Advances in the Diagnosis, Treatment and Prognosis of Chronic Kidney Disease

A special issue of Applied Sciences (ISSN 2076-3417). This special issue belongs to the section "Applied Biosciences and Bioengineering".

Deadline for manuscript submissions: closed (20 March 2024) | Viewed by 10761

Special Issue Editors


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Guest Editor
Non-Communicable Disease Research Unit, South African Medical Research Council, Parow, Cape Town 7535, South Africa
Interests: non-communicable diseases; chronic kidney disease; glucose metabolism; insulin resistance; physiology; diabetes; hypertension; blood pressure; metabolic diseases; metabolism

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Guest Editor
1. Non-Communicable Diseases Research Unit, South African Medical Research Council, Parow, Cape Town 7535, South Africa
2. Department of Internal Medicine, University of Cape Town, Cape Town 7505, South Africa
Interests: diabetes; hypertension; physical activity; blood pressure; epidemiology; atherosclerosis; cardiology; hemodialysis; diabetes mellitus; research and development

Special Issue Information

Dear Colleagues,

Chronic kidney disease (CKD), which impacts more than 840 million individuals worldwide, is a strong risk factor for many adverse outcomes, especially cardiovascular disorders and mortality, particularly among patients with diabetes and hypertension. Chronic kidney disease is a complex condition, and there is a need to reflect on the advances in our understanding of the pathophysiology, etiology, and treatment of the condition. Clinical practice and future research efforts would greatly benefit from an endeavor to summarize the many recent advances in the field. In this Special Issue, we will present a series of papers that highlights the complexity of CKD, and chart a path forward for investigating and more effectively managing the condition.

We are seeking submissions of original research articles on CKD (particularly in people with diabetes and hypertension), presenting novel, impactful advances into one or more of the following, but not limited to:

  • Recent developments in our understanding of the pathophysiology/etiology of CKD;
  • Exploring early prediction and detection of CKD and advances in the therapies used to address CKD;
  • The impact of technological developments in the management of glycaemia and blood pressure and the effects on CKD.

Dr. Cindy George
Prof. Dr. Andre P. Kengne
Guest Editors

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • chronic kidney disease
  • pathology
  • etiology
  • diabetes
  • hypertension
  • diagnosis
  • treatment
  • prognosis

Published Papers (6 papers)

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Research

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8 pages, 270 KiB  
Article
Associations between Genetic Variants in DAB, PRKAG, and DACH Genes and Gender in Chronic Kidney Disease
by Gabriella Kecskemétiné, Katalin Szilvia Zsóri, Sándor Kőmives, Mária Sohajda, Zoltán Csiki, János Mátyus, László Újhelyi, József Balla, Attila Nagy and Amir Houshang Shemirani
Appl. Sci. 2023, 13(11), 6633; https://doi.org/10.3390/app13116633 - 30 May 2023
Viewed by 884
Abstract
Background: Recent genome-wide association studies demonstrated the association between the prevalence of chronic kidney disease (CKD) and rs11959928, rs626277, and rs7805747 polymorphisms. Materials and Methods: In this study, we investigated the association between CKD and these polymorphisms in patients and controls according to [...] Read more.
Background: Recent genome-wide association studies demonstrated the association between the prevalence of chronic kidney disease (CKD) and rs11959928, rs626277, and rs7805747 polymorphisms. Materials and Methods: In this study, we investigated the association between CKD and these polymorphisms in patients and controls according to gender. High-resolution melting analysis was performed to detect DAB2 rs11959928, DACH1 rs626277, and PRKAG2 rs7805747 single nucleotide polymorphisms. Genomic DNA was extracted from the buffy coat of 163 patients with chronic renal disease and 218 control individuals. Ten percent of the results were also randomly confirmed by direct DNA sequencing. Results: Multivariable logistic regression analysis with adjustment for confounders showed rs7805747 (dominant model) has a statistically significant protective effect in females, and rs11959928 (additive and dominant models) was significantly associated with the prevalence of CKD in males. rs7805747 (recessive model) was significantly associated with the prevalence of CKD in males. Conclusion: The very same genetic variants have different effects in males and females separately. Our results warrant the need for similar studies in larger cohorts. Full article
11 pages, 1014 KiB  
Article
The Effect of Sleep Disorder Diagnosis on Mortality in End-Stage Renal Disease Patients
by Andrew Mixson, Jennifer L. Waller, Wendy B. Bollag, Varsha Taskar, Stephanie L. Baer, Sandeep Padala and William J. Healy
Appl. Sci. 2023, 13(9), 5354; https://doi.org/10.3390/app13095354 - 25 Apr 2023
Cited by 1 | Viewed by 1049
Abstract
Increased risk of all-cause mortality not accounted for by traditional cardiovascular risk factors has been linked to chronic kidney disease. This study tested the hypothesis that mortality may be greater in patients with end-stage renal disease (ESRD) and a sleep disorder diagnosis. The [...] Read more.
Increased risk of all-cause mortality not accounted for by traditional cardiovascular risk factors has been linked to chronic kidney disease. This study tested the hypothesis that mortality may be greater in patients with end-stage renal disease (ESRD) and a sleep disorder diagnosis. The United States Renal Data System database was queried to determine the effect of sleep disorder diagnoses on mortality in ESRD patients enrolled between 2004 and 2015. Sleep disorders were identified using International Classification of Diseases-9 and -10 codes. Mortality risk associated with sleep disorders was examined using Cox proportional hazards (CPH) modeling. In the final CPH model, sleep disorder diagnoses were associated with decreased risk of mortality, with hazard ratios (and 95% confidence intervals) for insomnia, hypersomnolence, restless leg syndrome, and obstructive/central sleep apnea of 0.76 (0.75–0.76), 0.81 (0.78–0.84), 0.79 (0.77–0.80), and 0.82 (0.81–0.82), respectively. Black or other race and Hispanic ethnicity, and to a small extent, female sex and increasing Charlson comorbidity index, were also associated with decreased risk, whereas increasing age, hemodialysis (versus peritoneal dialysis) and catheter or graft access type were associated with increased risk. This study suggests that the diagnosis of a sleep disorder may be associated with improved survival in ESRD patients. Full article
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17 pages, 2395 KiB  
Article
Evaluation of Chronic Kidney Disease Risk Factors after Radical Nephrectomy
by Jurijus Makevičius, Akvilė Pajaurytė, Artūras Samuilis, Raminta Lukšaitė-Lukštė, Eugenijus Jasiūnas, Feliksas Jankevičius and Marius Miglinas
Appl. Sci. 2023, 13(6), 3921; https://doi.org/10.3390/app13063921 - 20 Mar 2023
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Abstract
Intraoperative hypotension (IOH) and loss of blood during radical nephrectomy (RN) cause postoperative clinically significant renal dysfunction, which after 12 months can cause a reduction in serum creatinine clearance of <60 mL/min. We conducted a prospective study of 93 adult patients in which [...] Read more.
Intraoperative hypotension (IOH) and loss of blood during radical nephrectomy (RN) cause postoperative clinically significant renal dysfunction, which after 12 months can cause a reduction in serum creatinine clearance of <60 mL/min. We conducted a prospective study of 93 adult patients in which we investigated the risk factors for developing chronic kidney disease (CKD) after RN. Forty-six (49.5%) patients had CKD, and of them, 43 patients had acute kidney injury (AKI) 48 h after surgery. Sixty-six (73.1%) of the postoperative AKI patients had CKD upstage. With each 1 mL estimated blood loss during RN (OR 1.01, p < 0.001), IOH was evaluated as the main risk factor of postoperative CKD development (OR 1.09, p < 0.01). Dunn’s t-test revealed that only clinically significant AKI had a main effect (g = −1.08, p < 0.0001) on renal function 1 year after RN. A higher preoperative estimated glomerular filtration rate (eGFR), OR 0.89, p = 0.02, and contralateral kidney CT volume (OR 0.97, p = 0.04) had a clinically significantly decreased risk of postoperative CKD. Risk factors of AKI with CKD upstage were a small contralateral kidney CT volume (OR 46.70), NLR > 3.5 (OR 1.42), higher primary eGFR (OR 1.13) and longer IOH (OR 1.05), and for all of these, p < 0.03. A half of all patients after RN are at increased risk of CKD. Longer IOH and increased blood loss during RN are significant risk factors for CKD. Clinically significant postoperative AKI is related with a developed risk for postoperative eGFR decline and the presence of CKD 12 months after RN, and can be predicted by NLR > 3.5. A higher preoperative eGFR and contralateral kidney CT volume reduces the risk of postoperative CKD. Full article
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Review

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13 pages, 514 KiB  
Review
Genomic Approaches for Monogenic Kidney Diseases: A Comparative Review of Diagnostic Methods and Precision Medicine Implications
by Silvia Giovanella, Giulia Ligabue, Johanna Chester and Riccardo Magistroni
Appl. Sci. 2023, 13(23), 12733; https://doi.org/10.3390/app132312733 - 27 Nov 2023
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Abstract
Chronic kidney disease is a long-term condition with significant implications for quality of life and health care costs. To uncover the etiology in selected cases suspected of monogenicity, a genomic approach can be employed. There are multiple technologies available, but there is currently [...] Read more.
Chronic kidney disease is a long-term condition with significant implications for quality of life and health care costs. To uncover the etiology in selected cases suspected of monogenicity, a genomic approach can be employed. There are multiple technologies available, but there is currently no consensus on the most effective diagnostic approach. This review provides a comparison of currently available diagnostic methods in terms of diagnostic yield. However, the heterogeneity of patient cohort inclusion criteria limits direct comparisons. Our review identified three studies which compared a targeted gene panel and whole-exome sequencing for the same patient population. However, the results are inconclusive due to the different sizes and specificity of the targeted panels employed. The contribution of a whole-genome sequencing approach is highly debated. It is noteworthy that a large number of data are generated by these sequencing technologies. This allows for rapid analysis of coding and non-coding regions. However, the interpretation of variants is a significant burden, and the reporting of incidental findings is still challenging. Therefore, the identification of the most efficient technology is pivotal but still controversial. To conclude, an objective comparison of the three methods for the same population could overcome the limits of these studies’ heterogeneity and highlight the weaknesses and the strengths of individual approaches. Full article
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17 pages, 506 KiB  
Review
Advances in Chronic Kidney Disease in Africa
by Brian L. Rayner, Erika S. W. Jones, Bianca Davidson and Nicola Wearne
Appl. Sci. 2023, 13(8), 4924; https://doi.org/10.3390/app13084924 - 14 Apr 2023
Viewed by 3629
Abstract
Africa, particularly sub-Sharan Africa (SSA), faces major challenges in respect to chronic kidney disease (CKD). There is a rising prevalence due to the combined effects of hypertension, diabetes, and human immunodeficiency virus (HIV) (and the interaction between them) and the effect of apolipoprotein [...] Read more.
Africa, particularly sub-Sharan Africa (SSA), faces major challenges in respect to chronic kidney disease (CKD). There is a rising prevalence due to the combined effects of hypertension, diabetes, and human immunodeficiency virus (HIV) (and the interaction between them) and the effect of apolipoprotein L1 (APOL1) variants on the susceptibility to CKD. Epidemiological data on the prevalence of CKD are of low-to-medium quality, and reliable data are urgently needed for health planning. Furthermore, there are important deficiencies in creatinine-based equations in underestimating the prevalence of CKD in Africa, and evidence suggests that cystatin C based equations are more reliable. There is a changing spectrum of HIV related CKD with the greater availability of antiretroviral treatment. Major clinical trials using SGLT2 inhibitors have signalled a major advance in the treatment of CKD, especially in relation to type 2 diabetes, but the affordability, availability, and relevance to the African population is not established. The importance of the effects of hypertension in pregnancy and pregnancy related acute kidney injury on CKD and the newer concept of CKD of unknown cause (CKDu) are highlighted. Hypertension remains a dominant cause of CKD in Africa, and newer information suggests that the most appropriate treatment to control blood pressure and thus prevent CKD is the combination of either amlodipine plus a thiazide diuretic or angiotensin converting enzyme (ACE) inhibitor. Full article
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17 pages, 1125 KiB  
Review
The Gastrointestinal Microbiota as a Potential Cause and Target in Chronic Kidney Disease Accentuating Treatment and Intervention Strategies
by Ana Zupcic, Paul Slezak and Judith Radloff
Appl. Sci. 2023, 13(5), 3212; https://doi.org/10.3390/app13053212 - 02 Mar 2023
Cited by 4 | Viewed by 2157
Abstract
Dysbiosis and impaired gastrointestinal barrier function have emerged as potential chronic kidney disease (CKD) modulators. Accumulation of gut-derived uremic toxins, a subsequent shift in the gut microbiome, and modified expression levels of intestinal tight junction proteins are all contributing factors to hyperpermeability and [...] Read more.
Dysbiosis and impaired gastrointestinal barrier function have emerged as potential chronic kidney disease (CKD) modulators. Accumulation of gut-derived uremic toxins, a subsequent shift in the gut microbiome, and modified expression levels of intestinal tight junction proteins are all contributing factors to hyperpermeability and endotoxemia in CKD. Experimental studies in animals provide evidence that renal decline is linked to gastrointestinal health and that pharmacological or dietary intervention might attenuate this process. In this review, we will highlight the current knowledge on CKD-induced changes in the gut microbiome and the resulting consequences regarding gastrointestinal health with a focus on animal studies. Furthermore, we will explore possible disease management options linking to evidence in humans, if available. Full article
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