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Updated: Mar 3, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Chronic kidney disease - determinants of progression and cardiovascular risk. PROGREDIR cohort study: design and
Maria Alice Muniz Domingos1, Alessandra Carvalho Goulart2, Paulo Andrade Lotufo3
1MD, PhD. Nephrologist, Renal Division, Department of Clinical Medicine, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo (SP), Brazil.
Insights
This study established the PROGREDIR cohort to investigate chronic kidney disease (CKD) progression and cardiovascular risks in advanced CKD patients. Further research on CKD determinants and biomarkers is needed.
Area of Science:
- Nephrology
- Cardiology
- Epidemiology
Background:
- Chronic kidney disease (CKD) presents a significant public health challenge with high socioeconomic costs from renal replacement therapy (RRT) and cardiovascular complications.
- Current preventive and therapeutic strategies for CKD have limited efficacy, necessitating further research into disease determinants and progression.
- Existing cohort studies often lack sufficient representation of advanced CKD stages (3 and 4).
Purpose of the Study:
- To establish a prospective cohort (PROGREDIR) focusing on patients with advanced CKD (stages 3 and 4).
- To collect comprehensive data on renal and cardiovascular parameters to understand CKD progression.
- To identify determinants and validate biomarkers associated with CKD progression and mortality.
Main Methods:
- A prospective cohort study was conducted in São Paulo, Brazil, recruiting 454 participants from March 2012 to December 2013.
- Data collected included medical history, dietary information, anthropometry, laboratory tests, and advanced cardiovascular assessments (calcium score, echocardiography, carotid IMT, PWV, retinography, HRV).
- A biobank was established containing serum, plasma, urine, and DNA samples for future analyses.
Main Results:
- The cohort comprises 454 participants (60% male, 50% diabetic) with a mean age of 68 years and an average estimated glomerular filtration rate (eGFR) of 38 ml/min/1.73 m².
- Follow-up is ongoing, with primary outcomes including initiation of RRT, cardiovascular events, and mortality.
- The study successfully enrolled a population with advanced CKD, providing a foundation for future research.
Conclusions:
- The PROGREDIR cohort represents a valuable prospective study for advancing the understanding of CKD.
- The cohort will facilitate the identification of key determinants influencing CKD progression.
- It will enable the validation of novel biomarkers for predicting CKD progression and mortality risks.
Context And Objective::
Chronic kidney disease (CKD) has become an important public health issue. The socioeconomic burden of renal replacement therapy (RRT) is very high, as is CKD-related cardiovascular mortality and morbidity. Preventive and therapeutic measures only have modest impact and more research is needed. Few cohort studies have been conducted on populations with CKD. Our aim was to establish a cohort that would include more advanced forms of CKD (stages 3 and 4). Data collection was focused on renal and cardiovascular parameters.
Design And Setting::
Prospective cohort study; São Paulo, Brazil.
Methods::
Recruitment took place in Hospital das Clínicas, São Paulo, from March 2012 to December 2013. Data relating to medical history, food-frequency questionnaire, anthropometry, laboratory work-up, calcium score, echocardiography, carotid intimal-medial thickness, pulse-wave velocity, retinography and heart rate variability were collected. A biobank including serum, plasma, post-oral glucose tolerance test serum and plasma, urine (morning and 24-hour urine) and DNA was established.
Results::
454 participants (60% men and 50% diabetics) of mean age 68 years were enrolled. Their mean estimated glomerular filtration rate-CKD Epidemiology Collaboration was 38 ml/min/1.73 m2. Follow-up is ongoing and the main outcomes are the start of RRT, cardiovascular events and death.
Conclusions::
The PROGREDIR cohort is a promising prospective study that will allow better understanding of CKD determinants and validation of candidate biomarkers for the risks of CKD progression and mortality.
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