Chronic kidney disease: Definition, updated epidemiology, staging, and mechanisms of increased cardiovascular risk

Abstract

Chronic kidney disease (CKD) is a heterogeneous group of disorders that manifest in various ways depending upon the severity of disease and the underlying cause(s). 1 | CK D: DEFINITI ONChronic kidney disease is defined by the presence of kidney damage or decreased kidney function for at least three months, irrespective of the cause. 2 Kidney damage generally refers to pathologic anomalies in the native or transplanted kidney, established via imaging, biopsy, or deduced from clinical markers like increased albuminuria-that is, albumin-to-creatinine ratio (ACR) >30 mg/g (3.4 mg/mMol)-or urinary sediment alterations; decreased kidney function refers to a reduced glomerular filtration rate (GFR), which is usually estimated (eGFR) from the serum concentration of creatinine. 3 | UPDATED CK D EPIDEMI OLOGYAccording to the US Centers for Disease Control and Prevention (CDC), ~37 million people in the United States-~15% of adults-are estimated to have CKD. Of note, 90% of adults with CKD do not know they have it and 1 in 2 people with very low kidney function who are not on dialysis are not aware of the fact that they have CKD. 4 Diabetes and hypertension are the major causes of CKD in adults: According to the CDC, 1 in 3 adults with diabetes and 1 in 5 adults with hypertension may have CKD. According to the current CDC statistics, CKD is more common in people aged 65 years or older (38%) than in people aged 45-64 years (13%) or 18-44 years (7%), and is slightly more common in women (15%) than men (12%); moreover, African Americans are about 3 times more likely than whites to develop ESKD. 5

Global, Regional, and National Burden of Diabetes-Related Chronic Kidney Disease From 1990 to 2019

“…Chronic kidney disease (CKD) remains a public health problem ( 1 ), which increases and affects over 75 million people worldwide ( 2 , 3 ). At present, people suffer from CKD more than osteoarthritis, diabetes, or depression ( 4 ).…”

Synergic Renoprotective Effects Of Combined ASC Therapy With RAAS Blockade In Experimental Advanced CKD

“…According to recent surveys, by the end of 2020 there were at least 2.5 million of patients receiving renal replacement therapy worldwide, and this number is expected to double by 2030. The high mortality rates and the highly debilitating character of CKD, together with the current lack of an effective treatment to halt its progression, urge the world to seek for new therapeutic strategies to detain the advance of CKD [22, 23]. In the present study we sought to verify the potential renoprotective effects of cell therapy, using a high number of ASC (2 x 10 6 ), administered directly in the renal subcapsular area, in Wistar rats submitted to the 5/6 renal ablation model of CKD.…”

Functional Role of miR-155 in the Pathogenesis of Diabetes Mellitus and Its Complications

“…Several studies have demonstrated that miR-155 participates in the pathogenesis of diabetic complications, which include nephropathy, neuropathy, cardiomyopathy, and retinopathy [ 139 , 140 , 141 , 142 , 143 , 144 , 145 ].…”

“…The inflammatory response triggers activation of mesangial cells in the glomeruli, which start to proliferate and produce excessive extracellular matrix substituting capillaries and podocytes, thus resulting in a decline in the glomerular filtration rate. Eventually, glomerulosclerosis triggers tubular epithelium damage with irreversible fibrotic changes [ 145 , 148 , 149 , 150 ].…”