (1.39 to 1.59), respectively. ConclusionIn a national cohort, TSH levels in the upper reference range or higher (≥3.0 mIU/L) and below the reference range (<0.5 mIU/L) were associated with incident kidney dysfunction/CKD progression.

Physical activity, chronic kidney disease, and cardiovascular risk: A study in half a million adults.

There is a growing prevalence of chronic kidney disease (CKD), a condition associated with a higher cardiovascular disease (CVD) risk. We assessed the association between self-reported physical activity (PA) and CKD and also studied whether PA attenuates CKD-associated CVD risk. A cohort of Spanish adults (18-64 years) participated in this nationwide study. Participants were categorized at baseline as being either inactive (performing no PA), regularly, or insufficiently active (meeting or not, respectively, international PA recommendations) and were followed for up to 5 years. The presence of CKD (estimated glomerular filtration rate <60 mL/min/1.73 m2 ) and major CVD risk factors (diabetes, hypercholesterolemia, hypertension, obesity) was determined at baseline and at follow-up. 517 917 participants (44 ± 9 years, 67% male, CKD prevalence = 7%) were studied at baseline, with prospective analyses (median follow-up = 2 years, range = 2-5) in a subcohort of 264 581 individuals. Compared to physical inactivity, cross-sectional analyses at baseline showed that regular PA (odds ratio = 0.80; 95% confidence interval = 0.79-0.81), but not insufficient PA (1.02; 0.99-1.04) was associated with lower CKD prevalence. However, prospective analyses failed to confirm this association (p > 0.1). In turn, CKD was associated with a higher prevalence of hypertension (+3%) and diabetes (+5%) at baseline and with a greater incidence of hypertension at follow-up (+37%). Among those participants with CKD, regular PA was associated with a lower prevalence (-45% to -7%) and incidence (-38% to -4%) of all CVD risk factors. Although PA might not reduce incident CKD in the middle term (~2 years), it can attenuate the CVD risk linked to this condition.

Higher Arterial Stiffness Predicts Chronic Kidney Disease in Adults: The ELSA-Brasil Cohort Study.

Central Illustration : Higher Arterial Stiffness Predicts Chronic Kidney Disease in Adults: The ELSA-Brasil Cohort Study. Arterial stiffening can directly affect the kidneys, which are passively perfused by a high flow. However, whether the relation between arterial stiffness and renal function depends on diabetes and hypertension conditions, is a matter of debate. To investigate the relationship between arterial stiffening by carotid-to-femoral pulse wave velocity (cfPWV) and chronic kidney disease (CKD) incidence in individuals and verify whether this association is present in individuals without hypertension and diabetes. A longitudinal study of 11,647 participants of the ELSA-Brasil followed up for four years (2008/10-2012/14). Baseline cfPWV was grouped per quartile, according to sex-specific cut-offs. Presence of CKD was ascertained by glomerular filtration rate (eGFR-CKD-EPI) < 60 ml/min/1.73 m2 and/or albumin-to-creatinine ratio ≥ 30 mg/g. Logistic regression models were run for the whole cohort and a subsample free from hypertension and diabetes at baseline, after adjustment for age, sex, race, schooling, smoking, cholesterol/HDL ratio, body mass index, diabetes, use of antihypertensive, systolic blood pressure, heart rate, and cardiovascular disease. Statistical significance was set at 5%. The chance of CKD was 42% (CI 95%: 1.05;1.92) greater among individuals in the upper quartile of cfPWV. Among normotensive, non-diabetic participants, individuals in the 2nd, 3rd, and 4th quartiles of cfPWV presented greater chances of developing CKD, as compared to those in the lower quartile, and the magnitude of this association was the greatest for those in the upper quartile (OR: 1.81 CI 95%: 1.14;2.86). Higher cfPWV increased the chances of CKD and suggests that this effect is even greater in individuals without diabetes and hypertension.

Analysis of influencing factors in chronic kidney disease incidence in Indonesia

Background: The incidence of chronic kidney disease (CKD) continues to increase from year to year. There was an increase in CKD rates in the 2013 and 2018 basic health research or Riset kesehatan dasar (Riskesdas). Several provinces in Indonesia show a high incidence of CKD and require hemodialysis. As the incidence of CKD increases, it is important to investigate the influencing factors.Objective: To identify the influencing factors of CKD incidence in Indonesia.Methods: Data from 11 provinces with the highest incidence of CKD and hemodialysis were obtained from the Indonesian Ministry of Health through the Riskesdas 2018 survey. For comparison, the incidence of hemodialysis patients in 2020 at Immanuel Hospital Bandung was included in the investigation. All data were analysed using a Python software program, and a decision tree was determined. The results of the decision tree were analysed using Chi-square. Subject profiles were descriptively analysed for some Riskesdas 2018 data and medical records at Immanuel Hospital. Results: The total data from Riskesdas was 130,787 subjects, among those, there were 610 people with CKD/hemodialysis, meanwhile data of 79 people with hemodialysis were obtained from Immanuel Hospital. The odds ratios of diabetes mellitus was 4.54 (p=0.000), hypertension was 3.00 (p=0.000), salty food was 2.26 (p=0.000), waist circumference (WC) was 1.35 (p=0.025), and body mass index (BMI) was 1.06 (p=0.605). Conclusion: Diabetes, hypertension, salty foods, WC and BMI are the five most important factors influencing the incidence of CKD in Indonesia. These variables need to be managed properly to reduce the incidence of CKD.

Chronic kidney disease associated with hypertension

Background: Globally, chronic kidney disease (CKD) is acknowledged as a major public health issue. Both the incidence and prevalence of chronic kidney disease (CKD) are rising with immense pace worldwide. Hypertension and diabetes mellitus is the main risk factor of chronic kidney disease. Objective: To determine chronic Kidney disease associated with hypertension Methods: A cross-sectional study was conducted at district headquarter hospital, Mianwali, Pakistan, which was performed between June 2020 and February 2022, the total number of patients in our study were 120. The number of Male patients were 49 and female were 71. In 120 consecutive patients who underwent for blood tests and Blood pressure monitoring. We also took stages of chronic kidney disease (CKD stage 1,2,3A,3B,4 and 5). We did renal function test for all patients (serum creatinine and serum urea). Data was tabulated and analyzed by SPSS. Results: In a current study total 120 patients were enrolled. The minimum age of patients were30 and the maximum age of the patients were 84. The mean age were 50.60±10.9 years. The minimum systolic blood pressure were 130 and maximum systolic blood pressure were 200. The mean systolic blood pressure were 149.55±13.5. The minimum diastolic blood pressure were 80 and the maximum diastolic blood pressure were 100. The mean diastolic blood pressure were 89.57±3.76 The frequency of male patients were 49 and its percentage were 40.8. The frequency of female patients were 71 and its percentage were 59.2. The frequency of age group 30-50 years were 61 and its percentage were 50.8. The frequency of age group 51-70 years were 52 and its percentage were 43.3. The frequency of age group &gt;70 years were 7 and its percentage were 5.8. The mean of renal functional test Serum creatinine were 7.82 mg/dl and its SD value were 3.59 mg/dl. The mean of renal functional test Serum urea were 109.90 mg/dl and its SD value were 24.30 mg/dl. · The mean glomerular filtration rate were 20.36 ml/min and its SD value were 13.2 ml/min. · The mean weight of patients were 56.61 kg and its SD value were 10.19 kg. · The P-value of stages of Chronic kidney disease (CKD) were 0.133. The P-value of hypertension were 0.074. Conclusion: Hypertension and diabetes mellitus is the main cause of Chronic kidney disease (CKD). Stage 5 Chronic kidney disease (CKD) patients were more in our study as compare to other stages of CKD. We concluded in our study that after age of 30, patients have higher risk of Chronic kidney disease (CKD).