The KNOW-CKD Study: What we have learned about chronic kidney diseases

Oh, Kook Hwan; Kang, Min‐Jung; Kang, Eunjeong; Ryu, Hyunjin; Han, Seung Hyeok; Yoo, Tae‐Hyun; Kim, Soo Wan; Chae, Dong‐Wan; Lee, Kyu‐Beck; Park, Sung Sup; Kim, Yeong Hoon; Ahn, Curie; Investigators, Know-Ckd Study

doi:10.23876/j.krcp.20.042

Cited by 36 publications

(40 citation statements)

References 72 publications

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“…Clinical findings such as the estimated glomerular filtration rate (eGFR) and the urinary albumin excretion (UAE) can be used to diagnose diabetic kidney disease (DKD) in diabetic patients without kidney biopsy [ 2 - 5 ]. These clinical indicators for DKD are helpful to recognize the DKD; however, it has limitations.…”

Section: Introductionmentioning

confidence: 99%

The role of inflammation in diabetic kidney disease

Jung

Moon

2021

Korean J Intern Med

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Diabetic kidney disease (DKD) has been the leading cause of chronic kidney disease for over 20 years. Yet, over these two decades, the clinical approach to this condition has not much improved beyond the administration of glucose-lowering agents, renin-angiotensin-aldosterone system blockers for blood pressure control, and lipid-lowering agents. The proportion of diabetic patients who develop DKD and progress to end-stage renal disease has remained nearly the same. This unmet need for DKD treatment is caused by the complex pathophysiology of DKD, and the difficulty of translating treatment from bench to bed, which further adds to the growing argument that DKD is not a homogeneous disease. To better capture the full spectrum of DKD in our design of treatment regimens, we need improved diagnostic tools that can better distinguish the subgroups within the condition. For instance, DKD is typically placed in the broad category of a non-inflammatory kidney disease. However, genome-wide transcriptome analysis studies consistently indicate the inflammatory signaling pathway activation in DKD. This review will utilize human data in discussing the potential for redefining the role of inflammation in DKD. We also comment on the therapeutic potential of targeted anti-inflammatory therapy for DKD.

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Section: Introductionmentioning

confidence: 99%

The role of inflammation in diabetic kidney disease

Jung

Moon

2021

Korean J Intern Med

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“…CKD is a major public health problem [1][2][3] that elevates morbidity and mortality of cardiovascular diseases and other complications [4,5]. Despite the remarkable progress in medical care, kidney function in CKD patients still deteriorates progressively [3]. Furthermore, CKD is usually detected at moderately to severely decreased glomerular filtration rate due to the lack of early clinical symptoms and reduced sensitivity of serum creatinine (Cr).…”

Section: Introductionmentioning

confidence: 99%

“…CKD is a major public health problem [1-3] that elevates morbidity and mortality of cardiovascular diseases and other complications [4, 5]. Despite the remarkable progress in medical care, kidney function in CKD patients still deteriorates progressively [3].…”

Section: Introductionmentioning

confidence: 99%

Soluble ST2 and Galectin-3 as Predictors of Chronic Kidney Disease Progression and Outcomes

Kim

et al. 2021

Am J Nephrol

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Background: Soluble suppression of tumorigenicity-2 (sST2) and galectin-3, novel biomarkers of heart failure and cardiovascular stress, predict cardiovascular events (CVEs) and mortality. However, their relationship with kidney function and adverse outcomes in CKD are uncertain. The purpose of this study was to determine the association between sST2 and galectin-3 with CKD progression and adverse clinical outcomes. Methods: We measured baseline sST2 and galectin-3 levels in the CKD patient cohort at our institution between October 2013 and December 2014. The primary outcome was CKD progression (kidney failure with replacement therapy or ≥50% reduction in estimated glomerular filtration rate from the baseline). The secondary outcome was the composite of CVEs and death. We used a Cox proportional hazards model to evaluate the associations between sST2 and galectin-3 levels, with kidney and clinical outcomes. Results: In total, 352 patients were enrolled in this study. At baseline, log sST2 and galectin-3 were directly associated with the serum creatinine (Cr) and urine protein-to-Cr ratio. Cox regression analysis showed that the baseline log sST2 level independently predicted CKD progression and composite outcome after adjustment for age, sex, smoking, diabetes mellitus, hypertension, cardiovascular disease, renin-angiotensin system blocker, calcium channel blocker, β-blocker, diuretics, antiplatelet agents, anemia, and hypoalbuminemia. The baseline log galectin-3 level was independently associated with CKD progression, but not with the composite outcome after adjustment for confounding variables. Conclusions: Elevated levels of sST2 and galectin-3 are significantly associated with CKD progression, but only sST2 is associated with adverse clinical outcomes.

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“…Chronic kidney disease (CKD) and hypertension are closely connected and affect each other. Hypertensive kidney disease is the second most common cause of kidney failure with replacement therapy (KFRT), and deterioration of kidney function is accelerated by excessive high blood pressure (BP) [1][2][3][4]. Uncontrolled hypertension can cause adverse cardiovascular and cerebrovascular outcomes such as acute coronary syndrome, hemorrhagic and ischemic stroke, heart failure, and even death [5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Blood pressure control in patients with chronic kidney disease

Lee

Han

2021

Korean J Intern Med

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Uncontrolled blood pressure (BP) in patients with chronic kidney disease (CKD) can lead to serious adverse outcomes. To prevent the occurrence of cardiovascular events (CVEs), and end-stage kidney disease, achieving an optimal BP level is important. Recently, there has been a paradigm shift in the management of BP largely as a result of the Systolic Blood Pressure Intervention Trial (SPRINT), which showed a reduction in CVEs by lowering systolic BP to 120 mmHg. A lower systolic blood pressure (SBP) target has been accepted by the Kidney Disease: Improving Global Outcomes (KDIGO) 2021 guidelines. However, whether intensive control of SBP targeting < 120 mmHg is also effective in patients with CKD is controversial. Notably, this lower target SBP is associated with a higher risk of adverse kidney outcomes. Unfortunately, there have been no randomized controlled trials on this issue involving only patients with CKD, particularly those with advanced CKD. In this review, we discuss the optimal control of BP in patients with CKD in terms of reduction in death and CVEs as well as attenuation of CKD progression based on the evidence-based literature.

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The KNOW-CKD Study: What we have learned about chronic kidney diseases

Cited by 36 publications

References 72 publications

The role of inflammation in diabetic kidney disease

The role of inflammation in diabetic kidney disease

Soluble ST2 and Galectin-3 as Predictors of Chronic Kidney Disease Progression and Outcomes

Blood pressure control in patients with chronic kidney disease

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