Risk Factor For Kidney Disease Research Articles

Prevalence of Chronic Kidney Disease in Individuals With Type 2 Diabetes Within Primary Care: A Cross-Sectional Study.

To assess the prevalence and risk factors for chronic kidney disease (CKD) among adults with type 2 diabetes within primary care. This cross-sectional study evaluated 1319 individuals receiving standard care across 26 primary units from July 2017 to January 2023. The estimated glomerular filtration rate (eGFR) and albuminuria were used for the diagnosis of CKD. CKD was defined by eGFR values of <60 mL/min/1.73 m2 and/or albumin-to-creatine ratio ≥30 mg/g. Logistic regression was applied to identify factors associated with CKD and study variables. The median age of participants (60.6% females) was 55 years and the median diabetes duration was 10 years. The overall CKD prevalence in the study population was 39.2%. Within the CKD group, the prevalence rates of albuminuria, albuminuria coupled with low eGFR and isolated low eGFR were 72.1%, 19%, and 8.9%, respectively. The prevalence of CKD was 30.6% among participants under 40 years old and a higher value was observed in middle-aged adults with early-onset diabetes (at age <40 years) compared with the later-onset group. Multivariable analyses identified associations between CKD and factors such as age, the male sex, diabetes duration, hypertension, retinopathy, and metformin use. A relatively high prevalence of CKD, especially in non-elderly adults, was revealed in this primary care study. Early recognition strategies for CKD are crucial for timely prevention within primary care.

Age- and Sex-Specific Reference Values for Renal Volume and Association with Risk Factors for Chronic Kidney Disease in a General Population—An MRI-Based Study

Age- and Sex-Specific Reference Values for Renal Volume and Association with Risk Factors for Chronic Kidney Disease in a General Population—An MRI-Based Study

Social deprivation and diabetic kidney disease: A European view.

There is a large body of literature demonstrating a social gradient in health and increasing evidence of an association between social deprivation and diabetes complications. Diabetic kidney disease (DKD) increases mortality in people with diabetes. Socioeconomic deprivation is increasingly recognized as a modifier of risk factors for kidney disease but also an independent risk factor itself for kidney disease. This may not be truly appreciated by clinicians and warrants further attention and exploration. In this review we explore the literature to date from Europe on the relationship between social deprivation and DKD. The majority of the studies showed at least an association with microalbuminuria, an early marker of DKD, while many showed an association with overt nephropathy. This was seen across many countries in Europe using a variety of different measures of deprivation. We reviewed and considered the mechanisms by which deprivation may lead to DKD. Health related behaviors such as smoking and suboptimal control of risk factors such as hypertension, hyperglycemia and elevated body mass index (BMI) accounts for some but not all of the association. Poorer access to healthcare, health literacy, and stress are also discussed as potential mediators of the association. Addressing deprivation is difficult but starting points include targeted interventions for people living in deprived circumstances, equitable roll out of diabetes technology, and flexible outpatient clinic arrangements including virtual and community-based care.

Epidemiology of tobacco use in dialysis patients in France and survey of nephrologists' involvement in counseling ontobacco discontinuation.

Tobacco smoking is an independent risk factor for chronic kidney disease (CKD) and increases morbidity and mortality in CKD patients. The primary objective of the study was to investigate the epidemiology of smoking in patients undergoing maintenance dialysis in France. A second objective was to assess the involvement of nephrologists in supportingpatients forsmoking cessation. Data on the smoking history of prevalent patients on maintenance dialysis in France between 2010 and 2020 were obtained from the REIN database (Renal Epidemiology and Information Network),updated by all French nephrology and dialysiscenters. As for the support to smoking discontinuation, a questionnaire on smoking cessation assistance was sent to all members of the French Society of Nephrology, Dialysis and Transplantation (SFNDT). The proportion of current smokers among patients on maintenance dialysis was 10.4% in 2010, 11.2% in 2015 and 11.6% in 2020. A total of 228 nephrologists among the 790 members of the SFNDT participated in the survey (28.9%). Most respondents were women (57.3%), worked at a public hospital (61.1%), were under 40years of age (51.3%) and had no history of smoking (60.8%). The majority reported asking patients about their smoking status and offering brief advice. Among respondents, 72.8% offered help with smoking cessation, 46.3% referred their smoking patients to a tobacco specialist, 51.8% reported prescribing drugs to quit tobacco, and 81.6% requested further training in howtosupport patients forsmoking cessation. Smoking cessation training for nephrologists and dedicated programs for patients in nephrology units could improve our practices and decrease the high prevalence of smoking in patients with ESKD.

Mediation analysis of chronic kidney disease risk factors using kidney biomarkers in women living with HIV.

Novel urinary biomarkers reflecting kidney tubule health are associated with chronic kidney disease (CKD) risk in persons living with HIV. However, it is unknown whether these biomarkers provide mechanistic insight into the associations between clinical risk factors for CKD and subsequent CKD risk. Among 636 women living with HIV in the Women's Interagency HIV Study with estimated glomerular filtration rate (eGFR) >60 ml/min/1.73 m 2 , we used a counterfactual approach to causal mediation analysis to evaluate the extent to which systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin a1c (Hba1c) and serum albumin associations with incident CKD were mediated by eight urine proteins. These biomarkers reflect proximal tubular reabsorptive dysfunction (α1-microglobulin [a1m], β2-microglobulin, trefoil factor 3); tubular injury (interleukin 18 [IL-18], kidney injury molecule 1 [KIM-1]); kidney repair (epidermal growth factor); tubular reserve (uromodulin); and glomerular injury (urinary albumin). Incident CKD was defined as eGFR <60 ml/min/1.73 m 2 measured at two consecutive 6-month visits with an average annual eGFR decline ≥3% per year. During a median follow-up of 7 years, 11% developed CKD. Urinary albumin and KIM-1 mediated 32% (95% CI: 13.4%, 76.6%) and 23% (6.9%, 60.7%) of the association between SBP and incident CKD, respectively; and 19% (5.1%, 42.3%) and 22% (8.1%, 45.7%) of the association between DBP and incident CKD, respectively. Urinary albumin, α1m, and IL-18 were significant mediators of the association between Hba1c and incident CKD. None of the eight biomarkers mediated the association between serum albumin and incident CKD. Among women living with HIV, several urinary biomarkers reflecting distinct dimensions of kidney health may partially explain the associations between SBP, DBP, and Hba1c and subsequent CKD risk.

Correlation of Calcium Metabolic Axis with Urinary Stone Characteristics

Background: Urinary stone disease (USD) refers to the presence of stones or salt crystals within the urinary tract, with calcium stones accounting for approximately 80% of cases. Increased urinary calcium and phosphorus excretion predispose individuals to urinary stones, with hypercalciuria being the most significant risk factor. Vitamin D plays a pivotal role in modifying urine calcium and phosphorus excretion, and it enhances calcium and phosphorus reabsorption in the kidneys. Urinary stone disease is a recognized risk factor for chronic kidney disease (CKD) and may also lead to life-threatening complications such as perinephric abscesses, urosepsis, and urinary tract malignancies. The role of serum vitamin D and its effects on serum calcium and phosphorus in urinary stone formation have been subjects of controversy. Objectives: This study aims to evaluate the associations between serum calcium, phosphorus, and vitamin D levels and urinary stones. Methods: This retrospective study involved two groups of 90 patients, one with urinary stones and the other without. Demographic and biochemical data, including serum calcium, phosphorus, and 25-(OH) vitamin D levels, were recorded for all patients. Patients were categorized into four groups based on their serum vitamin D levels: Excess, sufficient, insufficient, and deficient. The presence and characteristics of urinary stones were assessed using non-contrast CT scans. Results: The mean age of the patients was 54.62 ± 15.46 years. Laboratory investigations revealed mean serum calcium, phosphorus, and vitamin D levels of 9.56 ± 0.65 mg/dL, 3.53 ± 0.79 mg/dL, and 25.05 ± 12.96 ng/mL, respectively. This study demonstrated a significant correlation between serum calcium levels and the maximum diameter of urinary stones (correlation = 0.313, P-value = 0.005). No other significant associations were found between serum calcium, serum phosphorus, and serum vitamin D levels and the number of kidney stones, stone laterality, and type of kidney stone. There was also no significant difference between the two groups. Conclusions: In conclusion, the role of serum calcium, phosphorus, and 25-(OH) vitamin D levels in urinary stone formation remains controversial. This study suggests that there is no significant association between serum calcium, phosphorus, or 25-(OH) vitamin D and urinary stones, except for a positive association between serum calcium and the diameter of the stone.

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

Historically, it takes an average of 17 years for new treatments to move 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. Now is the time 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 are diagnosed worldwide, and even fewer are treated to target. Similarly, the vast majority of people living with kidney disease are unaware of their condition, because it is often silent in the early stages. 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 the patient to the clinician to the 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.

Chronic kidney disease combined with metabolic syndrome is a non-negligible risk factor.

Metabolic syndrome (MetS) is a group of conditions characterized by hypertension (HTN), hyperglycaemia or insulin resistance (IR), hyperlipidaemia, and abdominal obesity. MetS is associated with a high incidence of cardiovascular events and mortality and is an independent risk factor for chronic kidney disease (CKD). MetS can cause CKD or accelerate the progression of kidney disease. Recent studies have found that MetS and kidney disease have a cause-and-effect relationship. Patients with CKD, those undergoing kidney transplantation, or kidney donors have a significantly higher risk of developing MetS than normal people. The present study reviewed the possible mechanisms of MetS in patients with CKD, including the disorders of glucose and fat metabolism after kidney injury, IR, HTN and the administration of glucocorticoid and calcineurin inhibitors. In addition, this study reviewed the effect of MetS in patients with CKD on important target organs such as the kidney, heart, brain and blood vessels, and the treatment and prevention of CKD combined with MetS. The study aims to provide strategies for the diagnosis, treatment and prevention of CKD in patients with MetS.

Associations between the Serum Triglyceride Level and Kidney Outcome in Patients with Chronic Kidney Disease: The Fukuoka Kidney disease Registry Study.

Hypertriglyceridemia is a risk factor for chronic kidney disease (CKD). However, whether or not it predicts the risk of CKD progression is unknown. This study evaluated the association between serum triglyceride (TG) levels and kidney disease progression in patients with non-dialysis-dependent CKD. The Fukuoka Kidney disease Registry (FKR) study was a multicenter, prospective longitudinal cohort study. In total, 4,100 patients with CKD were followed up for 5 years. The primary outcome was the incidence of CKD progression, defined as a ≥ 1.5-fold increase in serum creatinine level or the development of end-stage kidney disease. The patients were divided into quartiles according to baseline serum TG levels under non-fasting conditions: Q1 ＜87 mg/dL; Q2, 87-120 mg/dL; Q3, 121-170 mg/dL, and Q4 ＞170 mg/dL. During the 5-year observation period, 1,410 patients met the criteria for CKD progression. The multivariable-adjusted Cox proportional hazards model showed a significant association between high serum TG level and the risk of CKD progression in the model without macroalbuminuria as a covariate (multivariable hazard ratio[HR] for Q4 versus Q1, 1.20; 95% CI, 1.03-1.41; P=0.022), but the significance disappeared after adjusting for macroalbuminuria (HR for Q4 versus Q1, 1.06; 95% CI, 0.90-1.24; P=0.507). The present findings suggest that individuals with high serum TG levels are more likely to develop CKD progression than those without; however, whether or not higher serum TG levels reflect elevated macroalbuminuria or lead to CKD progression via elevated macroalbuminuria is unclear.

Risk factors for renal dysfunction after isolated intestinal transplantation.

Kidney dysfunction is a known complication of intestinal transplantation; however, the rate of development and risk factors for chronic kidney disease (CKD) remain poorly defined. This was a single-center retrospective review of isolated adult intestinal allograft recipients from 2011 to 2019. Patients who died or experienced graft loss within 1-year or had a prior transplant were excluded. Estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI equation at 0-, 6- and 12-months post-transplant, and multivariable linear regression was performed to identify variables associated with adjusted eGFR at 1-year. Independent variables included age, ethnicity, BMI, history of diabetes/hypertension, vasopressor use, TPN and stoma days, urinary or bloodstream infections, intravenous contrast exposure, rejection, concomitant immunosuppression, and time above the therapeutic range of tacrolimus. Variables with a p<.1 in univariate analysis were considered for multivariable modeling. Thirty-three patients were included with a mean age of 43.9±13.0. A mean 42.3% decline in eGFR was observed at 1-year post-transplant, with 15.2% of patients developing new stage 4/5 CKD. Factors associated with a greater decline in adjusted eGFR in the univariate model included increasing age, decreased BMI, stoma days, and vasopressor use. In the adjusted multivariable model patient age (β=-.77, p<.01) and stoma days (β=-.06, p<.01) remained significant. Tacrolimus and sirolimus exposure were not associated with decline in eGFR at 1 year. Renal dysfunction is common following intestinal transplantation. The need for stoma creation should be carefully considered, and reversal should be performed when feasible for renal protection.

The characterization and comorbidities of heterozygous Bardet-Biedl syndrome carriers.

Introduction: Bardet-Biedl syndrome (BBS) is a rare autosomal recessive disorder with clinical features of retinal dystrophy, obesity, postaxial polydactyly, renal anomalies, learning disabilities, hypogonadism, and genitourinary abnormalities. Nevertheless, previous studies on the phenotypic traits of BBS heterozygous carriers have generated inconclusive results. The aim of our study was to investigate the impact of BBS heterozygosity on carriers when compared to non-carriers within the Taiwanese population. Materials and Methods: This study follows a hospital-based case-control design. We employed the Taiwan Biobank version 2 (TWBv2) array to identify three specific loci associated with BBS (rs773862084, rs567573386, and rs199910690). In total, 716 patients were included in the case group, and they were compared to a control group of 2,864 patients who lacked BBS alleles. The control group was selected through gender and age matching at a ratio of 1:4. The association between BBS-related loci and comorbidity was assessed using logistic regression models. Results: We found that BBS heterozygous carriers exhibited a significant association with elevated BMI levels, especially the variant rs199910690 in MKS1 (p=0.0037). The prevalence of comorbidities in the carriers' group was not higher than that in the non-carriers' group. Besides, the average values of the biochemistry data showed no significant differences, except for creatinine level. Furthermore, we conducted a BMI-based analysis to identify specific risk factors for chronic kidney disease (CKD). Our findings revealed that individuals carrying the CA/AA genotype of the BBS2 rs773862084 variant or the CT/TT genotype of the MKS1 rs199910690 variant showed a reduced risk of developing CKD, irrespective of their BMI levels. When stratified by BMI level, obese males with the MKS1 rs199910690 variant and obese females with the BBS2 rs773862084 variant exhibited a negative association with CKD development. Conclusion: We found that aside from the association with overweight and obesity, heterozygous BBS mutations did not appear to increase the predisposition of individuals to comorbidities and metabolic diseases. To gain a more comprehensive understanding of the genetic susceptibility associated with Bardet-Biedl Syndrome (BBS), further research is warranted.

Improving Chronic Kidney Disease Risk Factor Screening Among Older Adults: A Quality Improvement Project

Improving Chronic Kidney Disease Risk Factor Screening Among Older Adults: A Quality Improvement Project

Improving Chronic Kidney Disease Risk Factor Screening Among Older Adults: A Quality Improvement Project

Improving Chronic Kidney Disease Risk Factor Screening Among Older Adults: A Quality Improvement Project

Cross sectional Study about Risk factors of increase the chronic kidney disease (CKD) in Wadi Ataba City southern Libya.

A retrospective study conducted in 2023 on risk factors for chronic kidney disease (CKD), in patients from Southern Libya (Wadi Ataba). The present study was focused on the relationship between a few disorders that have been linked to chronic kidney disease (CKD) and other diseases. The goal of the current study is to investigate the risk factors for chronic renal disease in the city of Wadi Ataba in southern Libya. The 27-questions questionnaire was used to gather the data, which were included categories such as personal information, health conditions, family history of diabetes, hypertension, and renal failure, questions regarding the abuse of analgesics and herbs, questions about energy drinks and their origins, and questions about lifestyle habits such as drinking water and source of them. 379 participants were interviewed. Response rate was 98 %. Among the patients in our samples, which found that the highest risk factors for CKD were hypertension (HT) at 28.5%, followed by diabetes mellitus (DM) and hypertension combined at 16.1%, and diabetes at 36.1%..One important finding of the current study is the increased association between diadetes and CDK. They represent about one third (29.1%).

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).

Chronic kidney disease in a murine model of non-alcoholic steatohepatitis (NASH)

Clinical studies suggest that non-alcoholic steatohepatitis (NASH) is an independent risk factor for chronic kidney disease (CKD), but causality and mechanisms linking these two major diseases are lacking. To assess whether NASH can induce CKD, we have characterized kidney function, histological features, transcriptomic and lipidomic profiles in a well-validated murine NASH model. Mice with NASH progressively developed significant podocyte foot process effacement, proteinuria, glomerulosclerosis, tubular epithelial cell injury, lipid accumulation, and interstitial fibrosis. The progression of kidney fibrosis paralleled the severity of the histologic NASH-activity score. Significantly, we confirmed the causal link between NASH and CKD by orthotopic liver transplantation, which attenuated proteinuria, kidney dysfunction, and fibrosis compared with control sham operated mice. Transcriptomic analysis of mouse kidney cortices revealed differentially expressed genes that were highly enriched in mitochondrial dysfunction, lipid metabolic process, and insulin signaling pathways in NASH-induced CKD. Lipidomic analysis of kidney cortices further revealed that phospholipids and sphingolipids were the most significantly changed lipid species. Notably, we found similar kidney histological changes in human NASH and CKD. Thus, our results confirm a causative role of NASH in the development of CKD, reveal potential pathophysiologic mechanisms of NASH-induced kidney injury, and established a valuable model to study the pathogenesis of NASH-associated CKD. This is an important feature of fatty liver disease that has been largely overlooked but has clinical and prognostic importance.

Association of blood metal exposure with age at menarche in Korean women: KNHANES (2008–2017)

Humans are exposed to metals in their daily lives and this metal exposure is responsible for various adverse health effects. Delayed pubertal development has been suggested as an adverse outcome of metal exposure; however, evidence in nationally representative populations, especially in Asia, is limited. We evaluated the association of blood cadmium (Cd), lead (Pb), and mercury (Hg) levels with the age at menarche in Korean females whose blood heavy metals were measured as part of the Korean National Health and Nutrition Examination Survey (KNHANES) 2008–2017. Among the females 16 years of age or older, all measured heavy metals in blood, i.e., Cd, Pb, and Hg, were positively associated with age at menarche. These associations remained significant in a model adjusted for age, survey year, income, education, body mass index, smoking history, and menopausal status as covariates (β: 0.10, 95% confidence interval (CI): 0.03–0.18 for Cd; β: 0.17, 95%CI: 0.06–0.27 for Pb; β: 0.12, 95%CI: 0.05–0.19 for Hg). When the population was separated by age group at the time of the survey, the significance between heavy metal levels and age at menarche became inconsistent, but the general trends were similar. Among those in their 20s and 40s, blood Cd showed a significant association, while Pb was significant among those in their 40s and 50s. A similar trend was observed in the sensitivity analysis in the girls aged 10–15 years at the time of the survey. Blood Cd levels were associated with decreased odds of precocious menarche (OR: 0.57, 95%CI: 0.31–1.03). Delayed menarche is a risk factor for cardiovascular and chronic kidney diseases in later life; hence, public health implication of heavy metal exposure warrants a public health attention.

Short-term duration of diabetic retinopathy as a predictor for development of diabetic kidney disease.

Diabetic retinopathy (DR) is a risk factor for diabetic kidney disease (DKD). Whether the duration, especially the short-term duration, of DR is associated with the development and progression of DKD remains unclear. A retrospective study and two-sample Mendelian randomization (MR) analysis were conducted. Kidney disease was defined by the urinary albumin-to-creatinine ratio (ACR) and the estimated glomerular filtration rate (eGFR). DR was diagnosed by an expert ophthalmologist by using a digital fundus camera. Binary and ordinal logistic regression analyses were performed. A restricted cubic spline was utilized to detect nonlinear associations. Summary statistics for DR- and DKD-associated single-nuclear polymorphisms (SNPs) were extracted from the FinnGen and the UK Biobank consortia. A total of 2674 patients with type 2 diabetes mellitus (T2DM) and type 2 diabetic kidney disease (T2DKD) were included. The prevalence and mean duration of DR increased with elevation of ACR and decline in eGFR. Renal function was significantly reduced in patients with DR in the fifth year of life. Binary and ordinal logistic regression showed that each 1-year increase in DR duration was associated with a 19% risk increase in the development of DKD, 16% in the elevation of ACR, and 21% in the decline of renal function. MR estimates indicated that DR was causally associated with DKD development, with an odds ratio of 2.89. DR and the duration of DR were independent risk factors for the development and progression of DKD. The short-term duration of DR may be associated with DKD development. DR had a statistically significant effect on DKD.

Dietary cholesterol intake is not associated with the development of chronic kidney disease: Results from two Korean cohort studies

Background and aimsAlthough dyslipidemia is a major risk factor for chronic kidney disease (CKD), the relationship between dietary cholesterol and CKD remains unknown. We investigated the association between cholesterol intake and CKD risk. Methods and resultsThe Korea National Health and Nutrition Examination Survey (KNHANES) 2019–2021 (n = 13,769) and the Korean Genome and Epidemiology Study (KoGES) (n = 9225) data were used for this study. Cholesterol intake was assessed using a 24-h recall food frequency questionnaire, and participants were categorized into three groups (T1, T2, and T3) based on cholesterol intake. Primary outcomes were prevalence and incidence of CKD. Higher cholesterol intake was modestly associated with increased serum levels of total, low-density lipoprotein, and high-density lipoprotein cholesterol in the KNHANES. However, we found no significant association between cholesterol intake and CKD prevalence in the KNHANES, regardless of a history of hypercholesterolemia. In the KoGES, during a median follow-up of 11.4 years, cholesterol intake was not associated with incident CKD in participants without hypercholesterolemia (hazard ratio [HR] per 10 mg increase, 1.00; 95 % confidence interval [CI], 0.99–1.01) and in those with hypercholesterolemia (HR, 1.01; 95 % CI, 0.98–1.04). Egg consumption also showed no significant association with the risk of incident CKD. Additionally, cholesterol intake had no significant interaction on the relationships between serum cholesterol levels and incident CKD. ConclusionAlthough cholesterol intake was associated with increased serum cholesterol levels, it was not associated with CKD prevalence and incidence. Our findings suggest that reducing cholesterol intake alone may not be sufficient to prevent CKD.

Pharmacological activation of nuclear factor erythroid 2-related factor-2 prevents hyperglycemia-induced renal oxidative damage: Possible involvement of O-GlcNAcylation

Hyperglycemia is a major risk factor for kidney diseases. Oxidative stress, caused by reactive oxygen species, is a key factor in the development of kidney abnormalities related to hyperglycemia. The nuclear factor erythroid 2-related factor-2 (Nrf2) plays a crucial role in defending cells against oxidative stress by activating genes that produce antioxidants. L-sulforaphane (SFN), a drug that activates Nrf2, reduces damage caused by hyperglycemia. Hyperglycemic Wistar rats and HEK 293 cells maintained in hyperglycemic medium exhibited decreased Nrf2 nuclear translocation and reduced expression and activity of antioxidant enzymes. SFN treatment increased Nrf2 activity and reversed decreased renal function, oxidative stress and cell death associated with hyperglycemia. To investigate mechanisms involved in hyperglycemia-induced reduced Nrf2 activity, we addressed whether Nrf2 is modified by O-linked β-N-acetylglucosamine (O-GlcNAc), a post-translational modification that is fueled in hyperglycemic conditions. In vivo, hyperglycemia increased O-GlcNAc-modified Nrf2 expression. Increased O-GlcNAc levels, induced by pharmacological inhibition of OGA, decreased Nrf2 activity in HEK 293 cells. In conclusion, hyperglycemia reduces Nrf2 activity, promoting oxidative stress, cell apoptosis and structural and functional renal damage. Pharmacological treatment with SFN attenuates renal injury. O-GlcNAcylation negatively modulates Nrf2 activity and represents a potential mechanism leading to oxidative stress and renal damage in hyperglycemic conditions.