Fluid intake and chronic kidney disease: effect of coaching an increase in fluid intake on kidney function decline

Abstract Background Initiation of renal replacement therapy often results from a combination of kidney function deterioration and symptoms related to chronic kidney disease (CKD) progression. We investigated the association between kidney function decline and symptom development in patients with advanced CKD. Methods In the European Quality study on treatment in advanced CKD (EQUAL study), a European prospective cohort study, patients with advanced CKD aged ≥65 years and a kidney function that dropped <20 mL/min/1.73 m2 were followed for 1 year. Linear mixed-effects models were used to assess the association between kidney function decline and symptom development. The sum score for symptom number ranged from 0 to 33 and for overall symptom severity from 0 to 165, using the Dialysis Symptom Index. Results At least one kidney function estimate with symptom number or overall symptom severity was available for 1109 and 1019 patients, respectively. The mean (95% confidence interval) annual kidney function decline was 1.70 (1.32; 2.08) mL/min/1.73 m2. The mean overall increase in symptom number and severity was 0.73 (0.28; 1.19) and 2.93 (1.34; 4.52) per year, respectively. A cross-sectional association between the level of kidney function and symptoms was lacking. Furthermore, kidney function at cohort entry was not associated with symptom development. However, each mL/min/1.73 m2 of annual kidney function decline was associated with an extra annual increase of 0.23 (0.07; 0.39) in the number of symptoms and 0.87 (0.35; 1.40) in overall symptom severity. Conclusions A faster kidney function decline was associated with a steeper increase in both symptom number and severity. Considering the modest association, our results seem to suggest that repeated thorough assessment of symptom development during outpatient clinic visits, in addition to the monitoring of kidney function decline, is important for clinical decision-making.

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Optimism is associated with chronic kidney disease and rapid kidney function decline among African Americans in the Jackson Heart Study

Journal of Psychosomatic Research ◽

10.1016/j.jpsychores.2020.110267 ◽

2020 ◽

Vol 139 ◽

pp. 110267

Author(s):

LáShauntá M. Glover ◽

Crystal Butler-Williams ◽

Loretta Cain-Shields ◽

Allana T. Forde ◽

Tanjala S. Purnell ◽

...

Keyword(s):

Chronic Kidney Disease ◽

African Americans ◽

Kidney Disease ◽

Kidney Function ◽

Jackson Heart Study ◽

Heart Study ◽

Kidney Function Decline

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Lifetime Cocaine and Opiate Use and Chronic Kidney Disease

American Journal of Nephrology ◽

10.1159/000452348 ◽

2016 ◽

Vol 44 (6) ◽

pp. 447-453 ◽

Cited By ~ 10

Author(s):

Tessa Novick ◽

Yang Liu ◽

Anika Alvanzo ◽

Alan B. Zonderman ◽

Michele K. Evans ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Kidney Function ◽

Healthy Aging ◽

Illicit Drugs ◽

Community Dwelling ◽

Rapid Decline ◽

Cocaine Use ◽

Opiate Use ◽

Kidney Function Decline

Background: More than 50% of American adolescents and adults report having used illicit drugs in their lifetime. We examined the association of lifetime opiate and cocaine use with reduced kidney function, albuminuria and rapid kidney function decline among urban-dwelling adults. Methods: Our prospective cohort included 2,286 Healthy Aging in Neighborhoods of Diversity across the Life Span study participants who were community-dwelling adults residing in Baltimore, MD. The predictive variables were lifetime opiate and cocaine use, defined as use of opiates or crack/cocaine ≥5 times. Outcomes included prevalent reduced estimated glomerular filtration rate (eGFR; <60 ml/min/1.73 m2 by Chronic Kidney Disease (CKD)-Epidemiology Collaboration), albuminuria (albumin-to-creatinine ratio >30 mg/g, n = 1,652) and rapid kidney function decline (>3 ml/min/1.73 m2 per year over a median of 4.7 years, n = 1,660). Results: Participants' mean age was 48 years, 15% reported opiate use, and 22% reported cocaine use. A total of 115 (5.0%) participants had reduced eGFR, 190 (11.5%) had albuminuria and 230 (13.8%) experienced rapid decline in kidney function. In adjusted logistic regression analyses, both substances were associated with greater odds of reduced eGFR (OR 2.71, 95% CI 1.50-4.89 for opiates; OR 1.40, 95% CI 0.87-2.24 for cocaine). Both substances were associated with greater odds of albuminuria (OR 1.20, 95% CI 0.83-1.73 for opiates; OR 1.80, 95% CI 1.29-2.51 for cocaine). Neither substance was associated with the rapid decline of kidney function. Conclusions: Lifetime opiate and cocaine use was associated with prevalent reduced eGFR and albuminuria, yet not with rapid kidney function decline. The use of opiate and cocaine may be an important risk factor for CKD in urban populations.

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Associations Between Weight Loss, Kidney Function Decline, and Risk of ESRD in the Chronic Kidney Disease in Children (CKiD) Cohort Study

American Journal of Kidney Diseases ◽

10.1053/j.ajkd.2017.08.013 ◽

2018 ◽

Vol 71 (5) ◽

pp. 648-656 ◽

Cited By ~ 10

Author(s):

Elaine Ku ◽

Joel D. Kopple ◽

Charles E. McCulloch ◽

Bradley A. Warady ◽

Susan L. Furth ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Weight Loss ◽

Cohort Study ◽

Kidney Disease ◽

Kidney Function ◽

Kidney Function Decline

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Metabolites associate with kidney function decline and incident chronic kidney disease in the general population

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gft217 ◽

2013 ◽

Vol 28 (8) ◽

pp. 2131-2138 ◽

Cited By ~ 62

Author(s):

Oemer-Necmi Goek ◽

Cornelia Prehn ◽

Peggy Sekula ◽

Werner Römisch-Margl ◽

Angela Döring ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

General Population ◽

Kidney Function ◽

Incident Chronic Kidney Disease ◽

Kidney Function Decline

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Urinary uromodulin independently predicts end-stage renal disease and rapid kidney function decline in a cohort of chronic kidney disease patients

Medicine ◽

10.1097/md.0000000000015808 ◽

2019 ◽

Vol 98 (21) ◽

pp. e15808 ◽

Cited By ~ 2

Author(s):

Dominik Steubl ◽

Matthias Block ◽

Victor Herbst ◽

Wolfgang Andreas Nockher ◽

Wolfgang Schlumberger ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Renal Disease ◽

Kidney Function ◽

End Stage Renal Disease ◽

Stage Renal Disease ◽

End Stage ◽

Kidney Function Decline

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Plasma C-terminal agrin fragment and rapid kidney function decline in chronic kidney disease patients

Medicine ◽

10.1097/md.0000000000015597 ◽

2019 ◽

Vol 98 (19) ◽

pp. e15597

Author(s):

Georg Lorenz ◽

Stefan Hettwer ◽

Wendy McCallum ◽

Susanne Angermann ◽

Ming Wen ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Kidney Function ◽

Kidney Function Decline

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Body Mass Index, Coronary Artery Calcification, and Kidney Function Decline in Stage 3 to 5 Chronic Kidney Disease Patients

Journal of Renal Nutrition ◽

10.1053/j.jrn.2011.12.008 ◽

2013 ◽

Vol 23 (1) ◽

pp. 4-11 ◽

Cited By ~ 5

Author(s):

Jocelyn S. Garland ◽

Rachel M. Holden ◽

Wilma M. Hopman ◽

Sudeep S. Gill ◽

Robert L. Nolan ◽

...

Keyword(s):

Body Mass Index ◽

Chronic Kidney Disease ◽

Coronary Artery ◽

Kidney Disease ◽

Kidney Function ◽

Body Mass ◽

Coronary Artery Calcification ◽

Kidney Function Decline

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Associations between urinary cysteine-rich protein 61 excretion and kidney function decline in outpatients with chronic kidney disease: a prospective cohort study in Taiwan

BMJ Open ◽

10.1136/bmjopen-2021-051165 ◽

2021 ◽

Vol 11 (10) ◽

pp. e051165

Author(s):

Chun-Fu Lai ◽

Jian-Jhong Wang ◽

Ya-Chun Tu ◽

Chia-Yu Hsu ◽

Hon-Yen Wu ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Cohort Study ◽

Kidney Disease ◽

Kidney Function ◽

Creatinine Ratio ◽

Discriminative Performance ◽

Cysteine Rich Protein ◽

Kidney Function Decline ◽

Egfr Decline

ObjectivesTo examine whether urinary excretion of cysteine-rich protein 61 (Cyr61), an acknowledged proinflammatory factor in kidney pathologies, increases in chronic kidney disease (CKD) and is associated with subsequent rapid kidney function decline.DesignAn observational cohort study.SettingIn the nephrology outpatient clinics of a tertiary hospital in Taiwan.ParticipantsWe enrolled 138 adult CKD outpatients (n=12, 32, 18, 18, 29 and 29 in stages 1, 2, 3a, 3b, 4 and 5 CKD, respectively) between February and October 2014 and followed them for 1 year. Their mean age was 60.46±13.16 years, and 51 (37%) of them were women.Primary outcome measuresUrinary Cyr61 levels were measured by ELISA. Rapid kidney function decline was defined as an estimated glomerular filtration rate (eGFR) decline rate ≥ 4 mL/min/1.73 m2/year or developing end-stage renal disease during subsequent 3-month or 1-year follow-up period. Models were adjusted for demographic and clinical variables.ResultsThe urine Cyr61-to-creatinine ratio (UCyr61CR) increased significantly in patients with stage 4 or 5 CKD. Multivariable linear regression analysis showed that log(UCyr61CR) was positively correlated with log(urine protein-to-creatinine ratio) (p<0.001) but negatively correlated with baseline eGFR (p<0.001) and hypertension (p=0.007). Complete serum creatinine data during the follow-up were available for 112 patients (81.2%). Among them, multivariable logistic regression identified log(UCyr61CR) was independently associated with rapid kidney function decline (adjusted OR 2.29, 95% CI 1.27 to 4.15) during the subsequent 3 months. UCyr61CR improved the discriminative performance of clinical models to predict 3-month rapid kidney function decline. In contrast, log(UCyr61CR) was not associated with rapid eGFR decline during the entire 1-year follow-up.ConclusionsElevated urinary Cyr61 excretion is associated with rapid short-term kidney function deterioration in patients with CKD. Measuring urinary Cyr61 excretion is clinically valuable for monitoring disease trajectory and may guide treatment planning.

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