A study published in Cardiovascular Diabetology suggests that cardiovascular mortality increases in patients with advanced chronic kidney disease, both in the presence and absence of diabetes, and in those with prior cardiovascular disease.
We conducted a Danish registry-based retrospective cohort study identifying persons aged ≥ 18 years with an eGFR < 30 mL/min/1.73mfrom 1 January 2002 until 31 December 2018. The assessment of eGFR was based on recorded plasma creatinine using the CKD-EPI creatinine equation []. People with prior renal transplantation or immigrating < 5 years prior to study inclusion were excluded.
Unadjusted cumulative risk of cardiovascular, non-cardiovascular, and all-cause mortality was computed based on the Aalen-Johansen estimator. Multiple Cox regressions stratified for matching variables and adjusted for cardiovascular disease were performed to calculate the hazard ratios for cardiovascular, non-cardiovascular, and all-cause mortality, respectively.
To further investigate risk factors of cardiovascular mortality, we calculated the standardized 1-year risk of cardiovascular mortality in models adjusted for age, sex, cardiovascular disease, and CKD stage stratified by baseline albuminuria status, plasma LDL-cholesterol level and plasma hemoglobin level, respectively.
All data management and analyses were performed in SAS and R ). A P-value below 0.05 was considered statistically significant, and all statistical tests were two-tailed.To assess for possible period effect, the main results were re-analyzed stratified according to index year . Regarding possible risk of misclassification of acute kidney injury as CKD, the main results were re-analyzed in sensitivity analyses including only patients with two measured eGFR < 30 mL/min/1.
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The impact of a vegetarian diet on chronic kidney disease (CKD) progression – a systematic review - BMC NephrologyBackground A vegetarian diet is a popular alternative to the casual diet - it is considered healthy, and was proven to positively affect cardiovascular health. The Chronic Kidney Disease (CKD) progression is a major issue in the healthcare system, and constitutes a leading cause of death for 1.5% of the global population. The objective of this systematic review was to investigate the potential impact of a vegetarian diet on kidney function in CKD patients. Method Our systematic review focused on randomized controlled trials (RCTs) which compared the effects of a vegetarian diet (experimental) and a standard omnivore diet (comparator) in terms of the estimated glomerular filtration rate (eGFR) in CKD patients. Inclusion criteria were based on PICO elements, with two researchers involved in browsing the Cochrane and Pubmed search engines. The investigation was performed using the PRISMA 2020 Checklist and PRISMA 2020 flow diagram. The search terms included: ‘vegetarian diet’ AND ‘nephropathy’, ‘eGFR’, ‘albuminuria’, ‘chronic kidney disease’. Bias assessment was performed using RoB 2 tool to determine the validity of the data collected from studies. Results Four RCTs with a total of 346 participants were included in the presented systematic review. Two largest RCTs reported an increase in eGFR following a change to a vegetarian diet (p = 0.01 and p = 0.001). Another two found no significant differences between the experimental and control groups, also these trials were associated with a high risk of bias in terms of missing data outcome and the randomization process. Conclusions The findings collected in this systematic review suggest that a vegetarian diet improves renal filtration function in CKD patients. Therefore, it seems essential to conduct further research involving the impact of the diet on the progression of CKD.
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Even a modest reduction in kidney function increases health risks in young adults, finds studyA study of more than 8 million adults in Ontario, Canada suggests that even a modest loss of kidney function is associated with increased health risks. The study, published in The BMJ, could lead to better approaches to prevent chronic kidney disease and related conditions, particularly in younger adults.
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