Mid-adulthood risk factor profiles for CKD

Area of Science:

• Nephrology
• Epidemiology
• Preventive Medicine

Background:

• Chronic kidney disease (CKD) poses a significant global health burden.
• Early identification of CKD risk factors is essential for timely intervention and prevention of disease progression.
• The long-term trajectory of CKD risk factor development remains incompletely understood.

Purpose of the Study:

• To investigate the presence of CKD risk factors up to 30 years prior to diagnosis.
• To determine if specific risk factor profiles precede CKD development.
• To inform early screening and intervention strategies for individuals at risk of CKD.

Main Methods:

• A case-control study utilizing data from the Framingham Offspring Study.
• Incident CKD cases (eGFR ≤60 ml/min per 1.73 m2) were age- and sex-matched to controls without CKD at baseline.
• Logistic regression models analyzed risk factor profiles (hypertension, obesity, triglycerides, HDLc, diabetes) at multiple time points preceding CKD diagnosis.

Main Results:

• Hypertension, obesity, and elevated triglyceride levels were significantly associated with CKD risk 30 years before diagnosis.
• Twenty years prior to diagnosis, hypertension, elevated triglycerides, lower HDLc, and diabetes remained significant risk factors.
• These findings highlight a prolonged period during which CKD risk factors manifest before clinical diagnosis.

Conclusions:

• CKD risk factors are detectable at least 30 years before the clinical diagnosis of CKD.
• Early and sustained identification and management of risk factors are critical for CKD prevention.
• This study underscores the importance of long-term risk factor monitoring in primary care for proactive CKD management.