Even in patients without diabetes or high blood pressure, the existence of chronic disease alone may be a powerful sign of the risk of death and end-stage renal disease (ESRD).
The findings, published in The Lancet, came from two recent studies from the Johns Hopkins Bloomberg School of Public Health and the Chronic Kidney Disease Prognosis Consortium.
According to previous research in the Journal of the American Medical Association (JAMA), the prevalence of chronic kidney disease has risen, party because there has been an increase in the number of people with diabetes and hypertension.
Chronic kidney disease is the slow loss of kidney function over time, the main function of the kidneys being to remove wastes and excess water from our bodies. It strikes 10 to 16% of all adults in the United States, Asia, Europe, and Australia. Frequent conditions with the disease are hypertension and diabetes, with hypertension being the most widespread.
A report from 2011 revealed that the health of chronic kidney disease patients can be improved by regular physical activity. For instance, they may benefit from improved physical fitness, healthier blood pressure, healthier heart rates, and higher health-related quality of life.
By estimating glomerular filtration rate (GFR) – the flow rate of filtered fluid that passes through the tiny filters in the kidneys, called glomeruli, each minute – kidney function can be measured. Results reading 60 or more indicate normal functioning, while a low number may imply kidney disease. Albumin, the major protein in the urine standardized for urine concentration, can be measured to quantify kidney damage.
An association was found between low kidney function and high urine protein with all-cause and cardiovascular mortality and ESRD (the fifth stage of chronic kidney disease meaning chronic kidney failure) in both participants with hypertension and in those without, in the hypertension meta-analysis.
Results showed that the associations of kidney function and urine protein with mortality outcomes were more significant in people without hypertension than in those with the condition. On the contrary, the associations between kidney function and urine protein with ESRD showed no differences whether hypertension existed or not.
The report from the diabetes analysis implied that subjects with diabetes had an increased risk of all-cause, cardiovascular mortality and ESRD, compared to those without diabetes across all ranges of kidney function and urine protein.
On the other hand, the comparative chances of these results by kidney function and urine protein are very similar regardless of the existence of diabetes.
Bakhtawar K. Mahmoodi, MD, PhD, lead author of the hypertension analyses, explained, “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.”
Josef Coresh, MD, PhD, MHS, the Consortium’s principal investigator and professor in the Bloomberg School’s Department of Epidemiology, concluded:
“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.”
Written by Sarah Glynn