Renal Function and Risk Factors of Moderate to Severe Chronic Kidney Disease in Golestan Province, Northeast of Iran

Objective.Since chronic kidney disease (CKD) is closely associated with cardiovascular disease and mortality as well as endstage renal disease, prediction of progressive CKD is a clinically important issue. We investigated the independent risk factors for the development of CKD in patients with lupus nephritis (LN).Methods.The cohort included 322 Korean patients diagnosed with LN between 1985 and 2010. We retrospectively analyzed the clinical and laboratory indices, treatment response, the final renal function, and the biopsy findings. The timing and cumulative risk of developing CKD were identified by Kaplan-Meier methods. The independent risk factors for developing CKD were examined by univariate and multivariate Cox proportional hazards regression analyses.Results.The median followup time after the diagnosis of LN was 84 months. CKD occurs in 22% of the patients within 10 years after the diagnosis of LN. The probability of developing CKD was significantly associated with the onset time of LN (delayed-onset LN vs initial-onset LN; HR 2.904, p = 0.003), deteriorated renal function [an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2 body surface area] at the onset of LN (HR 7.458, p < 0.001), relapse of LN after achieving remission (HR 2.806, p = 0.029), and resistance to induction therapy (HR 8.120, p < 0.001).Conclusion.Our results demonstrate that delayed-onset LN, a decreased eGFR at the time of LN onset, and the failure to achieve a sustained remission are predictors for the development of CKD in Korean patients with LN.

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Prevalence and risk factors of chronic kidney disease and diabetic kidney disease in a central Chinese urban population: a cross-sectional survey

10.21203/rs.2.10157/v4 ◽

2020 ◽

Author(s):

Jiayu Duan(Former Corresponding Author) ◽

Guang-Cai Duan ◽

Chong-Jian Wang ◽

Dong-Wei Liu ◽

Ying-Jin Qiao ◽

...

Keyword(s):

Risk Factors ◽

Chronic Kidney Disease ◽

Logistic Regression ◽

Renal Function ◽

Kidney Disease ◽

Diabetic Kidney Disease ◽

Density Lipoprotein ◽

Ordinal Logistic Regression ◽

Urinary Albumin ◽

Current Prevalence

Abstract Background : This study was conducted to evaluate and update the current prevalence of and risk factors for chronic kidney disease (CKD) and diabetic kidney disease (DKD) in China. Methods : From December 2017 to June 2018, a total of 5231 subjects were randomly recruited from 3 communities in 3 districts of Zhengzhou. CKD was defined as estimated glomerular filtration rate (eGFR) < 60 mL/min.1.73m 2 or urinary albumin to creatinine ratio ≥ 30 mg/g (albuminuria). Diabetic subjects with systolic blood blood pressure > 140 mmHg, albuminuria or an eGFR less than 60 mL/min/1.73 m 2 were classified as having DKD. Participants completed a questionnaire assessing lifestyle and relevant medical history, and blood and urine specimens were taken. Serum creatinine, uric acid, total cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein and urinary albumin were assessed. The age- and sex-adjusted prevalences of CKD and DKD were calculated, and risk factors associated with the presence of reduced eGFR, albuminuria, DKD, severity of albuminuria and progression of reduced renal function were analyzed by binary and ordinal logistic regression. Results : The overall adjusted prevalence of CKD was 16.8% (15.8 – 17.8%) and that of DKD was 3.5% (3.0 – 4.0%). Decreased renal function was detected in 132 participants (2.9%, 95% confidence interval [CI]: 2.5 – 3.2%), whereas albuminuria was found in 858 participants (14.9%, 95% CI: 13.9 – 15.9%). In all participants with diabetes, the prevalence of reduced eGFR was 6.3% (95% CI = 3.9 – 8.6%) and that of albuminuria was 45.3% (95% CI = 40.4 – 50.1%). The overall prevalence of CKD in participants with diabetes was 48.0% (95% CI = 43.1 – 52.9%). The results of the binary and ordinal logistic regression indicated that the factors independently associated with a higher risk of reduced eGFR and albuminuria were older age, sex, smoking, alcohol consumption, overweight, obesity, diabetes, hypertension, dyslipidemia and hyperuricemia. Conclusions : Our study shows the current prevalence of CKD and DKD in residents of Central China. The high prevalence suggests an urgent need to implement interventions to relieve the high burden of CKD and DKD in China.

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Prevalence of and risk factors for chronic kidney disease and diabetic kidney disease in a central Chinese urban population: a cross-sectional survey

10.21203/rs.2.10157/v1 ◽

2019 ◽

Author(s):

Jiayu Duan ◽

Duan Guang-Cai ◽

Wang Chong-Jian ◽

Liu Dong-Wei ◽

Qiao Ying-Jin ◽

...

Keyword(s):

Risk Factors ◽

Chronic Kidney Disease ◽

Logistic Regression ◽

Renal Function ◽

Kidney Disease ◽

Diabetic Kidney Disease ◽

Density Lipoprotein ◽

Ordinal Logistic Regression ◽

Central China ◽

Diabetic Kidney

Abstract Background This study was conducted to evaluate and update the current prevalence of and risk factors for chronic kidney disease (CKD) and diabetic kidney disease (DKD) in a China. Methods A total of 5231 participants were randomly recruited for this study. CKD and DKD were defined according to the combination of estimated glomerular filtration rate (eGFR), presence of albuminuria and diabetes. Participants completed a questionnaire assessing lifestyle and relevant medical history, and blood and urinary specimens were taken. Serum creatinine, uric acid, total cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein and urinary albumin were assessed. The age- and gender-adjusted prevalences of CKD and DKD were calculated, and risk factors associated with the presence of reduced eGFR, albuminuria, DKD, severity of albuminuria and progression of reduce renal function were analyzed by binary and ordinal logistic regression. Results The overall adjusted prevalence of CKD was 16.8% (15.8 – 17.8%) and that of DKD was 3.5% (3.0 – 4.0%). Decreased renal function was detected in 132 participants [2.9%, 95% confidence interval (CI): 2.5 – 3.2%], whereas albuminuria was found in 858 participants (14.9%, 95% CI: 13.9 – 15.9%). In all participants with diabetes, the prevalence of reduced eGFR was 6.3% (95% CI = 3.9 – 8.6%) and that of albuminuria was 45.3% (95% CI = 40.4 – 50.1%). The overall prevalence of CKD in participants with diabetes was 48.0% (95% CI = 43.1 – 52.9%). The results of the binary and ordinal logistic regression indicated that factors independently associated with higher risk of reduced eGFR and albuminuria were older age, gender, smoking, alcohol consumption, overweight, obesity, diabetes, hypertension, dyslipidemia and hyperuricemia. Conclusions Our study shows the current prevalences of CKD and DKD in residents of Central China. The high prevalence suggests an urgent need to implement interventions to relieve the high burden of CKD and DKD in China.

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Asymptomatic hypertension-mediated organ damage in patients with or without moderate to severe chronic kidney disease

European Heart Journal ◽

10.1093/ehjci/ehaa946.2715 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

M Schiavone ◽

C Gobbi ◽

A Ratti ◽

G Ferrari ◽

A Villarini ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Renal Function ◽

Kidney Disease ◽

Renal Impairment ◽

Severe Renal Impairment ◽

Organ Damage ◽

Vascular Damage ◽

Hypertensive Patients ◽

Severe Chronic Kidney Disease ◽

Fundus Oculi

Abstract Introduction Moderate or severe chronic kidney disease (CKD) is regarded as high or very high risk factor in the Systematic COronary Risk Evaluation (SCORE) system, as stated in the ESC guidelines on arterial hypertension. Assessment of cardiovascular (CV) risk should be completed evaluating hypertension-mediated organ damage (HMOD). Purpose The aim of our study was to find out differences in HMOD in patients with or without moderate to severe chronic kidney disease (CKD). Methods We enrolled 80 consecutive non-diabetic hypertensive patients, divided into two groups according to the presence of impaired renal function, evaluated by estimated glomerular filtration rate (eGFR): moderate to severe CKD group (n=26 patients, eGFR <60 mL/min/1.73 m2) and mild CKD - normal renal function group (n=54 patients, eGFR ≥60 mL/min/1.73 m2). A transthoracic echocardiogram was performed to evaluate cardiac HMOD. Small and large vessel damage was assessed by means of non-mydriatic digital fundus oculi examination in order to detect arteriolar narrowing using arteriolar-venular ratio (AVr), applanation tonometry to measure carotid-femoral pulse wave velocity (cfPWV) and carotid ultrasound to quantify intima-media tickness (IMT). Results Moderate to severe CKD patients appeared to be older (mean age 75.54±8.06 vs 63.38±9.62, p=0.001) and showed lower level of total and LDL cholesterol. Both groups showed abnormal values of cfPWV, but these were significantly higher in the presence of moderate to severe CKD (14.12±7.93 m/s vs 10.94±5.81 m/s, p=0.03). Abnormal AVr values were found in patients with higher grade of CKD, with statistically significant differences in the two groups (0.75±0.015 vs 0.81±0.06, p=0.00001). Carotid IMT resulted to be at the upper limit of normality in both groups (0.95±0.15 vs 0.90±0.18, p=0.35). With regard to echocardiography evaluation, left ventricular mass index (LVMi: 105.04±0.4 vs 96.35±1.7, p=0.06) and relative wall thickness (RWT: 0.43±0.02 vs 0.42±0.05, p=0.41) did not differ significantly in the two groups, with a mild trend for LVMi. Both groups showed abnormal diastolic dysfunction on average, but no differences emerged in the presence of more severe renal impairment (deceleration time 281.74±0.37 vs 256.30±0.54, p=0.08; E/A 0.86±0.03 vs 0.95±0.25, p=0.20; E/e' 7.89±2.93 vs 7.60±2.46, p=0.66). Conclusions Our study showed significant differences in HMOD in presence of moderate to severe renal impairment. Moderate to severe CKD seemed to be associated to vascular damage (hypertensive retinopathy and arterial stiffness), while no significant differences in echocardiographic markers of cardiac remodeling were found, suggesting that systemic vascular damage is more closely linked to CKD than cardiac damage. Therefore, the use of fundus oculi examination and PWV should always be considered to properly assess the target organ damage in hypertensive patients with CKD. Funding Acknowledgement Type of funding source: None

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