Estimated Prevalence and Testing for Albuminuria in US Adults at Risk for Chronic Kidney Disease

JAMA Network Open, Journal Year: 2023, Volume and Issue: 6(7), P. e2326230 - e2326230

Published: July 27, 2023

Importance Albuminuria testing is crucial for guiding evidence-based treatments to mitigate chronic kidney disease (CKD) progression and cardiovascular morbidity, but it widely underutilized among persons with or at risk CKD. Objective To estimate the extent of albuminuria underdetection from lack evaluate its association CKD treatment in a large US cohort patients hypertension diabetes. Design, Setting, Participants This study examined adults diabetes, using data 2007 2018 National Health Nutrition Examination Surveys (NHANES) Optum deidentified electronic health record (EHR) set diverse care organizations. Analyses were conducted October 31, 2022, May 19, 2023. Main Outcomes Measures Using NHANES as nationally representative sample, logistic regression model was developed (urine albumin-creatinine ratio ≥30 mg/g). then applied active outpatients EHR January 1, 2017, December 2018. The prevalence those without during this period estimated. A multivariable used examine associations between having therapies within subsequent year (prescription angiotensin-converting enzyme inhibitor [ACEi] angiotensin II receptor blocker [ARB], prescription sodium-glucose cotransporter 2 [SGLT2i], blood pressure control less than 130/80 mm Hg 140/90 on latest outpatient measure). Results total population included 192 108 (mean [SD] age, 60.3 [15.1] years; 185 589 [96.6%] hypertension; 50 507 [26.2%] diabetes; mean eGFR, 84 [21] mL/min/1.73 m ). There 33 629 (17.5%) who had testing; whom 11 525 (34.3%) albuminuria. Among 158 479 untested, estimated rate 13.4% (n = 21 231). Thus, only 35.2% (11 32 756) projected been tested. associated higher adjusted odds receiving ACEi ARB (OR, 2.39 [95% CI, 2.32-2.46]), SGLT2i 8.22 7.56-8.94]), controlled 1.20 1.16-1.23]). Conclusions Relevance In that approximately two-thirds undetected due testing. These results suggest improving detection represents substantial opportunity optimize delivery reducing complications.

Language: Английский

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Adherence to Life’s Essential 8 and incident chronic kidney disease: a prospective study of 147,988 UK Biobank participants

American Journal of Clinical Nutrition, Journal Year: 2023, Volume and Issue: 118(4), P. 804 - 811

Published: Aug. 19, 2023

The American Heart Association recently updated Life's Essential 8 (LE8) score. This amalgamation of health factors, recognized for their individual associations with chronic kidney disease (CKD) risk, provides a robust tool to assess overall cardiovascular (CVH), which could potentially be extrapolated predict CKD risk.This study aimed investigate the association between levels CVH, as measured by LE8 score, and risk in UK Biobank.A total 147,988 participants free from Biobank were included this prospective study. CVH categorized low (0-49), moderate (50-79), high (80-100) using An adjusted Cox proportional hazard model was used CKD. population attributable-risk (PAR) also calculated.During median follow-up 10 y, 1936 cases documented. A higher score associated significant lower (P < 0.001), linear dose-response relationship observed. Similar patterns found behavior biological subscale scores Compared category, 39% developing (hazard ratio [HR]: 0.61; 95% confidence interval [CI]: 0.52, 0.72); those had 57% incidence (HR: 0.43; CI: 0.35, 0.53) after adjustment covariates. Among distinct metrics BMI metric highest PAR (24.6%; 18.8, 30.2). Of 3.2% (95% 1.4, 5.0) attributable inadequate or excessive sleep duration.High defined LE8, is significantly These results suggest that promoting optimal may burden

Language: Английский

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Lifestyle Modifications and Nutritional and Therapeutic Interventions in Delaying the Progression of Chronic Kidney Disease: A Review

Cureus, Journal Year: 2023, Volume and Issue: unknown

Published: Feb. 2, 2023

Chronic kidney disease (CKD) is a debilitating progressive illness that affects more than 10% of the world's population. In this literature review, we discussed roles nutritional interventions, lifestyle modifications, hypertension (HTN) and diabetes mellitus (DM) control, medications in delaying progression CKD. Walking, weight loss, low-protein diet (LPD), adherence to alternate Mediterranean (aMed) diet, Alternative Healthy Eating Index (AHEI)-2010 slow However, smoking binge alcohol drinking increase risk CKD progression. addition, hyperglycemia, altered lipid metabolism, low-grade inflammation, over-activation renin-angiotensin-aldosterone system (RAAS), overhydration (OH) diabetic The Kidney Disease: Improving Global Outcomes (KDIGO) guidelines recommend blood pressure (BP) control <140/90 mmHg patients without albuminuria <130/80 with prevent Medical therapies aim target epigenetic alterations, fibrosis, inflammation. Currently, RAAS blockade, sodium-glucose cotransporter-2 (SGLT2) inhibitors, pentoxifylline, finerenone are approved for managing according completed Study Diabetic Nephropathy Atrasentan (SONAR), atrasentan, an endothelin receptor antagonist (ERA), decreased renal events patients. ongoing trials studying role other agents slowing

Language: Английский

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Smoking status, cadmium, and chronic kidney disease

Renal Replacement Therapy, Journal Year: 2024, Volume and Issue: 10(1)

Published: March 18, 2024

Abstract Background Chronic kidney disease (CKD) affects 10% of the general population in Western countries. Currently, CKD cannot be cured and there are only few strategies to prevent onset CKD, reverse early stages progression established end-stage disease. Cigarette smoking is a preventable cause CKD. Methods This narrative review analyses cause–effect relationship between cigarette discusses association inhaled cadmium smoking-induced damage. Results places individuals at risk for incident It accelerates (decline glomerular filtration rate, aggravation proteinuria) (ESKD), associated with shortened transplant graft survival. These harmful effects on function/structure dependent dose duration smoking. Smoking abstinence decreases higher proteinuria progression. Inhaled may biologic link dysfunction. Recent studies indicate that accumulation blood mediates smokers all-cause mortality. Conclusions cessation an effective intervention reduce as well smoking-attributable morbidity

Language: Английский

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Association between cardiometabolic index and albuminuria: Evidence from NHANES 2017–2020

PLoS ONE, Journal Year: 2025, Volume and Issue: 20(2), P. e0318736 - e0318736

Published: Feb. 25, 2025

Introduction Albuminuria is a crucial marker of kidney damage and serves as an early indicator the risk for chronic disease (CKD). Recent studies have suggested that cardiometabolic index (CMI), could be valuable screening renal insufficiency. However, relationship between CMI albuminuria remains underexplored. Therefore, aim this study was to investigate association albuminuria, with goal providing new insights clinical diagnosis, assessment, intervention disease. Methods The National Health Nutrition Examination Survey (NHANES) period 2017–2020 provided data cross-sectional investigation. Triglyceride (TG) (mmol/L)/High density lipid-cholesterol (HDL-C) (mmol/L) × Waist height ratio (WHtR) formula used calculating CMI. Using multifactorial logistic regression, independent connection investigated. threshold effect determined by means two-stage linear regression model. Additionally, subgroup analysis interaction tests were carried out. Results A total 3,339 participants included, 12.38% them had albuminuria. As quartiles grew (quartile 1: 7.78%, quartile 2: 13.43%, 3: 12.93%, 4: 17.01%), so did probability results adjusted model 3 showed greater prevalence strongly correlated (OR = 2.26, 95% CI: 1.58–3.23). This held true all subgroups (all P trend > 0.05). Furthermore, inflection point 0.92, we discovered nonlinear Conclusions Our findings indicate levels are significantly associated prevalence, suggesting serve biomarker assessing

Language: Английский

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Patient and Clinician Perspectives: To Create a Better Future for Chronic Kidney Disease, We Need to Talk About Our Kidneys

Advances in Therapy, Journal Year: 2024, Volume and Issue: 41(4), P. 1318 - 1324

Published: March 5, 2024

Chronic kidney disease (CKD) affects more than one in ten people worldwide. However, results from the REVEAL-CKD study suggest that it is often not diagnosed. Many patients are therefore unaware they have CKD, putting them at increased risk of progression and complications. Empowering with knowledge about CKD will allow to become active participants their own care, driving improvements diagnosis rates changing patient outcomes for better. In this article, we provide clinician perspectives on importance early management. We present an overview tests commonly used diagnose clinical practice, as well actionable suggestions patients, clinicians, health policymakers could help improve detection treatment.

Language: Английский

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Navigating the Crossroads: Understanding the Link Between Chronic Kidney Disease and Cardiovascular Health

Cureus, Journal Year: 2023, Volume and Issue: unknown

Published: Dec. 30, 2023

Chronic Kidney Disease (CKD) has emerged as a global healthcare challenge affecting significant portion of the world's population. This comprehensive narrative review delves into intricate relationship between CKD and cardiovascular disease (CVD). is characterized by kidney damage persisting for at least three months, often with or without decline in glomerular filtration rate (GFR). It closely linked CVD, individuals face high risk events, making cardiovascular-associated mortality concern advanced stages. The emphasizes importance precise assessment using biomarkers, imaging, tailored medication strategies to mitigate risks patients. Lifestyle modifications, early intervention, patient-centered care are crucial managing both conditions. Challenges awareness recognition need interdisciplinary highlighted. Recent advances research offer promising therapies, such SGLT2 inhibitors, MRAs, GLP-1R agonists, selective endothelin receptor antagonists. Stem cell-based gene editing, regenerative approaches under investigation. Patient-physician "risk discussions" assessments essential improving patient outcomes. In conclusion, underscores complexity interconnected health domains. Ongoing research, innovative personalized will be instrumental addressing challenges, reducing burden, enhancing well-being facing issues. Recognizing connections these conditions imperative providers, policymakers, researchers they seek improve quality outcomes affected individuals.

Language: Английский

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Structural and physiological changes of the kidney with age and its impact on chronic conditions and COVID-19

Ageing Research Reviews, Journal Year: 2023, Volume and Issue: 88, P. 101932 - 101932

Published: April 7, 2023

Language: Английский

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Novel Therapeutic Approaches in the Management of Chronic Kidney Disease

Biomedicines, Journal Year: 2023, Volume and Issue: 11(10), P. 2746 - 2746

Published: Oct. 11, 2023

Chronic kidney disease (CKD) is a progressive and incurable that impairs function. Its prevalence estimated to affect up 800 million individuals within the general population, patients with diabetes hypertension are particularly at risk. This disorder disrupts physiological mechanisms of body, including water electrolyte balance, blood pressure regulation, excretion toxins, vitamin D metabolism. Consequently, exposed risks such as hyperkalemia, hyperphosphatemia, metabolic acidosis, abnormalities. These can be reduced by implementing appropriate diagnostic methods, followed non-pharmacological (such physical activity, dietary, lifestyle adjustment) pharmacological strategies after diagnosis. Selecting diet suitable treatment imperative in maintaining function long possible. Drugs finerenone, canakinumab, pentoxifylline hold promise for improved outcomes among CKD patients. When these interventions prove insufficient, renal replacement therapy becomes essential. critical preserving residual while awaiting transplantation or deemed ineligible procedure. The aim this study present current state knowledge recent advances, providing novel insights into chronic disease.

Language: Английский

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Prevalence of locomotive syndrome and associated factors in patients receiving hemodialysis

Medicine, Journal Year: 2025, Volume and Issue: 104(1), P. e40007 - e40007

Published: Jan. 3, 2025

Muscle strength and joint nervous system functions decline with age in patients undergoing hemodialysis. The Japanese Orthopaedic Association has defined locomotive syndrome (LoS) as a musculoskeletal disorder primarily caused by aging. Therefore, this study aimed to investigate the prevalence of LoS identify factors associated its development Patients receiving outpatient hemodialysis at Kurume University Hospital were categorized into non-LoS groups using cutoff value 25-question Geriatric Locomotive Function Scale (GLFS-25). We analyzed differences malnutrition, biochemical examinations, Kt/V (a measure dialysis adequacy) between 2 Wilcoxon rank-sum tests. Additionally, we evaluated that correlated GLFS-25 through pairwise correlations. Multivariate analysis was performed determine independent LoS. Nineteen included. median score 18. group (n = 11) had significantly higher (P .0056) chloride levels than 8) .0175). Furthermore, Nutritional Risk Index for Hemodialysis patients, creatinine levels, lower .0156, .0026, .0163, respectively). showed significant correlations age, total protein C-reactive protein, chloride, creatinine, (with correlation coefficients -0.6133, -0.4779, 0.4738, 0.5381, -0.7923, 0.6508, 0.5747, identified life-space assessment (odds ratio [OR], 3.06; 95% confidence interval [CI], -676 674; P < .0001) (OR, 31.29; CI, -2061 2067; .0007) risk Age physical activity found be end-stage renal disease our hospital. This emphasizes importance implementing preventative measures LoS, especially older less physically active patients.

Language: Английский

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