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Chronic Kidney Disease: Current Challenges and Adverse Outcomes

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nephrology & Urology".

Deadline for manuscript submissions: 20 July 2026 | Viewed by 3625

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Special Issue Editors

Dr. Diana Tania Luminița Moldovan

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Guest Editor

Department of Nephrology, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
Interests: chronic kidney disease; CKD progression; hemodialysis; cardiovascular complications; vascular calcification; lifestyle; nutrition; bone and mineral disorders; mortality
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Prof. Dr. Flaviu Bob

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Guest Editor

1. Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine “Victor Babes”, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
2. Discipline of Nephrology, University of Medicine and Pharmacy “Victor Babes”, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
Interests: chronic kidney disease; hemodialysis; diabetic kidney disease; renal; glomerulonephritis

Special Issue Information

Dear Colleagues,

Chronic kidney disease (CKD) often remains asymptomatic until advanced stages, making early diagnosis difficult. Improved screening and biomarkers are essential to identify CKD earlier and initiate timely interventions. Controlling progression involves comprehensive management, including hypertension, diabetes, and lifestyle factors. Understanding individual patient risk profiles can tailor treatments to slow kidney function decline. CKD leads to complications like cardiovascular disease, anemia, and bone disorders and effective management strategies are needed to reduce adverse outcomes and to improve quality of life. By mobilizing interdisciplinary efforts, we aim to develop improved diagnostics, therapies, and management strategies to reduce CKD adverse outcomes. In this Special Issue, we encourage submissions from clinicians, health experts, and researchers worldwide to share insights and novel approaches to epidemiology, diagnosis, and treatment advances in chronic kidney disease.

Dr. Diana Tania Luminița Moldovan
Prof. Dr. Flaviu Bob
Guest Editors

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Keywords

chronic kidney disease
CKD progression
hemodialysis
cardiovascular complications
vascular calcification
lifestyle
nutrition
bone and mineral disorders
CKD-associated osteoporosis
mortality

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Published Papers (5 papers)

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Research

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14 pages, 590 KB

Open AccessArticle

Revisiting the Sarcopenic Index in Older Adults with Reduced Kidney Function: Association with EWGSOP2-Defined Probable Sarcopenia

by Diana Moldovan, Ina Kacso, Cosmina Bondor, Lucreția Avram, Dana Crişan, Ariana Condor, Crina Rusu, Alina Potra, Dacian Tirinescu, Maria Ticala, Yuriy Maslyennikov and Valer Donca

J. Clin. Med. 2026, 15(5), 1782; https://doi.org/10.3390/jcm15051782 - 26 Feb 2026

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Abstract

Background: Sarcopenia is highly prevalent in older adults and in individuals with impaired kidney function, where it is associated with adverse clinical outcomes. A creatinine–cystatin C–based sarcopenic index has been proposed as a surrogate marker of muscle status; however, its association with sarcopenia as defined by the EWGSOP2 framework, particularly in the context of renal dysfunction, remains uncertain. Methods: Older adults were classified according to EWGSOP2 criteria into probable, confirmed, and severe sarcopenia. Associations between the sarcopenic index and sarcopenia phenotypes were examined using group comparisons and multivariable logistic regression analyses in the overall cohort and in a subgroup of participants with an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m². Results: The sarcopenic index was not independently associated with probable, confirmed, or severe sarcopenia. In contrast, age emerged as the strongest independent correlate of probable sarcopenia (OR 1.12; 95% CI 1.05–1.19, p = 0.001), while body mass index was independently associated with confirmed sarcopenia (OR 0.91; 95% CI 0.86–0.96, p < 0.001). Similar patterns were observed in participants with reduced kidney function. Conclusions: Within the present analytical framework, the sarcopenic index did not show a meaningful association with EWGSOP2-defined probable sarcopenia, the most uniformly assessable EWGSOP2 stage, in older adults, including those with reduced kidney function. Exploratory analyses of more advanced sarcopenia stages did not reveal additional associative information. These findings should be interpreted within a descriptive and associative framework rather than a formal assessment of diagnostic or clinical decision-making performance. Full article

(This article belongs to the Special Issue Chronic Kidney Disease: Current Challenges and Adverse Outcomes)

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11 pages, 349 KB

Open AccessArticle

Exploring the Link Between Inflammatory Bowel Disease and Chronic Kidney Disease: A Nationwide Database Study

by Chloe Lahoud, Ali Sohail, Toni Habib, Omar Abureesh, Chapman Wei, Suzanne El Sayegh and Liliane Deeb

J. Clin. Med. 2026, 15(3), 1157; https://doi.org/10.3390/jcm15031157 - 2 Feb 2026

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Abstract

Background/Objectives: Inflammatory bowel disease (IBD) has widely been associated with various extraintestinal complications, including kidney disease. The literature suggests that IBD patients are at increased risk of developing chronic kidney disease (CKD). This study aims to assess the relationship between IBD and CKD, and to identify risk factors associated with CKD in patients with IBD. Methods: Data for hospitalized patients with IBD was obtained from The National Inpatient Sample (NIS) database from 2016 to 2020. Baseline risk factors were identified using ICD-10 codes. Patients were stratified into two groups: Crohn’s Disease (CD) and Ulcerative Colitis (UC). Primary outcomes were prevalence and risk factors of CKD. Secondary outcomes were mortality and length of hospital stay (LOS). Univariate and multivariate analyses were conducted using SPSS v. 30. Results: We identified 230,766 patients with IBD: 144,847 (63%) had CD and 85,919 (37%) had UC. After 1:1 matching, 148,498 patients were included: 74,249 with CD and 74,249 with UC. In this study group, the prevalence of CKD in patients with CD and patients with UC was the same (7.2%). CD patients with CKD had lower in-hospital mortality rates and lower in-hospital length of stay compared to UC patients with CKD. Conclusions: While the prevalence of CKD is similar amongst CD and UC patients, the risk factors and outcomes such as mortality and length of hospitalization differ significantly. This study emphasizes the need for tailored approaches and closer monitoring for the risk of developing CKD in IBD patients and especially patients with UC. Full article

(This article belongs to the Special Issue Chronic Kidney Disease: Current Challenges and Adverse Outcomes)

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14 pages, 261 KB

Open AccessArticle

Reducing Polypharmacy-Related Adverse Outcomes in Older Adults with Chronic Kidney Disease: A Retrospective Cohort Study of a Digitally Mediated Pharmacist Intervention

by Keren Dopelt, Ori Mayer, Adir Dagan, Guy Melamed, Aviva Ben-Baruch, Inbal Yifrach-Damari and Tamar Ritte

J. Clin. Med. 2026, 15(3), 1128; https://doi.org/10.3390/jcm15031128 - 1 Feb 2026

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Abstract

Background/Objectives: Older adults with chronic kidney disease (CKD) are particularly vulnerable to polypharmacy-related adverse outcomes due to altered pharmacokinetics, multimorbidity, and increased susceptibility to medication-related harm. Polypharmacy in CKD is associated with falls, hospitalizations, and functional decline. Clinical pharmacist-led medication reviews may mitigate these risks; however, access barriers limit their implementation in routine care. To evaluate the clinical impact of a digitally mediated pharmacist consultation service on medication burden, fall risk, healthcare utilization, and resource use among older adults with CKD and polypharmacy. Methods: We conducted a retrospective cohort study using anonymized electronic medical records from a large integrated healthcare organization. Adults aged ≥ 65 years with CKD and polypharmacy (≥8 chronic medications) were included. Patients receiving a structured digital medication review by a clinical pharmacist, delivered via the primary care physician, were compared with a comparable control group of eligible patients who did not receive the intervention during the study period. Outcomes included changes in medication use, fall risk, renal function, and healthcare utilization. Results: Among 6124 eligible patients (1226 intervention; 4898 control), pharmacist consultation was associated with a modest but clinically meaningful reduction in medication burden and a higher likelihood of fall-risk reduction compared with controls. Decreases in outpatient healthcare utilization were also observed following the intervention. Renal function decline was similar between groups. Conclusions: A digitally mediated, physician-integrated pharmacist consultation may reduce polypharmacy-related risks and adverse outcomes in older adults with CKD. This model offers a scalable approach to improving medication safety in a high-risk CKD population while minimizing reliance on patient digital engagement. Full article

(This article belongs to the Special Issue Chronic Kidney Disease: Current Challenges and Adverse Outcomes)

12 pages, 384 KB

Open AccessArticle

Dental Caries and Erosion in Children with Nephrotic Syndrome on Long-Term Liquid Medications—A Cross-Sectional Observational Study

by Adel N. Radwan, Osama M. Felemban, Jameela A. Kari, Sherif M. El Desoky, Khlood Baghlaf and Heba Mohamed Elkhodhary

J. Clin. Med. 2025, 14(24), 8669; https://doi.org/10.3390/jcm14248669 - 7 Dec 2025

Viewed by 498

Abstract

Objectives: This study aimed to evaluate the experience and consequences of dental caries and erosion in children aged 1–14 years on long-term liquid medications compared to those not on these medications. Methods: A cross-sectional observational study was conducted using a WHO-adapted questionnaire, medical surveys, and oral examinations. Participants included children with nephrotic syndrome in two groups: those on long-term liquid medications for at least three months (study group) and those not taking liquid medications (control group). The Decayed, Missing, and Filled Surfaces index (dmfs/DMFS) assessed caries, while the Pulpal Involvement, Ulceration, Fistula, and Abscess index (PUFA/pufa) measured caries consequences. The Basic Erosive Wear Examination index (BEWE) assessed erosion. Results: A total of 64 participants were included, with 33 in the study group and 31 in the control group. The study group had a significantly higher mean dmfs/DMFS of 16.9 ± 12.6 versus 5.2 ± 4.0 in the control group (p < 0.001). The PUFA/pufa index was also higher in the study group (0.8) compared to the control group (0.1) (p = 0.009). Erosion showed a non-significant increase with a BEWE score of 0.2 vs. 0.03 in the control group (p = 0.053). Conclusions: Long-term liquid medication use significantly affects dental caries in children after three months. Full article

(This article belongs to the Special Issue Chronic Kidney Disease: Current Challenges and Adverse Outcomes)

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Review

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22 pages, 1159 KB

Open AccessReview

IgA Nephropathy: Epidemiology, Outcomes, and Insights for Primary Glomerulonephritides

by Zuzanna Jakubowska, Filip Wantoch-Rekowski, Jacek S. Małyszko and Jolanta Małyszko

J. Clin. Med. 2026, 15(5), 2046; https://doi.org/10.3390/jcm15052046 - 7 Mar 2026

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Abstract

According to the Global Burden of Disease 2019 analysis, there were 606,300 new cases of chronic kidney disease due to glomerulonephritis worldwide, with 17.3 million prevalent cases and 183,700 deaths More interestingly, between 1990 and 2019, the global burden of glomerulonephritis increased by 77% in incidence and 81% in prevalence, mainly due to demographic aging and population growth. Among primary glomerulopathies, IgA Nephropathy (IgAN), also known as Berger’s disease, is the most common primary glomerulopathy worldwide, with significant geographic and ethnic variation in incidence, with the highest prevalence in Europe and Asia and the lowest in Africa. Its pathogenesis reflects a complex interaction between polygenic susceptibility and environmental modifiers, mucosal immune activation, infections of the upper respiratory and gastrointestinal tracts, dietary factors, and alterations in the gut microbiome. In addition, IgAN increasingly coexists with other chronic diseases, such as hypertension and diabetes, which complicates both diagnosis and treatment in aging societies. All these observations suggest that in the coming years, the epidemiology of IgAN will gradually transform from a description of “case counts” to a predictive tool that integrates genetic, environmental, and molecular biomarker data. In this sense, epidemiology is increasingly becoming the foundation of precision nephrology—allowing not only for disease risk prediction but also for the design of effective therapeutic strategies. The conceptual shift in IgAN—from a disease defined by biopsy prevalence to one understood through integrative epidemiology—illustrates the broader transition of GN research toward biomarker-based risk stratification and precision medicine. This review focuses on IgA nephropathy as the most prevalent primary glomerulonephritis and uses it as a reference disease to illustrate broader epidemiological patterns, outcome trajectories, and methodological limitations relevant to primary glomerulonephritides. Full article

(This article belongs to the Special Issue Chronic Kidney Disease: Current Challenges and Adverse Outcomes)

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