Chronic kidney disease a warning sign independent of hypertension or diabetes

September 25, 2012

Two new studies from the Johns Hopkins Bloomberg School of Public Health and the Chronic Kidney Disease Prognosis Consortium found that the presence of chronic kidney disease itself can be a strong indicator of the risk of death and end-stage renal disease (ESRD) even in patients without hypertension or diabetes. Both hypertension and diabetes are common conditions with chronic kidney disease with hypertension being the most prevalent. The studies were released online in advance of publication in The Lancet.

Chronic kidney disease affects 10 to 16 percent of all adults in Asia, Europe, Australia and the United States. Kidney function is measured by estimating glomerular filtration rate and kidney damage is often quantified by measuring albumin, the major protein in the urine standardized for urine concentration.

In the hypertension meta-analysis, low kidney function and high urine protein was associated with all-cause and cardiovascular mortality and ESRD in both individuals with and without hypertension. The associations of kidney function and urine protein with mortality outcomes were stronger in individuals without hypertension than in those with hypertension, whereas the kidney function and urine protein associations with ESRD did not differ by hypertensive status.

In the diabetes analysis, individuals with diabetes had a higher risk of all-cause, cardiovascular mortality and ESRD compared to those without diabetes across the range of kidney function and urine protein. Despite their higher risks, the relative risks of these outcomes by kidney function and urine protein are much the same irrespective of the presence or absence of diabetes.

"Chronic kidney disease should be regarded as at least an equally relevant risk factor for mortality and ESRD in individuals without hypertension as it is in those with hypertension," said Bakhtawar K. Mahmoodi, MD, PhD, lead author of the hypertension analyses.

"These data provide support for clinical practice guidelines which stage chronic kidney disease based on kidney function and urine protein across all causes of kidney disease. The conclusions are strengthened by the findings of leading studies and the participation of investigators from 40, countries and a detailed analysis of over 1 million participants," said Josef Coresh, MD, PhD, MHS, the Consortium's principal investigator and professor in the Bloomberg School's Department of Epidemiology.
-end-
"Association of kidney disease measures with mortality and end-stage renal disease in individuals with and without hypertension: a meta-analysis" (lead author, Bakhtawar K. Mahmoodi, MD, PhD, from the Johns Hopkins Bloomberg School of Public Health and University Medical Center Groningen, the Netherlands) and "Association of kidney disease measures with mortality and end-stage renal disease in individuals with and without diabetes: a meta-analysis" (lead author Caroline Fox, MD, from the Framingham Heart Study) were written by the Chronic Kidney Disease Prognosis Consortium (CKD-PC), which includes approximately 200 collaborators and data from 40 countries.

The US National Kidney Foundation and a variety of sources such as national institutes of health and medical research councils as well as foundations and industry sponsors supporting the authors and collaborating cohorts of the CKD-PC.

Johns Hopkins University Bloomberg School of Public Health

Related Diabetes Articles from Brightsurf:

New diabetes medication reduced heart event risk in those with diabetes and kidney disease
Sotagliflozin - a type of medication known as an SGLT2 inhibitor primarily prescribed for Type 2 diabetes - reduces the risk of adverse cardiovascular events for patients with diabetes and kidney disease.

Diabetes drug boosts survival in patients with type 2 diabetes and COVID-19 pneumonia
Sitagliptin, a drug to lower blood sugar in type 2 diabetes, also improves survival in diabetic patients hospitalized with COVID-19, suggests a multicenter observational study in Italy.

Making sense of diabetes
Throughout her 38-year nursing career, Laurel Despins has progressed from a bedside nurse to a clinical nurse specialist and has worked in medical, surgical and cardiac intensive care units.

Helping teens with type 1 diabetes improve diabetes control with MyDiaText
Adolescence is a difficult period of development, made more complex for those with Type 1 diabetes mellitus (T1DM).

Diabetes-in-a-dish model uncovers new insights into the cause of type 2 diabetes
Researchers have developed a novel 'disease-in-a-dish' model to study the basic molecular factors that lead to the development of type 2 diabetes, uncovering the potential existence of major signaling defects both inside and outside of the classical insulin signaling cascade, and providing new perspectives on the mechanisms behind insulin resistance in type 2 diabetes and possibly opportunities for the development of novel therapeutics for the disease.

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic
Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic.

Genetic profile may predict type 2 diabetes risk among women with gestational diabetes
Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions.

Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).

Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.

People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.

Read More: Diabetes News and Diabetes Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.