scholarly journals Risk factors for CKD progression in Japanese patients: findings from the Chronic Kidney Disease Japan Cohort (CKD-JAC) study

2016 ◽  
Vol 21 (3) ◽  
pp. 446-456 ◽  
Author(s):  
Daijo Inaguma ◽  
◽  
Enyu Imai ◽  
Ayano Takeuchi ◽  
Yasuo Ohashi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Japanese Patients ◽  
Ckd Progression

MO535PREVALENCE OF CHRONIC KIDNEY DISEASE AND ASSOCIATED RISK FACTORS ON THE ISLAND OF MONTSERRAT

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Keniel Chrysostom ◽  
Lori-Ann Fisher ◽  
Everard Barton ◽  
Adedamola Soyibo ◽  
Grethlyn West ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Female Gender ◽  
Health Care Facilities ◽  
Cluster Sampling ◽  
Long Term Effects ◽  
Ckd Progression ◽  
Cross Sectional ◽  
The Caribbean

Abstract Background and Aims Chronic Kidney Disease (CKD) is a global health problem with disproportionate burden in low- and middle-income countries in Latin America and the Caribbean. Despite these disparities, little is known of the prevalence and risk factors of CKD in the Caribbean. We sought to determine prevalence of CKD among patients attending ambulatory centres in Montserrat, an island that to date, has no facilities for renal replacement therapy. Method A cross-sectional observational study of Participants were individuals aged ≥18 years was performed. Random cluster sampling of at least 500 participants who attended clinic from January 1 to July 1, 2020 across all primary health care facilities on island was performed. Patients without lab values for creatinine were excluded. The main outcome measures was estimated CKD prevalence (as defined based on KDIGO 2012 guidelines of eGFR < 60mL/min/1.73m2 using creatinine based CKD-EPI for blacks; and estimated prevalence of CKD risk factors (Self-reported diabetes or hypertension and obesity, BMI> 30kg/m2). Multivariate Logistic regression was used to determine independent predictors of CKD. Results Three hundred and fifty-five participants (n = 355) were selected for participation. Participants’ mean age was 63 ± 17 years, with 60% (n=213) being female. 38% (n=135) had self-reported diabetes and 58% (n=201) had hypertension; and 44% were obese. Mean± SD estimated GFR was 81 ± 30 ml/min/1.73 m2 . One quarter of the participants (25%) had an eGFR <60 ml/min/1.73 m2, indicating CKD. Age [95% CI, OR 1.03 (1.01–1.07)], Self-reported hypertension [95% CI, OR 2.09, (1.13–3.90)] and female gender [95% CI ,OR 0.20 (0.10, 0.39)] were independent predictors of reduced eGFR. Conclusion CKD and its risk factors were prevalent among adults in Montserrat. Consideration must be made for infrastructural and/or policy changes to be mandated, to slow the progression of CKD. Primary prevention initiatives can be implemented to reduce the associated morbidity, mortality and cost associated with CKD. There is room for further longitudinal studies to identify etiology, as well as factors affecting CKD progression. This study will also propel creation of the Montserrat arm of the Caribbean Renal Registry, to allow for future follow up of long-term effects, as well as ascertain risk factors for CKD progression.

scholarly journals Disparities in Chronic Kidney Disease Progression by Medicare Advantage Enrollees

2021 ◽  
pp. 949-957
Author(s):  
Clarissa Jonas Diamantidis ◽  
Lindsay Zepel ◽  
Virginia Wang ◽  
Valerie A. Smith ◽  
Sarah Hudson Scholle ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Function ◽  
Race And Ethnicity ◽  
Fixed Effects ◽  
Geographic Location ◽  
Study Entry ◽  
Medicare Advantage ◽  
Ckd Progression

<b><i>Introduction:</i></b> The prevalence of chronic kidney disease (CKD) in Medicare beneficiaries has quadrupled in the past 2 decades, but little is known about risk factors affecting the progression of CKD. This study aims to understand the progression in Medicare Advantage enrollees and whether it differs by provider recognition of CKD, race and ethnicity, or geographic location. In a large cohort of Medicare Advantage (MA) enrollees, we examined whether CKD progression, up to 5 years after study entry, differed by demographic and clinical factors and identified additional risk factors of CKD progression. <b><i>Methods:</i></b> In a cohort of 1,002,388 MA enrollees with CKD stages 1–4 based on 2013–2018 labs, progression was estimated using a mixed-effects model that adjusted for demographics, geographic location, comorbidity, urine albumin-to-creatinine ratio, clinical recognition via diagnosed CKD, and time-fixed effects. Race and ethnicity, geographic location, and clinical recognition of CKD were interacted with time in 3 separate regression models. <b><i>Results:</i></b> Mean (median) follow-up was 3.1 (3.0) years. Black and Hispanic MA enrollees had greater kidney function at study entry than other beneficiaries, but their kidney function declined faster. MA enrollees with clinically recognized CKD had estimated glomerular filtration rate levels that were 18.6 units (95% confidence interval [CI]: 18.5–18.7) lower than levels of unrecognized patients, but kidney function declined more slowly in enrollees with clinical recognition. There were no differences in CKD progression by geography. After removal of the race coefficient from the eGFR equation in a sensitivity analysis, kidney function was much lower in all years among Black MA enrollees, but patterns of progression remained the same. <b><i>Discussion/Conclusions:</i></b> These results suggest that patients with clinically recognized CKD and racial and ethnic minorities merit closer surveillance and management to reduce their risk of faster progression.

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

2022 ◽  
Vol 12 (1) ◽  
pp. 97
Author(s):  
Ryoko Umebayashi ◽  
Haruhito Adam Uchida ◽  
Natsumi Matsuoka-Uchiyama ◽  
Hitoshi Sugiyama ◽  
Jun Wada
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Health Insurance ◽  
Kidney Disease ◽  
National Health Insurance ◽  
National Health ◽  
Health Problems ◽  
Ckd Progression ◽  
Increased Risk ◽  
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.

The Change of Serum FGF-23 Levels Predicts the Progression of Renal Function in Chronic Kidney Disease Patients

2020 ◽  
Vol 103 (11) ◽  
pp. 1155-1162
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Renal Function ◽  
Kidney Disease ◽  
Fibroblast Growth Factor 23 ◽  
Positive Association ◽  
Ckd Progression ◽  
Fgf 23

Background: The role of elevated baseline fibroblast growth factor 23 (FGF-23) levels on the progression of renal function in long term (years) follow-up studies is not yet established. Objective: To circumvent the confounding factors occurring during the study duration, the authors examined the roles of the changing values of FGF-23 and other risk factors on progression of renal function after a shorter term (months) follow-up. Materials and Methods: The present study was a 12-week prospective cohort study to determine the association between traditional and non-traditional risk factors on the progression of renal function. Results: Sixty-five chronic kidney disease (CKD) patients were included. After a 12-week follow-up, significant increases of serum creatinine, cystatin C, vitamin D level, and FGF-23 levels were observed. The delta FGF-23 values increased progressively according to the staging of the CKD. The baseline parathyroid hormone level, which was in the recommended range following the KDIGO guideline, and the delta FGF-23 values were the significant parameters that had association with the decline of the estimated glomerular filtration. There was a positive association between delta FGF-23 and delta 25-OH vitamin D values. Conclusion: The increasing change in serum FGF-23 level is significantly correlated with declining renal function. Thus, delta FGF-23 value could be utilized as a suitable biomarker for following and detecting CKD progression. Keywords: FGF-23, Vitamin D, CKD progression, Biomarker

scholarly journals The problem of chronic kidney disease in current medicine

2006 ◽  
Vol 12 (3) ◽  
pp. 185-193
Author(s):  
A. V. Smimov ◽  
V. A. Dobronravov ◽  
I. G. Kayukov
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Dysfunction ◽  
Ckd Progression ◽  
Prevention Of Cardiovascular Disease

The review describes a conception of chronic kidney disease (CKD) in contemporary nephrology. Recent data on risk factors of renal dysfunction development and cardiorenal relations are discussed. It is emphasized the need of combine prevention of cardiovascular disease and CKD progression.

scholarly journals Risk of chronic kidney disease in patients with obstructive sleep apnea

SLEEP ◽  
2021 ◽  
Author(s):  
Andrew E Beaudin ◽  
Jill K Raneri ◽  
Sofia B Ahmed ◽  
A J Marcus Hirsch Allen ◽  
Andrhea Nocon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
High Risk ◽  
Kidney Disease ◽  
Ckd Progression ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Very High

Abstract Study Objectives Chronic kidney disease (CKD) is a global health concern and a major risk factor for cardiovascular morbidity and mortality. Obstructive sleep apnea (OSA) may exacerbate this risk by contributing to the development of CKD. This study investigated the prevalence and patient awareness of the risk of CKD progression in individuals with OSA. Methods Adults referred to five Canadian academic sleep centers for suspected OSA completed a questionnaire, a home sleep apnea test or in-lab polysomnography and provided blood and urine samples for measurement of estimated glomerular filtration rate (eGFR) and the albumin:creatinine ratio (ACR), respectively. The risk of CKD progression was estimated from a heat map incorporating both eGFR and ACR. Results 1295 adults (42% female, 54±13y) were categorized based on the oxygen desaturation index (4% desaturation): &lt;15 (no/mild OSA, n=552), 15-30 (moderate OSA, n=322), and &gt;30 (severe OSA, n=421). After stratification, 13.6% of the no/mild OSA group, 28.9% of the moderate OSA group, and 30.9% of the severe OSA group had a moderate-to-very high risk of CKD progression (p&lt;0.001), which was defined as an eGFR &lt; 60 mL/min/1.73m2, an ACR ≥3 mg/mmol, or both. Compared to those with no/mild OSA, the odds ratio for moderate-to-very high risk of CKD progression was 2.63 (95% CI: 1.79-3.85) for moderate OSA and 2.96 (2.04–4.30) for severe OSA after adjustment for CKD risk factors. Among patients at increased risk of CKD progression, 73% were unaware they had abnormal kidney function. Conclusion Patients with moderate and severe OSA have an increased risk of CKD progression independent of other CKD risk factors; most patients are unaware of this increased risk.

scholarly journals Predictive factors of rapid linear renal progression and mortality in patients with chronic kidney disease

2020 ◽  
Author(s):  
Ibrahim Ali ◽  
Rajkumar Chinnadurai ◽  
Sara T. Ibrahim ◽  
Darren Green ◽  
Philip Kalra
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Diastolic Pressure ◽  
Adverse Outcomes ◽  
Cox Proportional Hazards Model ◽  
Rapid Progression ◽  
Ckd Progression ◽  
Factors Associated ◽  
Rapid Progressors

Abstract Background Risk factors predictive of rapid linear chronic kidney disease (CKD) progression and its associations with end-stage renal disease (ESRD) and mortality requires further exploration, particularly as patients with linear eGFR trajectory represent a clear paradigm for understanding true CKD progression. Methods A linear regression slope was applied to all outpatient estimated glomerular filtration rate (eGFR) values for patients in the Salford Kidney Study who had ≥2years follow-up, ≥4 eGFR values and baseline CKD stages 3a-4. An eGFR slope (ΔeGFR) of ≤-4ml/min/1.73m2/yr defined rapid progressors, whereas -0.5 to +0.5ml/min/1.73m2/yr defined stable patients. Binary logistic regression was utilised to explore variables associated with rapid progression and Cox proportional hazards model to determine predictors for mortality prior to ESRD. Results There were 157 rapid progressors (median ΔeGFR -5.93ml/min/1.73m2/yr) and 179 stable patients (median ΔeGFR -0.03ml/min/1.73m2/yr). Over 5 years, rapid progressors had an annual rate of mortality or ESRD of 47 per 100 patients compared with 6 per 100 stable patients. Factors associated with rapid progression included younger age, female gender, higher diastolic pressure, higher total cholesterol:high density lipoprotein ratio, lower albumin, lower haemoglobin and a urine protein:creatinine ratio of >50g/mol. The latter three factors were also predictive of mortality prior to ESRD, along with older age, smoking, peripheral vascular disease and heart failure. Conclusions There is a heterogenous interplay of risk factors associated with rapid linear CKD progression and mortality in patients with CKD. Furthermore, rapid progressors have high rates of adverse outcomes and require close specialist monitoring.

scholarly journals Predictive Factors of Rapid Linear Renal Progression and Mortality in Patients with Chronic Kidney Disease

2020 ◽  
Author(s):  
Ibrahim Ali ◽  
Rajkumar Chinnadurai ◽  
Sara T. Ibrahim ◽  
Darren Green ◽  
Philip Kalra
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Diastolic Pressure ◽  
Adverse Outcomes ◽  
Cox Proportional Hazards Model ◽  
Rapid Progression ◽  
Ckd Progression ◽  
Factors Associated ◽  
Rapid Progressors

Abstract Background: Risk factors predictive of rapid linear chronic kidney disease (CKD) progression and its associations with end-stage renal disease (ESRD) and mortality requires further exploration, particularly as patients with linear eGFR trajectory represent a clear paradigm for understanding true CKD progression.Methods: A linear regression slope was applied to all outpatient estimated glomerular filtration rate (eGFR) values for patients in the Salford Kidney Study who had ≥ 2 years follow-up, ≥ 4 eGFR values and baseline CKD stages 3a-4. An eGFR slope (ΔeGFR) of ≤-4 ml/min/1.73 m2/yr defined rapid progressors, whereas − 0.5 to + 0.5 ml/min/1.73 m2/yr defined stable patients. Binary logistic regression was utilised to explore variables associated with rapid progression and Cox proportional hazards model to determine predictors for mortality prior to ESRD.Results: There were 157 rapid progressors (median ΔeGFR − 5.93 ml/min/1.73 m2/yr) and 179 stable patients (median ΔeGFR − 0.03 ml/min/1.73 m2/yr). Over 5 years, rapid progressors had an annual rate of mortality or ESRD of 47 per 100 patients compared with 6 per 100 stable patients. Factors associated with rapid progression included younger age, female gender, higher diastolic pressure, higher total cholesterol:high density lipoprotein ratio, lower albumin, lower haemoglobin and a urine protein:creatinine ratio of > 50 g/mol. The latter three factors were also predictive of mortality prior to ESRD, along with older age, smoking, peripheral vascular disease and heart failure.Conclusions: There is a heterogenous interplay of risk factors associated with rapid linear CKD progression and mortality in patients with CKD. Furthermore, rapid progressors have high rates of adverse outcomes and require close specialist monitoring.

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