Risk factor analysis for a rapid progression of chronic kidney disease

Anne H S Vestergaard; Simon K Jensen; Uffe Heide-Jørgensen; Line E Frederiksen; Henrik Birn; Dorte E Jarbøl; Jens Søndergaard; Frederik Persson; Reimar W Thomsen; Christian F Christiansen

doi:10.1093/ndt/gfad271

Risk factor analysis for a rapid progression of chronic kidney disease

Anne H S Vestergaard^*, Simon K Jensen, Uffe Heide-Jørgensen, Line E Frederiksen, Henrik Birn, Dorte E Jarbøl, Jens Søndergaard, Frederik Persson, Reimar W Thomsen, Christian F Christiansen

^*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

BACKGROUND: Chronic kidney disease (CKD) is a growing global health concern. Identifying individuals in routine clinical care with new-onset CKD at high risk of rapid progression of the disease is imperative to guide allocation of prophylactic interventions, but community-based data are limited. We aimed to examine the risk of rapid progression, kidney failure, hospitalization and death among adults with incident CKD stage G3 and to clarify the association between predefined risk markers and rapid CKD progression.

METHODS: Using plasma creatinine measurements for the entire Danish population from both hospitals and primary care, we conducted a nationwide, population-based cohort study, including adults in Denmark with incident CKD stage G3 in 2017-2020. We estimated 3-year risks of rapid progression (defined by a confirmed decline in estimated glomerular filtration rate of ≥5 mL/min/1.73 m2/year), kidney failure, all-cause hospitalization and death. To examine risk markers, we constructed a heat map showing the risk of rapid progression based on predefined markers: albuminuria, sex, diabetes and hypertension/cardiovascular disease.

RESULTS: Among 133 443 individuals with incident CKD stage G3, the 3-year risk of rapid progression was 14.6% [95% confidence interval (CI) 14.4-14.8]. The 3-year risks of kidney failure, hospitalization and death were 0.3% (95% CI 0.3-0.4), 53.3% (95% CI 53.0-53.6) and 18.1% (95% CI 17.9-18.4), respectively. In the heat map, the 3-year risk of rapid progression ranged from 7% in females without albuminuria, hypertension/cardiovascular disease or diabetes, to 46%-47% in males and females with severe albuminuria, diabetes and hypertension/cardiovascular disease.

CONCLUSION: This population-based study shows that CKD stage G3 is associated with considerable morbidity in a community-based setting and underscores the need for optimized prophylactic interventions among such patients. Moreover, our data highlight the potential of using easily accessible markers in routine clinical care to identify individuals who are at high risk of rapid progression.

Original language	English
Journal	Nephrology Dialysis Transplantation
Volume	39
Issue	7
Pages (from-to)	1150-1158
Number of pages	9
ISSN	0931-0509
DOIs	https://doi.org/10.1093/ndt/gfad271
Publication status	Published - 1 Jul 2024

Keywords

Adult
Aged
Cohort Studies
Denmark/epidemiology
Disease Progression
Female
Glomerular Filtration Rate
Hospitalization/statistics & numerical data
Humans
Male
Middle Aged
Renal Insufficiency, Chronic/diagnosis
Risk Factors
hospitalization
renal insufficiency
disease progression
mortality
risk

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10.1093/ndt/gfad271

Cite this

@article{49ab77ac3ebe47bd859d35bd07a48366,

title = "Risk factor analysis for a rapid progression of chronic kidney disease",

abstract = "BACKGROUND: Chronic kidney disease (CKD) is a growing global health concern. Identifying individuals in routine clinical care with new-onset CKD at high risk of rapid progression of the disease is imperative to guide allocation of prophylactic interventions, but community-based data are limited. We aimed to examine the risk of rapid progression, kidney failure, hospitalization and death among adults with incident CKD stage G3 and to clarify the association between predefined risk markers and rapid CKD progression.METHODS: Using plasma creatinine measurements for the entire Danish population from both hospitals and primary care, we conducted a nationwide, population-based cohort study, including adults in Denmark with incident CKD stage G3 in 2017-2020. We estimated 3-year risks of rapid progression (defined by a confirmed decline in estimated glomerular filtration rate of ≥5 mL/min/1.73 m2/year), kidney failure, all-cause hospitalization and death. To examine risk markers, we constructed a heat map showing the risk of rapid progression based on predefined markers: albuminuria, sex, diabetes and hypertension/cardiovascular disease.RESULTS: Among 133 443 individuals with incident CKD stage G3, the 3-year risk of rapid progression was 14.6% [95% confidence interval (CI) 14.4-14.8]. The 3-year risks of kidney failure, hospitalization and death were 0.3% (95% CI 0.3-0.4), 53.3% (95% CI 53.0-53.6) and 18.1% (95% CI 17.9-18.4), respectively. In the heat map, the 3-year risk of rapid progression ranged from 7% in females without albuminuria, hypertension/cardiovascular disease or diabetes, to 46%-47% in males and females with severe albuminuria, diabetes and hypertension/cardiovascular disease.CONCLUSION: This population-based study shows that CKD stage G3 is associated with considerable morbidity in a community-based setting and underscores the need for optimized prophylactic interventions among such patients. Moreover, our data highlight the potential of using easily accessible markers in routine clinical care to identify individuals who are at high risk of rapid progression.",

keywords = "Adult, Aged, Cohort Studies, Denmark/epidemiology, Disease Progression, Female, Glomerular Filtration Rate, Hospitalization/statistics & numerical data, Humans, Male, Middle Aged, Renal Insufficiency, Chronic/diagnosis, Risk Factors, hospitalization, renal insufficiency, disease progression, mortality, risk",

author = "Vestergaard, {Anne H S} and Jensen, {Simon K} and Uffe Heide-J{\o}rgensen and Frederiksen, {Line E} and Henrik Birn and Jarb{\o}l, {Dorte E} and Jens S{\o}ndergaard and Frederik Persson and Thomsen, {Reimar W} and Christiansen, {Christian F}",

note = "{\textcopyright} The Author(s) 2024. Published by Oxford University Press on behalf of the ERA.",

year = "2024",

month = jul,

day = "1",

doi = "10.1093/ndt/gfad271",

language = "English",

volume = "39",

pages = "1150--1158",

journal = "Nephrology Dialysis Transplantation",

issn = "0931-0509",

publisher = "Oxford University Press",

number = "7",

}

Risk factor analysis for a rapid progression of chronic kidney disease. / Vestergaard, Anne H S ; Jensen, Simon K ; Heide-Jørgensen, Uffe et al.
In: Nephrology Dialysis Transplantation, Vol. 39, No. 7, 01.07.2024, p. 1150-1158.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Risk factor analysis for a rapid progression of chronic kidney disease

AU - Vestergaard, Anne H S

AU - Jensen, Simon K

AU - Heide-Jørgensen, Uffe

AU - Frederiksen, Line E

AU - Birn, Henrik

AU - Jarbøl, Dorte E

AU - Søndergaard, Jens

AU - Persson, Frederik

AU - Thomsen, Reimar W

AU - Christiansen, Christian F

N1 - © The Author(s) 2024. Published by Oxford University Press on behalf of the ERA.

PY - 2024/7/1

Y1 - 2024/7/1

N2 - BACKGROUND: Chronic kidney disease (CKD) is a growing global health concern. Identifying individuals in routine clinical care with new-onset CKD at high risk of rapid progression of the disease is imperative to guide allocation of prophylactic interventions, but community-based data are limited. We aimed to examine the risk of rapid progression, kidney failure, hospitalization and death among adults with incident CKD stage G3 and to clarify the association between predefined risk markers and rapid CKD progression.METHODS: Using plasma creatinine measurements for the entire Danish population from both hospitals and primary care, we conducted a nationwide, population-based cohort study, including adults in Denmark with incident CKD stage G3 in 2017-2020. We estimated 3-year risks of rapid progression (defined by a confirmed decline in estimated glomerular filtration rate of ≥5 mL/min/1.73 m2/year), kidney failure, all-cause hospitalization and death. To examine risk markers, we constructed a heat map showing the risk of rapid progression based on predefined markers: albuminuria, sex, diabetes and hypertension/cardiovascular disease.RESULTS: Among 133 443 individuals with incident CKD stage G3, the 3-year risk of rapid progression was 14.6% [95% confidence interval (CI) 14.4-14.8]. The 3-year risks of kidney failure, hospitalization and death were 0.3% (95% CI 0.3-0.4), 53.3% (95% CI 53.0-53.6) and 18.1% (95% CI 17.9-18.4), respectively. In the heat map, the 3-year risk of rapid progression ranged from 7% in females without albuminuria, hypertension/cardiovascular disease or diabetes, to 46%-47% in males and females with severe albuminuria, diabetes and hypertension/cardiovascular disease.CONCLUSION: This population-based study shows that CKD stage G3 is associated with considerable morbidity in a community-based setting and underscores the need for optimized prophylactic interventions among such patients. Moreover, our data highlight the potential of using easily accessible markers in routine clinical care to identify individuals who are at high risk of rapid progression.

AB - BACKGROUND: Chronic kidney disease (CKD) is a growing global health concern. Identifying individuals in routine clinical care with new-onset CKD at high risk of rapid progression of the disease is imperative to guide allocation of prophylactic interventions, but community-based data are limited. We aimed to examine the risk of rapid progression, kidney failure, hospitalization and death among adults with incident CKD stage G3 and to clarify the association between predefined risk markers and rapid CKD progression.METHODS: Using plasma creatinine measurements for the entire Danish population from both hospitals and primary care, we conducted a nationwide, population-based cohort study, including adults in Denmark with incident CKD stage G3 in 2017-2020. We estimated 3-year risks of rapid progression (defined by a confirmed decline in estimated glomerular filtration rate of ≥5 mL/min/1.73 m2/year), kidney failure, all-cause hospitalization and death. To examine risk markers, we constructed a heat map showing the risk of rapid progression based on predefined markers: albuminuria, sex, diabetes and hypertension/cardiovascular disease.RESULTS: Among 133 443 individuals with incident CKD stage G3, the 3-year risk of rapid progression was 14.6% [95% confidence interval (CI) 14.4-14.8]. The 3-year risks of kidney failure, hospitalization and death were 0.3% (95% CI 0.3-0.4), 53.3% (95% CI 53.0-53.6) and 18.1% (95% CI 17.9-18.4), respectively. In the heat map, the 3-year risk of rapid progression ranged from 7% in females without albuminuria, hypertension/cardiovascular disease or diabetes, to 46%-47% in males and females with severe albuminuria, diabetes and hypertension/cardiovascular disease.CONCLUSION: This population-based study shows that CKD stage G3 is associated with considerable morbidity in a community-based setting and underscores the need for optimized prophylactic interventions among such patients. Moreover, our data highlight the potential of using easily accessible markers in routine clinical care to identify individuals who are at high risk of rapid progression.

KW - Adult

KW - Aged

KW - Cohort Studies

KW - Denmark/epidemiology

KW - Disease Progression

KW - Female

KW - Glomerular Filtration Rate

KW - Hospitalization/statistics & numerical data

KW - Humans

KW - Male

KW - Middle Aged

KW - Renal Insufficiency, Chronic/diagnosis

KW - Risk Factors

KW - hospitalization

KW - renal insufficiency

KW - disease progression

KW - mortality

KW - risk

UR - http://www.scopus.com/inward/record.url?scp=85196494112&partnerID=8YFLogxK

U2 - 10.1093/ndt/gfad271

DO - 10.1093/ndt/gfad271

M3 - Journal article

C2 - 38168720

SN - 0931-0509

VL - 39

SP - 1150

EP - 1158

JO - Nephrology Dialysis Transplantation

JF - Nephrology Dialysis Transplantation

IS - 7

ER -

Risk factor analysis for a rapid progression of chronic kidney disease

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