Translational research in nephrology: chronic kidney disease prevention and public health

Abstract

This narrative review evaluates translational research with respect to five important risk factors for chronic kidney disease (CKD): physical inactivity, high salt intake, smoking, diabetes and hypertension. We discuss the translational research around prevention of CKD and its complications both at the level of the general population, and at the level of those at high risk, i.e. people at increased risk for CKD or CKD complications. At the population level, all three lifestyle risk factors (physical inactivity, high salt intake and smoking) have been translated into implemented measures and clear population health improvements have been observed. At the ‘high-risk’ level, the lifestyle studies reviewed have tended to focus on the individual impact of specific interventions, and their wider implementation and impact on CKD practice are more difficult to establish. The treatment of both diabetes and hypertension appears to have improved, however the impact on CKD and CKD complications was not always clear. Future studies need to investigate the most effective translational interventions in low and middle income countries.

Mesenchymal Stem Cell-Based Therapy for Kidney Disease: A Review of Clinical Evidence

“…The number of individuals affected with chronic kidney disease (CKD) is rising worldwide, mainly due to a remarkable increase in atherosclerosis and type 2 diabetes. An estimated 8–16% of the general population has CKD, and its prevalence increases with age to about 30% in people aged over 70 years [ 120 ]. CKD is a progressive condition causing significant morbidity and mortality, as patients often develop end-stage renal disease (ESRD) and present an increased risk of cardiovascular disease.…”

International differences in chronic kidney disease prevalence: a key public health and epidemiologic research issue

“…Some evidence exists on the positive effect of salt reduction on both hypertension and proteinuria in people with CKD [30] and of smoking cessation on kidney function [31]. However, within these studies the outcomes were limited to proteinuria and kidney function instead of hard renal outcomes such as end stage renal disease [11].…”

“…Moreover, health policies addressing CKD prevention and treatment also vary widely across the region [11]. A better understanding of this complexity would guide the medical community and policy makers in targeting primary and secondary prevention efforts.…”

Risk factors and knowledge of the elderly people about chronic kidney disease

“…Thus, the Unified Health System reorganized its actions, focusing on the main characteristics of these diseases: the long duration and the strong interrelationship with the habits of life. Care has been given primarily to Primary Health Care, through a care mo-del focused on coordinated, continuous, organized, proactive, integrated care and with the capacity to support individuals in lifestyle changes (9) . Also, nurses should play a relevant role in Primary Health Care, in screening for possible risk factors for the development of chronic kidney disease in the elderly, counseling on the disease and implementing intervention programs for these at-risk groups (10) .…”