Risk Factors For Chronic Kidney Disease Research Articles

Development of chronic kidney disease influenced by serum urate and body mass index based on young-to-middle-aged Japanese men: a propensity score-matched cohort study

ObjectiveTo investigate the association between serum uric acid (SUA) level and body mass index (BMI) on the development of chronic kidney disease (CKD) in working men aged 20–60 years.DesignRetrospective cohort...

Prevalence of chronic kidney disease and end-stage renal disease in a bariatric versus nonbariatric population: a retrospective analysis of the U.S. National Inpatient Sample database.

In the past five 5 years our team has studied the effects of bariatric surgery on chronic kidney disease (CKD) at our institution. The objective of this study was to assess the impact of bariatric surgery (BaS) on the prevalence and likelihood of CKD and end-stage renal disease (ESRD) nationwide. Academic hospital, United States. We conducted a retrospective analysis of the U.S. National Inpatient Sample (NIS) database for the years 2010-2015 and compared. Univariate and multivariable analysis were performed to assess the impact of BaS on the point prevalence and the probability of CKD and ESRD. Similarly, a multivariable logistic regression was conducted to measure the impact of the most important risk factors for CKD exclusively in a severely obese population. Data on 296,041 BaS cases and 2,004,804 severely obese controls was extracted from the NIS database and relative to controls, all baseline CKD risk factors were less common among bariatric surgery cases. Nonetheless, even after adjusting for all CKD risk factors, controls exhibited marked increases in the odds of CKD-stage III (odds ratio [OR] 3.10 [3.05-3.14], P < .0001) and modes increase for ESRD (OR 1.13 [1.09-1.18], P < .0001). Overall, even after adjusting for risk factors we observed that the rate of CKD is significantly higher in the control group, 12% when compared with 5.3% in the bariatric surgery group (P < .0001). In this retrospective, case control study of a large, representative national sample of patients with severe obesity, BaS was found to be associated with significantly reduced point-prevalence and likelihood for CKD when adjusted for baseline CKD risk factors as compared with patients with obesity who did not undergo BaS. Overall, BaS resulted in a reduced rate and a moderate decrease in the likelihood of ESRD.

POS-313 Screening for CKD in a rural population in the Himalayan foothills of India

In India, given its huge population and rapid rise in chronic kidney disease (CKD) risk factors such as diabetes and hypertension, the rising incidence of CKD is likely to pose major problems for both healthcare and economy in future years. Unfortunately, there is paucity of information on CKD screening programs in rural India. The main objective of this pilot study was to test the effectiveness of a targeted screening program for early stages CKD in Manali, Himachal Pradesh (HP).

POS-200 NEW GAB CHRONIC KIDNEY DISEASES CLASSIFICATION

The present study proposes to use a new Chronic Kidney Disease (CKD) classification called GAB, which uses the following variables, G: glomerular filtration rate (GFR), A: albumin/creatinine ratio (ACR) in narrower ranges to achieve a more accurate diagnosis and follow-up of CKD and adds B: blood pressure as a classifying parameter because it has been shown to be the second risk factor and progression of CKD as reported in the current literature.

Association between liver stiffness measurement by transient elastography and chronic kidney disease.

Transient elastography or elastometry (TE) is widely used for clinically cirrhosis and liver steatosis examination. Liver fibrosis and fatty liver had been known to share some co-morbidities that may result in chronic impairment in renal function. We conducted a study to analyze the association between scores of 2 TE parameters, liver stiffness measurement (LSM) and controlled attenuation parameter (CAP), with chronic kidney disease among health checkup population.This was a retrospective, cross-sectional study. Our study explored the data of the health checkup population between January 2009 and the end of June 2018 in a regional hospital. All patients were aged more than 18 year-old. Data from a total of 1940 persons were examined in the present study. The estimated glomerular filtration rate (eGFR) was calculated by the modification of diet in renal disease (MDRD-simplify-GFR) equation. Chronic kidney disease (CKD) was defined as eGFR < 60 mL/min/1.73 m2.The median of CAP and LSM score was 242, 265.5, and 4.3, 4.95 in non-CKD (eGFR > 60) and CKD (eGFR < 60) group, respectively. In stepwise regression model, we adjust for LSM, CAP, inflammatory markers, serum biochemistry markers of liver function, and metabolic risks factors. The P value of LSM score, ALT, AST, respectively is .005, <.001, and <.001 in this model.The LSM score is an independent factor that could be used to predict renal function impairment according to its correlation with eGFR. This result can further infer that hepatic fibrosis may be a risk factor for CKD.

Genetically Predicted Circulating Copper and Risk of Chronic Kidney Disease: A Mendelian Randomization Study.

Elevated circulating copper levels have been associated with chronic kidney disease (CKD), kidney damage, and decline in kidney function. Using a two sample Mendelian randomization approach where copper-associated genetic variants were used as instrumental variables, genetically predicted higher circulating copper levels were associated with higher CKD prevalence (odds ratio 1.17; 95% confidence interval 1.04, 1.32; p-value = 0.009). There was suggestive evidence that genetically predicted higher copper was associated with a lower estimated glomerular filtration rate and a more rapid kidney damage decline. In conclusion, we observed that elevated circulating copper levels may be a causal risk factor for CKD.

Prevalence of Chronic Kidney Disease and Variation of Its Risk Factors by the Regions in Okayama Prefecture.

Objective: The prevention of chronic kidney disease (CKD) progression is an important issue from health and financial perspectives. We conducted a single-year cross-sectional study to clarify the prevalence of CKD and its risk factors along with variations in these factors among five medical regions in Okayama Prefecture, Japan. Methods and Results: Data concerning the renal function and proteinuria as well as other CKD risk factors were obtained from the database of the Japanese National Health Insurance. The proportion of CKD patients at an increased risk of progression to end-stage renal disease (ESRD), classified as orange and red on the CKD heatmap, ranged from 6–9% and did not vary significantly by the regions. However, the causes of the increased severity differed between regions where renal dysfunction was predominant and regions where there were many patients with proteinuria. CKD risk factors, such as diabetes mellitus, hypertension, hyper low-density lipoprotein-cholesterolemia, obesity, smoking and lack of exercise, also differed among these regions, suggesting that different regions need tailored interventions that suit the characteristics of the region, such as an increased health checkup ratio, dietary guidance and promotion of exercise opportunities. Conclusions: Approximately 6–9% of people are at an increased risk of developing ESRD (orange or red on a CKD heatmap) among the population with National Health Insurance in Okayama Prefecture. The underlying health problems that cause CKD may differ among the regions. Thus, it is necessary to consider intervention methods for preventing CKD progression that are tailored to each region’s health problems.

È possibile una gestione “ideale” della pandemia da malattia renale cronica?

Chronic Kidney Disease (CKD) is recognized as one of the major categories of noncommunicable epidemic diseases and in the last decades it has been largely growing in incidence and prevalence all over the world. Ideal management of CKD pandemic should be comprehensive of measures of tertiary, secondary, primary and primordial prevention. So, it should include prompt diagnosis and treatment of traditional and non-traditional risk factors for CKD, optimal conservative treatment for non-dialysis dependent CKD patients and appropriated dialysis therapy or renal transplantation for patients with end-stage renal disease. However, these goals are not easy to obtain on a global scale. It would be possible only by a broad and holistic approach, ranging from good governance to achievement of the sustainable development goals (SDGs).

Chronic Kidney Disease and Its Clinical Correlates in a Rural Community in Southwestern Nigeria.

Chronic kidney disease (CKD) is a burgeoning problem globally, and more than a billion adults were affected as of 2016, with 1.2 million people dying from renal failure in 2017. To arrest the seemingly relentless progression of CKD to renal failure, there is a need to detect CKD early in the community. A community-based study was carried out to look at the prevalence and risk factors of CKD. Anthropometric and other clinical variables were measured. Blood samples were taken for determining creatinine, uric acid, urea, and lipids. CKD was defined as an estimated glomerular filtration rate of ≤60 mL/min/1.73 m2. Electrocardiograms and renal ultrasound scans were performed. In total, 201 people were recruited. Those with CKD had a male:female ratio of 1:3.9 and were older. The prevalence of autosomal-dominant polycystic kidney disease and CKD was 531.9 persons/100,000 population and 46.3%, respectively. Systolic blood pressure, pulse pressure, total cholesterol, triglycerides, high-density lipoprotein (HDL), uric acid, QTc interval, and electrocardiographic left ventricular hypertrophy were higher in those with CKD. Age, female sex, and HDL were independently associated with CKD. There was a steep rise in CKD at the community level. Increased awareness of CKD and prompt interventions are therefore imperative.

Quality indicators for primary health care in chronic kidney disease in the public service of a city in the State of São Paulo, Brazil.

Complications of chronic kidney disease (CKD) can be avoided when promptly diagnosed and treated. The objective was to describe quality indicators of CKD detection and health care in the primary care public service of a city in the State of São Paulo, Brazil. This retrospective study analyzed charts of patients who attended primary care in the public service between November 2019 and February 2020. We selected 10 health quality indicators based on their scientific relevance and availability from the medical records that could express how CKD was identified and managed in primary health care. We estimated the adequate percentage of health indicators with data from 1,066 individuals who had ≥ one risk factor for CKD: hypertension, diabetes, or > 60 years old. Among patients, 79.4% had information on serum creatinine, whereas 58.8% were investigated for proteinuria. Blood pressure data were found in 98.9% of the records. The percentage of patients with blood pressure < 140x90mmHg, glycosylated hemoglobin < 6.5% and LDL-cholesterol < 100mg/dL was 79.2%, 49.2%, and 33.3%, respectively. Renin-angiotensin system blockers were prescribed to 82.8% of the patients with hypertension and CKD. Serum potassium was measured in 35.7% for those who were using renin-angiotensin system blockers. Among those people with CKD, 16.7% had CKD assigned in the medical records as a diagnose. Among those participants at higher risk for CKD, the referral rate to a nephrologist was 31.6%. This study confirmed some missed quality indicators of CKD in primary healthcare. Our results may help administrators develop public policies that improve health care for individuals at high risk for CKD. Long-term follow-up of the health indicators we proposed here will be useful to assess the impact of policy intervention.

Multiple Stakeholder Perspectives on the Reinvigorated Case for Kidney Disease Screening.

The United States Preventive Services Task Force has no current recommendation to guide primary care physician screening for chronic kidney disease (CKD). This is misaligned with the scope of the CKD public health emergency, recommendations from clinical practice guidelines, health spending on CKD, the changing landscape of CKD detection and treatment, and the focus by policymakers on identifying tangible approaches to improving health equity. This review summarizes patient, clinician, health equity, and health system perspectives in support of screening adults with risk factors for CKD. This review concludes with the assessment that the United States Preventive Services Task Force should revisit targeted CKD screening specifically for adults with diabetes and/or hypertension.

‘Kidney Health for All’ - Implications for India

‘Kidney Health for All’ - Implications for India

Challenges of conducting kidney health checks among patients at risk of chronic kidney disease and attending an urban Aboriginal and Torres Strait Islander primary healthcare service.

The increasing incidence of chronic kidney disease (CKD) globally highlights the importance of early targeted screening of at-risk persons in primary healthcare settings. This study investigated the early detection of CKD among Aboriginal and Torres Strait Islander patients attending an urban primary healthcare service. Routine data extracted for all patients with an active electronic medical record on 7 December 2017 were used to identify patients who were eligible to have a kidney health check (KHC), comprising estimated glomerular filtration rate (eGFR) and urine albumin creatinine ratio (UACR) tests. A subsequent manual search of electronic health records identified the presence of CKD risk factors and follow-up KHCs. Of the 1181 eligible patients, 171 (15%) had a complete initial KHC. Of the eight patients with an initial abnormal eGFR, two (25%) had a repeat eGFR assessment within 3 months to confirm the presence of CKD. Of the 30 patients who had an initial abnormal UACR result, three (10%) had at least one repeat UACR measurement within 3 months. In patients with diabetes and/or hypertension and a normal initial KHC, 51% had a repeat eGFR and 36% had UACR within the recommended time frame of 12 months. Similar findings were observed for the recommended time frame of 24 months in patients without diabetes or hypertension. Accurate documentation of risk factors for CKD and processes to address the barriers to implementation of Kidney Health Australia guidelines will assist in preventing or delaying progression of CKD.

Awareness Regarding Chronic Kidney Disease Among Adults in a Hospital of Siddharthanagar Municipality

INTRODUCTION: Chronic kidney disease (CKD) has been recognized as a leading public health problem worldwide. Early detection and management of the risk factors of CKD is helpful for its prevention and reduction of burden caused by it. This study aimed to find out the awareness regarding chronic kidney disease among adults in a hospital of Siddharthanagar Municipality. MATERIAL AND METHODS: Hospital based descriptive cross-sectional study was used to find out the awareness regarding chronic kidney disease among 165 adults attending Medical out patient department of Universal College of Medical Sciences, Bhairahawa, Rupandehi, Nepal from July 11 to July 25, 2021. Descriptive and inferential statistics were used to assess the awareness level and its association with different socio-demographic variables. RESULTS: The findings of the study showed that 57.6% of respondents had low level of awareness regarding chronic kidney disease. Respondents have high awareness on risk factors of chronic kidney disease whereas respondents have relatively low awareness on meaning and clinical features of chronic kidney disease. CONCLUSION: On the basis of findings, it is concluded that more than half of the respondents have low awareness level regarding chronic kidney disease so an effort should be made to improve the awareness regarding chronic kidney disease for early identification and management of chronic kidney disease.

Workplace Outreach Program Improves Management of Chronic Kidney Disease.

Assess whether an employee outreach program improved management of chronic kidney disease (CKD). Participants with suspected CKD (eGFR <60 mL/min/1.73m 2 ) identified in employee health assessments in 2017 and 2018 were contacted by phone and offered physician consultation. Subsequent nephrologist visits at 11 months of follow up were compared between those who were (outreach group) and were not (control group) successfully contacted. Most CKD risk factors at baseline were similar in outreach and control groups. At the end of the follow-up, outreach participants had more than 2-fold greater incidence of visiting a nephrologist compared with controls (HR = 2.3; 95% CI 1.2-4.2, P = 0.01), after adjusting for potential confounders. Conclusions: Employee outreach program increased utilization of nephrologist care.

Gender Differences in the Association Between Obesity Indices and Chronic Kidney Disease Among Middle-Aged and Elderly Taiwanese Population: A Community-Based Cross-Sectional Study.

BackgroundTraditional risk factors for chronic kidney disease (CKD) include diabetes mellitus (DM), hypertension (HTN), and metabolic syndrome, which are health conditions related to obesity. We aimed to investigate which of the three obesity indices has the strongest association with CKD and to explore whether there are gender differences in these relationships in the middle-aged and elderly Taiwanese population.MethodsThis was a cross-sectional, community-based study. It included 400 residents (141 males and 259 females, age 50–90 years) residing in a community in northern Taiwan. Each participant was asked to fill a questionnaire that collected personal information, medical history, medication use, and anthropometric measurements. The laboratory data were obtained by testing the blood and urine samples. The baseline characteristics were compared, and the obesity indices included body mass index (BMI), waist circumference (WC), and visceral adiposity index (VAI). CKD was defined as the presence of renal dysfunction (urine albumin-creatinine ratio ≥ 30 mg/g) or estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m2. We used a multiple logistic regression model to evaluate the association between each obesity index and CKD for both genders. Further, we used the area under the receiver operating characteristic (ROC) curve (AUC) to examine the best obesity indices to predict CKD in different genders.ResultsThe average age of the subjects was 64.47 ± 8.45 years, and men were significantly older. CKD was found in 31 (22.0%) males and 50 (19.3%) females. In men, there was no significant difference between the CKD and non-CKD groups among the three obesity indices. However, in women, only VAI was significantly higher in subjects with CKD (1.9 [1.1, 3.4]) than in subjects without CKD (1.5 [1.0, 2.2]) (p-value = 0.03). The multivariate logistic regression revealed that even after adjusting for possible confounding factors, VAI was found to be an independent risk factor for CKD in women (OR: 1.32, 95% CI: 1.04-1.69, p = 0.02), but not in men (OR: 1.20, 95% CI: 0.85-1.69, p = 0.30). The AUC of VAI had a significant ability to predict CKD in women but not in men.ConclusionOur results showed that among the three obesity indices, VAI had the strongest association with CKD compared to BMI and WC in women. In addition, VAI in women should be given more importance in the screening for CKD among the middle-aged and elderly Taiwanese population.

Assessment of Alveolar Bone and Periodontal Status in Peritoneal Dialysis Patients.

Chronic kidney disease (CKD) affects 8–13% of the global population and has become one of the largest burdens on healthcare systems around the world. Peritoneal dialysis is one of the ultimate treatments for patients with severe CKD. Recently, increasing severe periodontal problems have been found in CKD patients. Periodontitis has been identified as a new variable risk factor for CKD. The aim of this study was to investigate the periodontal status and severity of alveolar bone loss in CKD patients with peritoneal dialysis (PD). One hundred and six patients undergoing PD (PD group) and 97 systemically healthy periodontitis patients (control group) were enrolled. The differences in the dimensions of the alveolar bone between two groups were compared, and the distribution of alveolar bone defects was analyzed by cone-beam computed tomography (CBCT). Gingival index (GI), plaque index (PLI), periodontal probing depth (PPD), and attachment loss (AL) were recorded. The levels of inflammatory factors in gingival crevicular fluid were assessed by ELISA. Compared to control group, there was a higher degree of alveolar bone loss in maxillary premolars, maxillary 2nd molar and mandibular 1st molar in patients with PD (p < 0.05). A comparison of bone loss in different sites revealed that the area with the highest degree of bone loss were on the mesial-buccal, mid-buccal, distal-buccal, and mesial-lingual site in PD patients. The expression levels of inflammatory factors were higher in PD group (p < 0.01). In conclusion, PD patients presented more severe periodontal and inflammatory status than systemically healthy periodontitis patients. The loss of the alveolar bone differed between the two groups. Different sites and teeth exhibited a diverse degree of bone loss. This study highlights that clinicians should pay close attention to periodontal status of peritoneal dialysis patients and provides a new thinking to improve healthcare for CKD.

Statin Use and Incidence of Chronic Kidney Disease in Hypercholesterolemia Patients with Normal Renal Function

Introduction: Dyslipidemia is a known risk factor for chronic kidney disease (CKD). The effects of statins on CKD have already been studied in patients with CKD; however, data on the general population are limited. This study aimed to determine the relationship between statin use and the incidence of CKD in patients with hypercholesterolemia having normal renal function. Methods: A total of 7,856 participants aged 40–79 years at baseline (2009–2010) were included in the final analyses. The participants were divided into statin users (n = 4,168) and statin nonusers (n = 3,668), according to the statin usage. The Cox proportional hazard regression model was used to evaluate the adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for CKD. Results: The median follow-up duration was 5.8 years. A total of 543 cases of CKD (285 cases in males and 258 cases in females) occurred during the study period. The estimated cumulative incidence of CKD was significantly different between male statin nonusers and users (p < 0.001), while it was not statistically significant between female statin nonusers and users (p = 0.126). Compared with statin nonusers, the fully adjusted HRs (95% CIs) for CKD in statin users were 1.014 (0.773–1.330) in males and 1.117 (0.843–1.481) in females. Conclusion: Dyslipidemia is an obvious risk factor for CKD; however, statin use in patients with hypercholesterolemia having normal renal function does not demonstrate a clear relationship with the incidence of CKD.

High Prevalence of Chronic Kidney Disease Among People Living with Hypertension in Rural Sierra Leone: A Cross-Sectional Study.

IntroductionCurrently, there are no data on prevalence and associated risk factors of chronic kidney disease (CKD) among patients with hypertension in rural Sierra Leone.PurposeTo estimate the prevalence and associated risk factors of CKD in rural Sierra Leone.Patients and MethodsA cross-sectional study of hypertension patients aged between 18 and 75 years attending a non-communicable disease clinic at Koidu Government Hospital, Kono District, Sierra Leone was conducted between February and December 2020. Using systematic random sampling, a structured questionnaire, which comprised of questions on social demographic characteristics and past and current clinical history, was administered followed by measurement of creatinine and urinary protein and glucose. Estimated glomerular filtration rate (eGFR) was estimated using CKD-epidemiology formula without race as a factor. Baseline eGFR between 60–89 min/mL/1.73m2 and <60 min/mL/1.73m2 defined reduced eGFR and renal impairment, respectively. Estimated GFR less than 60 min/mL/1.73m2 measured two times at least 3 months apart was used to define CKD.ResultsNinety-six percent (n = 304) patients out of 317 patients were included in the study. Among all included patients, only 3.9% (n = 12) had eGFR of 90 min/mL/1.73m2 and above. The prevalence of renal impairment and CKD was 52% (158/304, CI 46.2–57.7) and 29.9% (91/304, CI 24.8–34.5), respectively. In adjusted logistic regression analysis, currently taking herbal medications as treatment of hypertension (OR 4.11 (CI 1.14–14.80), p = 0.03) and being overweight and/or obese (OR 2.16 (CI 1.24–3.78), p < 0.001) was associated with CKD. Additionally, receiving some education was associated with a 48% (OR 0.52 (CI 0.29–0.91), p = 0.02) reduced likelihood of CKD.ConclusionThe prevalence of renal impairment and CKD is high among hypertensive patients in rural Sierra Leone. CKD was associated with current history of taking herbal medications and being overweight and/or obese. Additionally, CKD was associated with reduced likelihood in patients who received some education.

Improved oral hygiene care and chronic kidney disease occurrence: A nationwide population-based retrospective cohort study.

Oral diseases or poor oral hygiene have close connections with systemic inflammatory reaction, which is one of major mechanism in the development of chronic kidney disease (CKD). We conducted a research assuming that better oral hygiene care would be negatively related with the risk of developing new-onset CKD.From 2003 to 2004, a total of 158,495 participants from the Korean national health insurance data sharing service which provides health screening data including variables as age, sex, vascular risk factors, medication information, indicators regarding oral hygiene, and laboratory results. The diagnosis of CKD and vascular risk factors were defined according to the International Statistical Classification of Diseases and Related Health Problems codes-10th revision. The follow-up period for the study subject was until the occurrence of CKD, until death, or Dec 31, 2015.Approximately 13.3% of the participants suffered from periodontal disease, and 40.7% brushed their teeth at least three times a day. With a median of 11.6 (interquartile range 11.3–12.2) years’ follow-up, the cohort included 3223 cases of incident CKD. The 10-year incidence rate for CKD was 1.80%. In multivariable analysis with adjustment for age, sex, demographics, vascular risk factors, blood pressure, and blood laboratory results, frequent tooth brushing (≥3 times a day) was negatively related to occurrence of CKD (hazard ratio: 0.90, 95% confidence interval [0.83–0.99], P = .043, P value for trend = .043).Participants with improved oral hygiene (≥3 times a day) have showed less risk of CKD. Additional interventional studies are in need to establish causative relationship between oral hygiene and risk of CKD.