KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease

Stevens, Paul E.; Ahmed, Sofia B.; Carrero, Juan Jesus; Foster, Bethany; Francis, Anna; Hall, Rasheeda K.; Herrington, Will G.; Hill, Guy; Inker, Lesley A.; Kazancıoğlu, Rümeyza; Lamb, Edmund; Lin, Peter; Madero, Magdalena; McIntyre, Natasha; Morrow, Kelly; Roberts, Glenda; Sabanayagam, Dharshana; Schaeffner, Elke; Shlipak, Michael; Shroff, Rukshana; Tangri, Navdeep; Thanachayanont, Teerawat; Ulasi, Ifeoma; Wong, Germaine; Yang, Chih-Wei; Zhang, Luxia; Levin, Adeera

doi:10.1016/j.kint.2023.10.018

Cited by 442 publications

(59 citation statements)

References 833 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These results partly agreed with those of the Ibaraki Prefecture Health Study (IPHS), a previous cohort study in diabetes-free Japanese participants 16,43 . The IPHS showed the dose- response relationship between BMI categories and the onset of CKD: aHRs were higher in BMI categories 23.0–24.9, 25.0–26.9, 27.0–29.9, and ≥30.0 kg/m 2 in men and 27.0–29.9 and ≥30.0 kg/m 2 in women compared with the BMI category 21.0–22.9 kg/m 2 . However, no clear evidence of a dose-response relationship was observed in our study, and only obesity class I shortened survival to CKD.…”

Section: Discussionmentioning

confidence: 99%

“…Three sensitivity analyses were conducted in this study. In the first sensitivity analysis, conventional BMI classification (underweight [<18.5 kg/m 2 ], normal weight [18.5–24.9 kg/m 2 ], overweight [25.0–29.9 kg/m 2 ], obesity class I [30.0–34.9 kg/m 2 ], obesity class II [35.0–39.9 kg/m 2 ], and obesity class III [≥40 kg/m 2 ]) were treated as exposure variables 42 . Obesity classes I–III were combined as one obesity category because of the small number of participants in this study with BMI ≥30.0 kg/m 2 .…”

Section: Methodsmentioning

confidence: 99%

“…The third sensitivity analysis attempted to eliminate temporary abnormal eGFR values by including the stringent definition of CKD, in which CKD is defined by two or more consecutive observations of eGFR < 60 mL/min/1.73 m 2 . Because the study included data from annual checkups, the duration of renal dysfunction in the stringent CKD definition was longer than that in the KDIGO definition of 3 months or longer 2 .…”

Section: Sensitivity Analysesmentioning

confidence: 99%

“…A previous cohort study of non-diabetic Japanese men and women examined whether a dose-response relationship exists between body mass index (BMI) and the development of CKD 16 . The study categorized BMI into seven groups and reported that individuals in the BMI categories ≥23.0 kg/m 2 for men and ≥27 kg/m 2 for women were at an elevated risk of developing CKD compared with the reference group 16 . This suggests that even in a non-diabetic Asian population, elevated BMI is associated with the development of CKD and that sex differences are observed.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Obesity in the Asia-Pacific body mass index classification is associated with the development of chronic kidney disease in non-diabetic Japanese men and women

Okawa,

Mitsuhashi,

Tsuda

2024

Preprint

View full text Add to dashboard Cite

Background/ObjectivesObesity is a risk factor for the development of chronic kidney disease (CKD). However, little is known about the relationship between the Asia-Pacific body mass index classification (Asia-Pacific classification) and the subsequent development of CKD in non-diabetic Asian men and women.Subjects/MethodsBody mass index (BMI) was categorized in accordance with the Asia-Pacific classification: underweight (< 18.5 kg/m2), normal weight (18.5–22.9 kg/m2), overweight (23.0–24.9 kg/m2), obesity class I (25.0–29.9 kg/m2), and obesity class II (≥ 30.0 kg/m2). Using administrative checkup data for non-diabetic Japanese adults (1998–2023), we assessed the relationship between the Asia-Pacific classification and new-onset CKD by sex. The Weibull accelerated failure time model was selected because the proportional hazards assumption was violated.ResultsIn total, 34.2% of 3,098 men and 34.8% of 4,391 women had newly developed CKD. The mean follow-up time was 7.41 person-years for men and 8.25 person-years for women. Compared with those of normal weight, obesity class I was associated with a 6% (95% confidence interval [CI]: 2%–10%) shorter time to CKD development in men and a 6% (95% CI: 2%–9%) shorter time to CKD development in women. Obesity class II was associated with the shortest survival to CKD onset by point estimate in men but had an almost null value in women (i.e., 95% CIs crossed 1 in all of the models).ConclusionsAmong non-diabetic Japanese men and women, obesity class I in the Asia-Pacific classification was associated with a shorter survival time to CKD onset than normal weight. Low point estimates for obesity class II suggested a dose-response relationship in men but a less clear relationship in women. The conventional cutoff value for obesity, BMI ≥ 30.0 kg/m2, may be too high a risk factor for new-onset CKD in non-diabetic Asians, regardless of sex.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Sensitivity Analysesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Obesity in the Asia-Pacific body mass index classification is associated with the development of chronic kidney disease in non-diabetic Japanese men and women

Okawa,

Mitsuhashi,

Tsuda

2024

Preprint

View full text Add to dashboard Cite

show abstract

“…Para hacer un diagnóstico de ERC en una persona se deben evaluar 2 condiciones: 1) La disminución de la función renal y 2) La presencia de albuminuria como marcador de daño renal (es reconocido para el uso clínico, como el marcador de daño renal más temprano). Estos 2 criterios son los recomendados a nivel internacional por las guías de diagnóstico y manejo de los pacientes con ERC (Stevens et al, 2024). Una vez que alguien cumple con éstos 2 criterios se le hace diagnóstico de ERC; entonces, se puede clasificar la enfermedad que tiene, entre 1-5 estadios (Kidney International Supplements, 2013; Stevens et al, 2024).…”

Section: Epidemiología De La Enfermedad Renal Crónicaunclassified

El derecho a la evaluación nutricional del paciente con enfermedad renal crónica

ROJAS-CAMPOS,

BARAJAS-GONZÁLEZ,

LUNA-NAVARRO

2024

TraHs

View full text Add to dashboard Cite

Antecedentes: La enfermedad renal crónica (ERC), tiene muchos retos: el diagnóstico temprano, atención especializada, aspectos económicos, sin embargo el aspecto nutricional es de la misma relevancia. No se conoce el número de especialistas en nutrición renal en muchos países (entre ellos México). El derecho a la salud, a la nutrición y a la nutrición clínica son reconocidos internacionalmente; sin embargo, no se tiene la certeza que en la ERC se goce de ellos. La adecuada evaluación nutricional contempla evaluaciones antropométrica, bioquímica, clínica, dietética y de estilo de vida; pero evaluar el sentido del gusto no se hace de manera regular. Objetivo y Resultados: análisis bibliográfico sobre el derecho a la evaluación nutricional adecuada, optima y completa en la ERC. La alta prevalencia tanto de ERC como de desnutrición de pacientes en diálisis predice los resultados clínicos y de sobrevida de los pacientes; aunque el número de nutriólogos en algunos países es mayor que en otros, el número de especialistas en nutrición renal no parece haberse alcanzado. No se puede confirmar que los pacientes con ERC gozan del derecho a la nutrición clínica, incluso no hay evaluaciones tan importantes como la del sentido del gusto de manera habitual. Conclusiones: aunque existe el derecho a la salud, a la nutrición y a la nutrición clínica, se debe asegurar que se lleve a cabo por un especialista en nutrición renal y que abarque la evaluación del sentido de gusto, hecha por profesionales de la nutrición entrenados que puedan interpretar los resultados de la misma.

show abstract

When to Start Population-Wide Screening for Chronic Kidney Disease

Cusick,

Tisdale,

Chertow

et al. 2024

JAMA Health Forum

View full text Add to dashboard Cite

ImportanceSodium-glucose cotransporter-2 (SGLT2) inhibitors have changed clinical management of chronic kidney disease (CKD) and made populationwide screening for CKD a viable strategy. Optimal age of screening initiation has yet to be evaluated.ObjectiveTo compare the clinical benefits, costs, and cost-effectiveness of population-wide CKD screening at different initiation ages and screening frequencies.Design, Setting, and ParticipantsThis cost-effectiveness study used a previously published decision-analytic Markov cohort model that simulated progression of CKD among US adults from age 35 years and older and was calibrated to population-level data from the National Health and Nutrition Examination Survey (NHANES). Effectiveness of SGLT2 inhibitors was derived from the Dapagliflozin and Prevention of Adverse Outcomes in Chronic Kidney Disease (DAPA-CKD) trial. Mortality, quality-of-life weights, and cost estimates were obtained from published cohort studies, randomized clinical trials, and US Centers for Medicare &amp; Medicaid Services data. Analyses were performed from June 2023 through September 2024.ExposuresOne-time or periodic (every 10 or 5 years) screening for albuminuria, initiated at ages between 35 and 75 years, with and without addition of SGLT2 inhibitors to conventional CKD therapy (angiotensin-converting enzyme inhibitors/angiotensin receptor blockers).Main Outcomes and MeasuresCumulative incidence of kidney failure requiring kidney replacement therapy (KRT); life years, quality-adjusted life years (QALYs), lifetime health care costs (2024 US currency), and incremental cost-effectiveness ratios discounted at 3% annually.ResultsFor those aged 35 years, starting screening at age 55 years, and continuing every 5 years through age 75 years, combined with SGLT2 inhibitors, decreased the cumulative incidence of kidney failure requiring KRT from 2.4% to 1.9%, increased life expectancy by 0.13 years, and cost $128 400 per QALY gained. Although initiation of screening every 5 years at age 35 or 45 years yielded greater gains in population-wide health benefits, these strategies cost more than $200 000 per additional QALY gained. The comparative values of starting screening at different ages were sensitive to the cost and effectiveness of SGLT2 inhibitors; if SGLT2 inhibitor prices drop due to patent expirations, screening at age 55 years continued to be cost-effective even if SGLT2 inhibitor effectiveness were 30% lower than in the base case.Conclusions and RelevanceThis study found that, based on conventional benchmarks for cost-effectiveness in medicine, initiating population-wide CKD screening with SGLT2 inhibitors at age 55 years would be cost-effective.

show abstract

KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease

Cited by 442 publications

References 833 publications

Obesity in the Asia-Pacific body mass index classification is associated with the development of chronic kidney disease in non-diabetic Japanese men and women

Obesity in the Asia-Pacific body mass index classification is associated with the development of chronic kidney disease in non-diabetic Japanese men and women

El derecho a la evaluación nutricional del paciente con enfermedad renal crónica

When to Start Population-Wide Screening for Chronic Kidney Disease

Contact Info

Product

Resources

About