Risk Factor For Kidney Disease Research Articles

Sex Differences in Profile and In-Hospital Death for Acute Stroke in Chile: Data From a Nationwide Hospital Registry.

Knowledge of local contextual sex differences in the profile and outcome for stroke can improve service delivery. We aimed to determine sex differences in the profile of patients with acute stroke and their associations with in-hospital death in the national hospital database of Chile. We present a retrospective cohort based on the analysis of the 2019 Chilean database of Diagnosis-Related Groups, which represents 70% of the operational expenditure of the public health system. Random-effects multiple logistic regression models were used to determine independent associations of acute stroke (defined by main diagnosis International Classification of Diseases, Tenth Revision [ICD-10] codes) and in-hospital death, and reported with odds ratios (ORs) and 95% CIs. Of 1 048 575 hospital discharges, 15 535 were for patients with acute stroke (7074 [45.5%] in women), and 2438 (15.6%) of them died during hospitalization. Differences by sex in sociodemographic and clinical characteristics were identified for stroke and main subtypes. After fully adjusted model, women with ischemic stroke had lower in-hospital death (OR, 0.79 [95% CI, 0.69-0.91]) compared with men; other independent predictors included age per year increase (OR, 1.03 [95% CI, 1.03-1.04]), chronic kidney disease (OR, 1.47 [95% CI, 1.20-1.80]), atrial fibrillation (OR, 1.50 [95% CI, 1.26-1.80]), and other risk factors. Conversely, for intracerebral hemorrhage, women had a higher in-hospital mortality rate than men (OR, 1.19 [95% CI, 1.02-1.40]); other independent predictors included age per year increase (OR, 1.009 [95% CI, 1.003-1.01]), chronic kidney disease (OR, 1.55 [95% CI, 1.23-1.97]), oral anticoagulant use (OR, 1.88 [95% CI, 1.37-2.58]), and other risk factors. Sex differences in characteristics and in-hospital death of hospitalized patients exist for acute stroke in Chile. In-hospital death is higher for acute ischemic stroke in men and higher for intracerebral hemorrhage in women. Future research is needed to better identify contributing factors.

Systemic impacts of metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH) on heart, muscle, and kidney related diseases

Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease (NAFLD), is the most common liver disorder worldwide, with an estimated global prevalence of more than 31%. Metabolic dysfunction-associated steatohepatitis (MASH), formerly known as non-alcoholic steatohepatitis (NASH), is a progressive form of MASLD characterized by hepatic steatosis, inflammation, and fibrosis. This review aims to provide a comprehensive analysis of the extrahepatic manifestations of MASH, focusing on chronic diseases related to the cardiovascular, muscular, and renal systems. A systematic review of published studies and literature was conducted to summarize the findings related to the systemic impacts of MASLD and MASH. The review focused on the association of MASLD and MASH with metabolic comorbidities, cardiovascular mortality, sarcopenia, and chronic kidney disease. Mechanistic insights into the concept of lipotoxic inflammatory “spill over” from the MASH-affected liver were also explored. MASLD and MASH are highly associated (50%–80%) with other metabolic comorbidities such as impaired insulin response, type 2 diabetes, dyslipidemia, hypertriglyceridemia, and hypertension. Furthermore, more than 90% of obese patients with type 2 diabetes have MASH. Data suggest that in middle-aged individuals (especially those aged 45–54), MASLD is an independent risk factor for cardiovascular mortality, sarcopenia, and chronic kidney disease. The concept of lipotoxic inflammatory “spill over” from the MASH-affected liver plays a crucial role in mediating the systemic pathological effects observed. Understanding the multifaceted impact of MASH on the heart, muscle, and kidney is crucial for early detection and risk stratification. This knowledge is also timely for implementing comprehensive disease management strategies addressing multi-organ involvement in MASH pathogenesis.

Mind the gap in kidney care: translating what we know into what we do

Historically, it takes an average of 17 years to move new treatments from clinical evidence to daily practice. Given the highly effective treatments now available to prevent or delay kidney disease onset and progression, this is far too long. The time is now to narrow the gap between what we know and what we do. Clear guidelines exist for the prevention and management of common risk factors for kidney disease, such as hypertension and diabetes, but only a fraction of people with these conditions worldwide are diagnosed, and even fewer are treated to target. Similarly, the vast majority of people living with kidney disease are unaware of their condition, because in the early stages it is often silent. Even among patients who have been diagnosed, many do not receive appropriate treatment for kidney disease. Considering the serious consequences of kidney disease progression, kidney failure, or death, it is imperative that treatments are initiated early and appropriately. Opportunities to diagnose and treat kidney disease early must be maximized beginning at the primary care level. Many systematic barriers exist, ranging from patient to clinician to health systems to societal factors. To preserve and improve kidney health for everyone everywhere, each of these barriers must be acknowledged so that sustainable solutions are developed and implemented without further delay.

A Comparative Study of the Epidemiology and Risk Factors of Chronic Kidney Disease Among Rural and Urban Residents in Peshawar, Pakistan

A Comparative Study of the Epidemiology and Risk Factors of Chronic Kidney Disease Among Rural and Urban Residents in Peshawar, Pakistan

Mind the gap in kidney care: translating what we know into what we do.

Historically, it takes an average of 17 years to move new treatments from clinical evidence to daily practice. Given the highly effective treatments now available to prevent or delay kidney disease onset and progression, this is far too long. The time is now to narrow the gap between what we know and what we do. Clear guidelines exist for the prevention and management of common risk factors for kidney disease, such as hypertension and diabetes, but only a fraction of people with these conditions worldwide are diagnosed, and even fewer are treated to target. Similarly, the vast majority of people living with kidney disease are unaware of their condition, because in the early stages, it is often silent. Even among patients who have been diagnosed, many do not receive appropriate treatment for kidney disease. Considering the serious consequences of kidney disease progression, kidney failure, or death, it is imperative that treatments are initiated early and appropriately. Opportunities to diagnose and treat kidney disease early must be maximized beginning at the primary care level. Many systematic barriers exist, ranging from patient to clinician to health systems to societal factors. To preserve and improve kidney health for everyone everywhere, each of these barriers must be acknowledged so that sustainable solutions are developed and implemented without further delay.

Knowledge and Competence Regarding the Management of Chronic Kidney Disease among Family Medicine Professionals in the Eastern Province of Saudi Arabia: A Cross-Sectional Study

Diabetes is a significant risk factor for chronic kidney disease (CKD) and a primary cause of global morbidity and mortality, resulting in significant costs to healthcare systems. The management of diabetic CKD in the primary care setting remains an ongoing challenge despite the current best practices in the quality of care. This study evaluated family medicine physicians’ knowledge and confidence regarding managing CKD in the Eastern Province of Saudi Arabia. A self-administered online questionnaire was distributed to physicians through various social media sites and email lists. The largest number of participants reported a full confidence in knowing kidney disease stages, blood pressure targets and the importance of urine albumin–creatinine ratio testing. Overall, 71.8% of physicians reported a high confidence level, followed by 23.9% reporting average and 4.2% reporting low confidence. Being younger and working at PHC were identified as significant predictors of increased confidence. Although most of the physicians reported a high confidence in managing CKD patients, the need for improvement was evident. Age and workplace institutions were the greater contributors to physicians’ confidence. Continuous education among healthcare practitioners is crucial to updating knowledge and providing optimum quality of care among this group of patients.

High levels of high-density lipoprotein cholesterol may increase the risk of diabetic kidney disease in patients with type 2 diabetes

Studies have indicated that low high-density lipoprotein cholesterol (HDL-C) level is an important risk factor for diabetic kidney disease (DKD) in patients with type 2 diabetes (T2D). However, whether higher HDL-C levels decrease the risk of developing DKD remains unclear. This study aimed to clarify the relationship between HDL-C levels and DKD risk in individuals with T2D in China. In total, 936 patients with T2D were divided into DKD and non-DKD groups. The association between HDL-C levels and DKD risk was evaluated using logistic regression analysis and restricted cubic spline curves adjusted for potential confounders. Threshold effect analysis of HDL-C for DKD risk was also performed. Higher HDL-C levels did not consistently decrease the DKD risk. Furthermore, a nonlinear association with threshold interval effects between HDL-C levels and the incidence of DKD was observed. Patients with HDL-C ≤ 0.94 mmol/L or HDL-C > 1.54 mmol/L had significantly higher DKD risk after adjusting for confounding factors. Interestingly, the association between high HDL-C levels and increased DKD risk was more significant in women. A U-shaped association between HDL-C levels and DKD risk was observed; therefore, low and high HDL-C levels may increase the DKD risk in patients with T2D.

Integrin αM promotes macrophage alternative M2 polarization in hyperuricemia-related chronic kidney disease.

Hyperuricemia is an essential risk factor in chronic kidney disease (CKD), while urate-lowering therapy to prevent or delay CKD is controversial. Alternatively activated macrophages in response to local microenvironment play diverse roles in kidney diseases. Here, we aim to investigate whether and how macrophage integrin αM (ITGAM) contributes to hyperuricemia-related CKD. In vivo, we explored dynamic characteristics of renal tissue in hyperuricemia-related CKD mice. By incorporating transcriptomics and phosphoproteomics data, we analyzed gene expression profile, hub genes and potential pathways. In vitro, we validated bioinformatic findings under different conditions with interventions corresponding to core nodes. We found that hyperuricemia-related CKD was characterized by elevated serum uric acid levels, impaired renal function, activation of macrophage alternative (M2) polarization, and kidney fibrosis. Integrated bioinformatic analyses revealed Itgam as the potential core gene, which was associated with focal adhesion signaling. Notably, we confirmed the upregulated expression of macrophage ITGAM, activated pathway, and macrophage M2 polarization in injured kidneys. In vitro, through silencing Itgam, inhibiting p-FAK or p-AKT1 phosphorylation, and concurrent inhibiting of p-FAK while activating p-AKT1 all contributed to the modulation of macrophage M2 polarization. Our results indicated targeting macrophage ITGAM might be a promising therapeutic approach for preventing CKD.

Andrias davidianus bone peptides alleviates hyperuricemia-induced kidney damage in vitro and in vivo

Hyperuricemia (HUA) is a vital risk factor for chronic kidney diseases (CKD) and development of functional foods capable of protecting CKD is of importance. This paper aimed to explore the amelioration effects and mechanism of Andrias davidianus bone peptides (ADBP) on HUA-induced kidney damage. In the present study, we generated the standard ADBP which contained high hydrophobic amino acid and low molecular peptide contents. In vitro results found that ADBP protected uric acid (UA)-induced HK-2 cells from damage by modulating urate transporters and antioxidant defense. In vivo results indicated that ADBP effectively ameliorated renal injury in HUA-induced CKD mice, evidenced by a remarkable decrease in serum UA, creatinine and blood urea nitrogen, improving kidney UA excretion, antioxidant defense and histological kidney deterioration. Metabolomic analysis highlighted 14 metabolites that could be selected as potential biomarkers and attributed to the amelioration effects of ADBP on CKD mice kidney dysfunction. Intriguingly, ADBP restored the gut microbiome homeostasis in CKD mice, especially with respect to the elevated helpful microbial abundance, and the decreased harmful bacterial abundance. This study demonstrated that ADBP displayed great nephroprotective effects, and has great promise as a food or functional food ingredient for the prevention and treatment of HUA-induced CKD.

Serum hydroxycotinine was associated with chronic kidney disease (CKD): a cross-sectional study based on NHANES

Objective Smoking has been suggested as a modifiable and cardiovascular risk factor for chronic kidney disease (CKD). Although long-term smoking has been associated with CKD, the potential relationship between its metabolite hydroxycotinine and CKD has not been clarified. Methods A total of 8,544 participants aged 20 years and above from the National Health and Nutrition Examination Survey (NHANES) 2017 - March 2020 were enrolled in our study. CKD was defined by estimated glomerular filtration rate (eGFR) < 60 mL/(min*1.73 m2). Serum hydroxycotinine was measured by an isotope-dilution high-performance liquid chromatography/atmospheric pressure chemical ionization tandem mass spectrometric (ID HPLC-APCI MS/MS) method with a lower limit of detections (LLOD) at 0.015 ng/mL. The non-linear relationship was explored with restricted cubic splines (RCS). Pearson’s correlation coefficient and a multivariate logistic regression model were used for correlation analysis. Results Serum hydroxycotinine and eGFR were negatively correlated in both non-CKD group (r= −0.05, p < 0.001) and CKD group (r= −0.04, p < 0.001). After serum hydoxycotinine dichotominzed with LLOD, serum hydroxycotinine ≥ 0.015 ng/mL was negatively correlated with eGFR not only in non-CKD group (r = −0.05, p < 0.001) but also in CKD group (r = −0.09, p < 0.001). After adjusting for comprehensive confounders, results from the multivariate logistic regression analysis showed that participants with serum hydroxycotinine ≥ 0.015 ng/mL had increased odds of CKD (OR = 1.505, p < 0.001). Conclusions Serum hydroxycotinine might be positively associated with CKD. Further study is warranted to find the right concentration of hydroxycotinine to measure the CKD.

Knowledge of Associated Risk Factors of Chronic Kidney Disease among Secondary School Teachers in Anambra State Nigeria

Knowledge of Associated Risk Factors of Chronic Kidney Disease among Secondary School Teachers in Anambra State Nigeria

Mind the gap in kidney care: Translating what we know into what we do.

Historically, it takes an average of 17 years to move new treatments from clinical evidence to daily practice. Given the highly effective treatments now available to prevent or delay kidney disease onset and progression, this is far too long. The time is now to narrow the gap between what we know and what we do. Clear guidelines exist for the prevention and management of common risk factors for kidney disease, such as hypertension and diabetes, but only a fraction of people with these conditions worldwide are diagnosed, and even fewer are treated to target. Similarly, the vast majority of people living with kidney disease are unaware of their condition, because in the early stages it is often silent. Even among patients who have been diagnosed, many do not receive appropriate treatment for kidney disease. Considering the serious consequences of kidney disease progression, kidney failure, or death, it is imperative that treatments are initiated early and appropriately. Opportunities to diagnose and treat kidney disease early must be maximized beginning at the primary care level. Many systematic barriers exist, ranging from patient to clinician to health systems to societal factors. To preserve and improve kidney health for everyone everywhere, each of these barriers must be acknowledged so that sustainable solutions are developed and implemented without further delay.

Prevalence and risk factors for chronic kidney disease of unknown aetiology (CKDu) among industrial workers

Objectives Industrial workers are facing an occurrence of high risk factors. Exploring the frequency of CKDu and associated risk factors in industrial workers is needed. This study examined the CKDu prevalence and associated risk factors in industrial workers. Design: Cross section study. Material and Methods We enrolled 134 (83 male and 41 female) industrial workers. Modifying diet in renal disease (MDRD) equation was used to determine the estimated glomerular filtration rate (eGFR). The CKDu stages 1–5 were assessed using Kidney Disease: Improving Global Outcomes (KIDGO) guidelines. Results The mean eGFR was reported to be 99.2 for male workers and 85.2 ml/min per 1.73 m2 for female workers. The average eGFR among male workers was higher than female workers. 43.3% of workers had normal eGFR (&gt; 90), while 52.2% of workers had a mild reduction (89–60), and 4.5% of workers had a moderate loss (59–45). No cases of severe loss and kidney failure (&lt; 15) were noted. CKDu stage 2 was significantly higher in female workers than male workers. The increased odd ratio (OR) of CKDu stage 3 (&lt; 60) was noted among male workers, with an increase in age, overweight, obesity, hypertension, diabetes, habits of smoking, and alcohol consumption. Conclusion The present study noted a lower eGFR and a higher OR of CKDu in industrial workers with risk factors. To avoid the progression from moderate severe loss and kidney failure, suggested weight reduction, avoiding smoking and alcohol consumption, and controlling diabetes and hypertension.

Incidence of Chronic Kidney Failure and Alcohol Consumption: Meta Analysis

One of the main risk factors for chronic kidney disease (CKD) is excessive alcohol consumption. Alcohol consumption can damage the kidneys and disrupt their function because the kidneys filter toxins and waste products from the blood. This study aims to estimate the magnitude of the relationship between alcohol consumption and the incidence of chronic kidney failure. This research is a systematic review and meta analysis with PICO as follows, population: Adults. Intervention: alcohol consumption, Comparison: no alcohol consumption. Outcome: chronic failure events. The articles used in this research were obtained from three databases, namely Google Scholar, Pubmed, and Science Direct. Keywords to search for articles are "Alcohol" AND "Chronic Kidney Disease" OR CKD AND Multivariate. Articles used from 2018 – 2023. Article selection was carried out using the PRISMA flow diagram. Articles were analyzed using the Review Manager 5.3 application. A total of 6 cohort studies, namely Asia and Europe, were selected for systematic review and meta analysis. Cohort studies show that alcohol consumption influences the incidence of CKD. Patients who consume alcohol have a risk of experiencing CKD that is 1.05 times compared to those who do not consume alcohol, but the resulting increase in risk is not statistically significant (aHR= 1.04 95% CI= 0.85 to 1.27; p= 0.710). Forest Plot also shows heterogeneity of effect estimates between primary studies I2= 84%; p= 0.040, which means that the estimated effect between primary studies in this meta-analysis varies. Thus, the calculation of the average effect estimate was carried out using a random effect model approach.

#1623 Risk factors for end-stage kidney disease and death in ANCA-associated vasculitis with glomerulonephritis

Abstract Background and Aims ANCA-associated vasculitis (AAV) with glomerulonephritis (AAV-GN) still carries poor prognosis despite treatment improvement over the last years. Currently, improving assessment of disease activity and severity and defining risk factors for ESKD pose challenges. In this study we aim to determine and characterize risk factors associated with progression to ESKD or death in patients with AAV-GN. Method We retrospectively analysed all AAV-GN cases of our Center. ESKD was considered as a composite outcome of eGFR&amp;lt;15 or dialysis dependency. Biopsies were classified according to Berden's classification (BC), Brix's renal risk score (RRS), Mayo Clinic Chronicity Score (MCCS) and AAV-GN combined score (AAV-GN-CS). Categorical variables were analysed by non-parametric chi-square or fisher's exact test; and continuous variables by Mann-Whitney U test. Cox regression models were applied for death and Kaplan-Meier estimator. Significance value α = 0.05 was considered. Results A total of 74 patients, 56.8% male, 69 years-old median age were included. Of them, 81.2% were MPO, 11.6% PR3 and 7.2% negative. At presentation, 35.3% had alveolar haemorrhage, 13.4% GI and 66.7% constitutional manifestations. At diagnosis, median eGFR was 7.5 mL/min/1.73 m2 (5.0-13.0), proteinuria 2.2g/g (0.45-4.17) and all patients had haematuria. Initial median ANCA titer (ATi) was 100 UI/mL (51-134) and at last follow-up 44 (15-101). 64.2% of all patients required dialysis at presentation. Of these, 14.0% recovered until discharge. We also analyzed biopsies of 57 patients. According to BC, 15.8% were focal, 40.4% crescentic, 26.3% mixed, and 17.5% focal. ESKD risk was medium in 28.3% and high in 69.8%, as determined by RRS; whereas low in 31%, intermediate in 42.3% and high in 19% as per AAV-GN-CS. Induction treatment (IT) used was cyclophosphamide (CYC) in 46.3%, CYC plus rituximab (RTX) in 18.3% and RTX in 3.3%. Only 17 patients (26.2%) were added plasmapheresis (PLEX). Only 28% achieved kidney remission (KRm), 7% relapsed and 68.7% developed ESKD. Of them, 95.5% had eGFR&amp;lt;15 at diagnosis, 30% low C3, 37.5% crescentic pattern, 28.1% mixed and 28.1% sclerotic. 87% of ESKD patients had &amp;lt;25% normal glomeruli (NG), and 87.1% high ESKD risk (RRS). Progression to ESKD was associated with lower eGFR (p &amp;lt; 0.001) and low C3 at diagnosis (p = 0.026), lower %NG (p = 0.004), higher %CG (p = 0.004), higher %IFTA (p = 0.011), worse BC (p = 0.012), higher RRS (p &amp;lt; 0.001) and MCCS categories (p = 0.010), but not with AAV-GN-CS. ATi reduction seems to determine better renal outcome (p = 0.042). No significant differences were seen with IT or maintenance treatment, nor with PLEX addition. No patient treated with RTX, or combined treatment developed ESKD. Mortality was 32.8% and the best predictive model includes age, GI manifestations and KRm (p &amp;lt; 0.001). Age (p = 0.004), lower eGFR at diagnosis (p = 0.016) and GI manifestations (p = 0.003) were predictive of death, while achieving KRm improved survival (p = 0.009). Conclusion Our results reveal that AAV-GN patients have poor kidney outcome when presenting with severe kidney dysfunction, high ANCA titers and low C3 levels. Worse histological scoring is determinant of ESKD. The prediction power of AAV-GN-CS must be demonstrated in large cohorts. RTX effectivity on kidney survival must be further supported. Patient survival is related with younger age at diagnosis, organ systems involved at clinical presentation, and achievement of kidney remission.

#208 Obesity is associated with incident chronic kidney disease in individuals with normal renal function

Abstract Background and Aims Obesity is a representative modifiable risk factor for chronic kidney disease (CKD). This study aimed to investigate whether both body mass index (BMI), waist-to-hip ratio (WHR) and changes of WHR during follow-up are risk factors for development of incident CKD. Method A total of 2 711 participants from a community-based cohort with normal renal function were prospectively analyzed. Among participants with obesity, we analyzed the change in WHR to evaluate the association of obesity reduction with CKD development. Results During a mean follow-up of 11.03 ± 4.22 years, incident CKD occurred in 190 (7.0%) participants. In the fully adjusted multivariable Cox proportional hazard models, the risk of incident CKD increased with higher BMI (hazard ratio, 1.06; 95% confidence interval, 1.00–1.11; p = 0.033) and higher WHR (hazard ratio, 1.33; 95% confidence interval, 1.07–1.66; p = 0.009). In the Kaplan–Meier analysis, cumulative adverse renal events were significantly more common in the maintained obesity group than in the reduced obesity group (p = 0.001). Conclusion Both higher BMI and WHR were associated with development of CKD, but the magnitude of the effect of WHR was higher than that of BMI. Moreover, reducing obesity would be beneficial for renal prognosis.

Expression and localization of HSD17B13 along mouse urinary tract.

17β-hydroxysteroid dehydrogenase-13 (HSD17B13), a newly identified lipid droplet-associated protein, plays an important role in the development of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). Emerging evidence demonstrates that NASH is an independent risk factor for chronic kidney disease (CKD), which is frequently accompanied by renal lipid accumulation. In addition, the HSD17B13 rs72613567 variant is associated with lower levels of albuminuria in patients with biopsy-proven NAFLD. At present, the role of HSD17B13 in lipid accumulation in the kidney is unclear. ​This study utilized bioinformatic and immunostaining approaches to examine the expression and localization of HSD17B13 along mouse urinary tract. We found that HSD17B13 is constitutively expressed in the kidney, ureter and urinary bladder. Our findings reveal for the first time the precise localization of HSD17B13 in mouse urinary system, providing a basis for further studying the pathogenesis of HSD17B13 in various renal and urological diseases.

#745 Age and gender specific reference values for renal volume and association with risk factors for chronic kidney disease in a general population

Abstract Background and Aims Renal volume (RV) is associated with renal function and with a variety of cardiovascular risk factors (CVRF). We analyzed RV by magnetic resonance imaging (MRI) in a large population-based study (Study of Health in Pomerania; SHIP-TREND) and tested the influence of age, sex, smoking status, BSA, systolic and diastolic blood pressure, type 2 diabetes, HDL-C, LDL-C, estimated glomerular filtration rate (eGFR) and uric acid on RV. Method 1,815 participants without kidney disease (930 women) aged 21-81 years were included in our study. Right and left RV with and without body surface area (BSA) indexation were compared among three age groups (22-39 years, 40-59 years, 60-81 years) by median and interquartile range and tested separately in women and men. Results eGFR, uric acid, right and left RV were higher in men compared to women (all p &amp;lt; 0.001). Left kidney were larger than right kidneys (both sexes). With age, RV showed a continuously decreasing trend in women and an upside down U-shape relation in men. In multivariable linear regression models, current smoking (β = 14.96, 95% CI 12.12; 17.79), BSA (β = 97.66, 95% CI 90.4; 104.93), diastolic blood pressure (β = 0.17, 95% CI 0.01; 0.32), and eGFR (β = 0.57, 95% CI 0.50; 0.65) were positively associated with both left and right renal volume whereas uric acid (β = −0.03, 95% CI −0.05; −0.01) showed an inverse association with RV. Interestingly, the same eGFR correlated with higher RV in men compared to women. Conclusion Reference values for RV are different for age-groups and sex. For any given age, female kidneys are smaller than male kidneys. RV associates positively with eGFR, but for any chosen eGFR, renal volume in females is lower compared to males. RV decreases with age, but in men, RV first increases in the age group 40-59 years before finally decreasing with a faster decline after 60 years. This may reflect hyperfiltration and glomerular hypertrophy associated with the presence of CVRF.

#1029 Factors associated with chronic kidney disease in patients with recurrent kidney stones: a case-control study

Abstract Background and Aims Kidney stones have been described in multiple studies as an independent risk factor for chronic kidney disease (CKD). However, this relationship remains partially understood, and there is limited local, regional, and national information available. While common factors contribute to both kidney stones and CKD development, other factors favoring CKD occurrence in patients with recurrent renal lithiasis have been reported. This study aimed to identify factors associated with chronic kidney disease in patients with recurrent renal lithiasis in the city of Cartagena, Colombia. Method This was an observational nested case-control study within a cohort, where cases were patients diagnosed with recurrent kidney stones who developed CKD during follow-up, and controls were patients with recurrent kidney stones without CKD during follow-up. The cohort comprised all adult patients with recurrent kidney stones between 2010 and 2019, without an initial diagnosis of CKD, and with a minimum follow-up period of two years or more. Data on demographic variables (age, gender, type of insurance), clinical factors (overweight, history of hyperuricemia, diabetes mellitus, hypertension, dyslipidemia, alcohol consumption, smoking, exercise habits), and variables related to recurrent kidney stones (course of kidney stones, onset time of CKD, metabolic disorders, history of renal colic, stone localization, number, and size) were collected. Variables associated with the development of chronic kidney disease were identified using association measures via the chi-square test. Variables of clinical and statistical significance were further analyzed for association using multivariable logistic regression. Results The study included 31 cases and 39 controls, with mean ages of 65.2±11.5 and 51.8±14.6 years, respectively (p=0.00002). The duration of recurrent kidney stones was 174.7±148.6 and 163.3±129.5 months for cases and controls (p=0.738). The onset time of CKD was 61.1±35.4 months. Among cases, 93.5% were men, 77.4% were hypertensive, and 67.9% had dyslipidemia, significantly differing from the controls (see Table 1). There were no differences between cases and controls concerning the duration of recurrent kidney stones, type of health insurance, overweight status, hyperuricemia, diabetes mellitus, exercise habits, metabolic study alterations, history of renal colic, renal stone localization, number, and size. The difference was borderline for alcohol consumption and smoking habits. Multivariable logistic regression, incorporating variables with statistical significance (age, gender, hypertension, alcohol consumption, smoking habit) into the model, revealed that higher age corresponds to a greater risk of CKD (Odds ratio 1.052; 95% CI, 1.003 to 1.103). Furthermore, the male gender exhibited a 5.5 times higher likelihood of suffering from CKD (Odds ratio 5.5; 95% CI, 1.2 to 26.5). Conclusion In patients with recurrent kidney stones, higher age, and male gender were identified as factors associated with the development of CKD.

Mind the gap in kidney care: Translating what we know into what we do.

Historically, it takes an average of 17 years to move new treatments from clinical evidence to daily practice. Given the highly effective treatments now available to prevent or delay kidney disease onset and progression, this is far too long. The time is now to narrow the gap between what we know and what we do. Clear guidelines exist for the prevention and management of common risk factors for kidney disease, such as hypertension and diabetes, but only a fraction of people with these conditions worldwide are diagnosed, and even fewer are treated to target. Similarly, the vast majority of people living with kidney disease are unaware of their condition, because in the early stages it is often silent. Even among patients who have been diagnosed, many do not receive appropriate treatment for kidney disease. Considering the serious consequences of kidney disease progression, kidney failure,or death, it is imperative that treatments are initiated early and appropriately. Opportunities to diagnose and treat kidney disease early must be maximized beginning at the primary care level. Many systematic barriers exist, ranging from patient to clinician to health systems to societal factors. To preserve and improve kidney health for everyone everywhere, each of these barriers must be acknowledged so that sustainable solutions are developed and implemented without further delay.