Natural History of Progression of Chronic Kidney Disease in Stages 4 and 5

Abstract Background Knowledge about the nature of long-term changes in kidney function in the general population is sparse. We aim to identify whether primary care electronic healthcare records capture sufficient information to study the natural history of kidney disease. Methods The National Chronic Kidney Disease Audit database covers ∼14% of the population of England and Wales. Availability of repeat serum creatinine tests was evaluated by risk factors for chronic kidney disease (CKD) and individual changes over time in estimated glomerular filtration rate (eGFR) were estimated using linear regression. Sensitivity of estimation to method of evaluation of eGFR compared laboratory-reported eGFR and recalculated eGFR (using laboratory-reported creatinine), to uncover any impact of historical creatinine calibration issues on slope estimation. Results Twenty-five per cent of all adults, 92% of diabetics and 96% of those with confirmed CKD had at least three creatinine tests, spanning a median of 5.7 years, 6.2 years and 6.1 years, respectively. Median changes in laboratory-reported eGFR (mL/min/1.73 m2/year) were −1.32 (CKD) and −0.60 (diabetes). Median changes in recalculated eGFR were −0.98 (CKD) and −0.11 (diabetes), underestimating decline. Magnitude of underestimation (and between-patient variation in magnitude) decreased with deteriorating eGFR. For CKD Stages 3, 4 and 5 (at latest eGFR), median slopes were −1.27, −2.49 and -3.87 for laboratory-reported eGFR and −0.89, −2.26 and −3.75 for recalculated eGFR. Conclusions Evaluation of long-term changes in renal function will be possible in those at greatest risk if methods are identified to overcome creatinine calibration problems. Bias will be reduced by focussing on patients with confirmed CKD.

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Impact of chronic kidney disease on the natural history of alkaptonuria

Clinical Kidney Journal ◽

10.1093/ckj/sfs079 ◽

2012 ◽

Vol 5 (4) ◽

pp. 352-355 ◽

Cited By ~ 5

Author(s):

B. Faria ◽

J. Vidinha ◽

C. Pego ◽

H. Correia ◽

T. Sousa

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Natural History ◽

History Of

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Natural history of chronic kidney disease in Australian Indigenous and non‐Indigenous children: a 4‐year population‐based follow‐up study

The Medical Journal of Australia ◽

10.5694/j.1326-5377.2009.tb02417.x ◽

2009 ◽

Vol 190 (6) ◽

pp. 303-306 ◽

Cited By ~ 13

Author(s):

Leigh Haysom ◽

Rita Williams ◽

Elisabeth M Hodson ◽

Pamela A Lopez‐Vargas ◽

Leslie P Roy ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Natural History ◽

Population Based ◽

Follow Up Study ◽

Indigenous Children ◽

History Of

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Natural History of Skeletal Muscle Mass Changes in Chronic Kidney Disease Stage 4 and 5 Patients: An Observational Study

PLoS ONE ◽

10.1371/journal.pone.0065372 ◽

2013 ◽

Vol 8 (5) ◽

pp. e65372 ◽

Cited By ~ 33

Author(s):

Stephen G. John ◽

Mhairi K. Sigrist ◽

Maarten W. Taal ◽

Christopher W. McIntyre

Keyword(s):

Skeletal Muscle ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Natural History ◽

Observational Study ◽

Skeletal Muscle Mass ◽

Chronic Kidney Disease Stage ◽

Disease Stage ◽

Stage 4 ◽

History Of

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The natural history of, and risk factors for, progressive Chronic Kidney Disease (CKD): the Renal Impairment in Secondary care (RIISC) study; rationale and protocol

BMC Nephrology ◽

10.1186/1471-2369-14-95 ◽

2013 ◽

Vol 14 (1) ◽

Cited By ~ 27

Author(s):

Stephanie Stringer ◽

Praveen Sharma ◽

Mary Dutton ◽

Mark Jesky ◽

Khai Ng ◽

...

Keyword(s):

Risk Factors ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Natural History ◽

Renal Impairment ◽

Secondary Care ◽

History Of

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An observational claims data analysis on the risk of maternal chronic kidney disease after preterm delivery and preeclampsia

Scientific Reports ◽

10.1038/s41598-021-92078-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Maren Goetz ◽

Mitho Müller ◽

Raphael Gutsfeld ◽

Tjeerd Dijkstra ◽

Kathrin Hassdenteufel ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Preterm Birth ◽

Kidney Disease ◽

Preterm Delivery ◽

Claims Data ◽

Maternal Risk ◽

Live Births ◽

Increased Risk ◽

History Of

AbstractWomen with complications of pregnancy such as preeclampsia and preterm birth are at risk for adverse long-term outcomes, including an increased future risk of chronic kidney disease (CKD) and end-stage kidney disease (ESKD). This observational cohort study aimed to examine the risk of CKD after preterm delivery and preeclampsia in a large obstetric cohort in Germany, taking into account preexisting comorbidities, potential confounders, and the severity of CKD. Statutory claims data of the AOK Baden-Wuerttemberg were used to identify women with singleton live births between 2010 and 2017. Women with preexisting conditions including CKD, ESKD, and kidney replacement therapy (KRT) were excluded. Preterm delivery (< 37 gestational weeks) was the main exposure of interest; preeclampsia was investigated as secondary exposure. The main outcome was a newly recorded diagnosis of CKD in the claims database. Data were analyzed using Cox proportional hazard regression models. The time-dependent occurrence of CKD was analyzed for four strata, i.e., births with (i) neither an exposure of preterm delivery nor an exposure of preeclampsia, (ii) no exposure of preterm delivery but exposure of at least one preeclampsia, (iii) an exposure of at least one preterm delivery but no exposure of preeclampsia, or (iv) joint exposure of preterm delivery and preeclampsia. Risk stratification also included different CKD stages. Adjustments were made for confounding factors, such as maternal age, diabetes, obesity, and dyslipidemia. The cohort consisted of 193,152 women with 257,481 singleton live births. Mean observation time was 5.44 years. In total, there were 16,948 preterm deliveries (6.58%) and 14,448 births with at least one prior diagnosis of preeclampsia (5.61%). With a mean age of 30.51 years, 1,821 women developed any form of CKD. Compared to women with no risk exposure, women with a history of at least one preterm delivery (HR = 1.789) and women with a history of at least one preeclampsia (HR = 1.784) had an increased risk for any subsequent CKD. The highest risk for CKD was found for women with a joint exposure of preterm delivery and preeclampsia (HR = 5.227). These effects were the same in magnitude only for the outcome of mild to moderate CKD, but strongly increased for the outcome of severe CKD (HR = 11.90). Preterm delivery and preeclampsia were identified as independent risk factors for all CKD stages. A joint exposure or preterm birth and preeclampsia was associated with an excessive maternal risk burden for CKD in the first decade after pregnancy. Since consequent follow-up policies have not been defined yet, these results will help guide long-term surveillance for early detection and prevention of kidney disease, especially for women affected by both conditions.

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The Accuracy of Emergency Physicians’ Suspicions of Active Pulmonary Tuberculosis

Journal of Clinical Medicine ◽

10.3390/jcm10040860 ◽

2021 ◽

Vol 10 (4) ◽

pp. 860

Author(s):

Shiang-Jin Chen ◽

Chun-Yu Lin ◽

Tzu-Ling Huang ◽

Ying-Chi Hsu ◽

Kuan-Ting Liu

Keyword(s):

Chronic Kidney Disease ◽

Weight Loss ◽

Kidney Disease ◽

Pulmonary Tuberculosis ◽

General Ward ◽

Chest Radiographs ◽

Emergency Physicians ◽

Active Pulmonary Tuberculosis ◽

Factors Associated ◽

History Of

Objective: To investigate factors associated with recognition and delayed isolation of pulmonary tuberculosis (PTB). Background: Precise identification of PTB in the emergency department (ED) remains challenging. Methods: Retrospectively reviewed PTB suspects admitted via the ED were divided into three groups based on the acid-fast bacilli culture report and whether they were isolated initially in the ED or general ward. Factors related to recognition and delayed isolation were statistically compared. Results: Only 24.94% (100/401) of PTB suspects were truly active PTB and 33.77% (51/151) of active PTB were unrecognized in the ED. Weight loss (p = 0.022), absence of dyspnea (p = 0.021), and left upper lobe field (p = 0.024) lesions on chest radiographs were related to truly active PTB. Malignancy (p = 0.015), chronic kidney disease (p = 0.047), absence of a history of PTB (p = 0.013), and lack of right upper lung (p ≤ 0.001) and left upper lung (p = 0.020) lesions were associated with PTB being missed in the ED. Conclusions: Weight loss, absence of dyspnea, and left upper lobe field lesions on chest radiographs were related to truly active PTB. Malignancy, chronic kidney disease, absence of a history of PTB, and absence of right and/or left upper lung lesions on chest radiography were associated with isolation delay.

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History of kidney stones and risk of chronic kidney disease: a meta-analysis

PeerJ ◽

10.7717/peerj.2907 ◽

2017 ◽

Vol 5 ◽

pp. e2907 ◽

Cited By ~ 9

Author(s):

Weifeng Shang ◽

Lixi Li ◽

Yali Ren ◽

Qiangqiang Ge ◽

Ming Ku ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Kidney Stones ◽

Meta Analysis ◽

Positive Association ◽

Significant Heterogeneity ◽

Adjusted Risk ◽

Increased Risk ◽

Subgroup Analyses ◽

History Of

Background Although the relationship between a history of kidney stones and chronic kidney disease (CKD) has been explored in many studies, it is still far from being well understood. Thus, we conducted a meta-analysis of studies comparing rates of CKD in patients with a history of kidney stones. Methods PubMed, EMBASE, and the reference lists of relevant articles were searched to identify observational studies related to the topic. A random-effects model was used to combine the study-specific risk estimates. We explored the potential heterogeneity by subgroup analyses and meta-regression analyses. Results Seven studies were included in this meta-analysis. Pooled results suggested that a history of kidney stones was associated with an increased adjusted risk estimate for CKD [risk ratio (RR), 1.47 95% confidence interval (CI) [1.23–1.76])], with significant heterogeneity among these studies (I2 = 93.6%, P < 0.001). The observed positive association was observed in most of the subgroup analyses, whereas the association was not significant among studies from Asian countries, the mean age ≥50 years and male patients. Conclusion A history of kidney stones is associated with increased risk of CKD. Future investigations are encouraged to reveal the underlying mechanisms in the connection between kidney stones and CKD, which may point the way to more effective preventive and therapeutic measures.

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