Circulating Proteins for Prediction of Kidney Disease Progression and Cardiovascular Outcomes: Individual Participant Data Meta-Analysis of Four Cohorts.

Introduction: KIM-1, TNFRSF1A, and TNFRSF1B have been accepted as early risk markers in diabetic kidney disease by the US Food and Drug Administration. Whether they may be useful in identifying high-risk patients for cardiovascular/kidney clinical trial enrollment in other important subgroups is uncertain.

Methods: We evaluated the potential prognostic enrichment of KIM-1, TNFRSF1A, and TNFRSF1B in four cohorts: the Atherosclerosis Risk in Communities (ARIC) (N = 4,594, mean age 76 years, 55% women, mean eGFR 68 mL/min/1.

Associations of Proteinuria Trajectories with Kidney Failure and Death in Individuals with CKD.

Background: Despite repeating proteinuria measurements multiple times during the clinical course of a patient with CKD, clinicians may overlook the significance of temporal patterns of proteinuria. In addition, it is unclear whether proteinuria trajectories identify sub-populations with varying risks of adverse clinical outcomes.

Methods: We used group-based trajectory modeling to identify proteinuria trajectories based on annual urine protein-to-creatinine ratio (UPCR) measurements in 3209 participants of the Chronic Renal Insufficiency Cohort Study who were alive and did not reach end-stage kidney disease (ESKD) within 3 years of study entry.

Urine Biomarkers for Diabetic Kidney Disease Progression in Participants of the Chronic Renal Insufficiency Cohort Study.

Key Points: Higher urine levels of kidney injury molecule-1 and monocyte chemoattractant protein-1 were associated with higher risk of CKD progression. Higher urine levels of EGF were associated with lower risk of CKD progression. Urine kidney injury molecule-1, monocyte chemoattractant protein-1, and EGF may noninvasively assess tubule and interstitial health in diabetes and identify those at higher risk of CKD progression.

Time-Updated Estimated GFR Variability Is Associated With Mortality, Cardiovascular Disease, and End-Stage Kidney Disease in Patients With CKD: Findings From the CRIC Study.

Rationale & Objective: Previous reports have identified increased estimated glomerular filtration rate (eGFR) variability, measured during a single ascertainment window, as a risk factor for cardiovascular disease and all-cause mortality. We hypothesized that repeated measures of eGFR variability that are time-updated would exhibit stronger associations with common chronic kidney disease outcomes compared with eGFR variability derived from a single ascertainment window.

Study Design: Retrospective cohort study.

Validation of the Beck Depression Inventory in US Hispanic Patients with CKD.

Key Points: The Beck Depression Inventory is a valid instrument to screen for depressive symptoms in Hispanic adults with CKD. Using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Disorders as the gold standard, a Beck Depression Inventory of ≥16 was found to be the optimal screening cutoff in Hispanic adults with nondialysis CKD or ESKD.

Background: Depression is common in patients with CKD.

Neighborhood Socioeconomic Status and Cardiovascular Events in Adults With CKD: The CRIC Study.

Rationale & Objective: In the general population, neighborhood socioeconomic status (SES) has been found to be associated with cardiovascular risk, but this relationship has not been well studied among patients with chronic kidney disease (CKD). This study seeked to evaluate the association between neighborhood SES and cardiovascular outcomes in a CKD cohort.

Study Design: Multicenter prospective cohort.

Matrix Metalloproteinase-2 and CKD Progression: The Chronic Renal Insufficiency Cohort (CRIC) Study.

Rationale & Objective: Matrix metalloproteinase 2 (MMP-2) plays an important role in the development of fibrosis, the final common pathway of chronic kidney disease (CKD). This study aimed to assess the relationship between repeated measures of MMP-2 and CKD progression in a large, diverse prospective cohort.

Study Design: In a prospective cohort of Chronic Renal Insufficiency Cohort (CRIC) participants (N = 3,827), MMP-2 was measured at baseline.

Chronic Kidney Disease Stage and Cardiovascular and Mortality Events Among Older Adults: The SPRINT Trial.

Rationale & Objective: The risk implications of the Kidney Disease: Improving Global Outcomes (KDIGO) chronic kidney disease classification in older adults are controversial. We evaluated the risk of adverse outcomes in this population across categories of estimated glomerular filtration rate (eGFR) and urinary albumin-creatinine ratio (UACR).

Study Design: Prospective cohort.

Depressive Symptoms, Antidepressants, and Clinical Outcomes in Chronic Kidney Disease: Findings from the CRIC Study.

Rationale & Objective: The extent to which depression affects the progression of chronic kidney disease (CKD) and leads to adverse clinical outcomes remains inadequately understood. We examined the association of depressive symptoms (DS) and antidepressant medication use on clinical outcomes in 4,839 adults with nondialysis CKD.

Study Design: Observational cohort study.

Prevalence of infertility and pregnancy loss among individuals with kidney disease in the Hispanic Community Health Study/Study of Latinos.

Background: Hispanic/Latino individuals are less likely to receive optimal treatment for chronic kidney disease than non-Hispanic whites. This may be particularly detrimental for women of reproductive age as chronic kidney disease increases risk for infertility, menstrual irregularities, and pregnancy loss. While these maternal outcomes have been associated with advanced chronic kidney disease, their occurrence in early chronic kidney disease is unclear.

Adherence to Plant-Based Diets and Risk of CKD Progression and All-Cause Mortality: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study.

Rationale & Objective: Studies have shown that generally healthy individuals who consume diets rich in plant foods have a lower risk of incident chronic kidney disease (CKD) and cardiovascular disease. This study investigated the prospective associations of plant-based diets with the risk of CKD progression and all-cause mortality in individuals with CKD.

Study Design: Prospective cohort study.

Frailty and Cardiovascular Outcomes in Adults With CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study.

Rationale & Objective: Frailty is common in individuals with chronic kidney disease (CKD) and increases the risk of adverse outcomes in adults with kidney failure requiring dialysis. However, this relationship has not been thoroughly evaluated among those with non-dialysis-dependent CKD.

Study Design: Prospective cohort study.

Ideal Cardiovascular Health in Mexican Adults with CKD Living in Mexico City Versus Chicago.

Evidence suggests that Mexican adults living in Mexico have a more favorable cardiovascular risk profile than Mexican adults living in the U.S. However, this relationship has not been evaluated among patients with chronic kidney disease (CKD), which is a question of importance given the high risk for cardiovascular disease among patients with CKD.

Risk for Chronic Kidney Disease Progression After Acute Kidney Injury: Findings From the Chronic Renal Insufficiency Cohort Study.

Background: Prior studies associating acute kidney injury (AKI) with more rapid subsequent loss of kidney function had methodological limitations, including inadequate control for differences between patients who had AKI and those who did not.

Objective: To determine whether AKI is independently associated with subsequent kidney function trajectory among patients with chronic kidney disease (CKD).

Design: Multicenter prospective cohort study.

Trends and perspectives for improving quality of chronic kidney disease care: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference.

Chronic kidney disease (CKD) affects over 850 million people globally, and the need to prevent its development and progression is urgent. During the past decade, new perspectives have arisen related to the quality and precision of care for CKD, owing to the development of new tools and interventions for CKD diagnosis and management. New biomarkers, imaging methods, artificial intelligence techniques, and approaches to organizing and delivering healthcare may help clinicians recognize CKD, determine its etiology, assess the dominant mechanisms at given time points, and identify patients at high risk for progression or related events.

The Kidney Failure Risk Equation: Evaluation of Novel Input Variables including eGFR Estimated Using the CKD-EPI 2021 Equation in 59 Cohorts.

Significance Statement: The kidney failure risk equation (KFRE) uses age, sex, GFR, and urine albumin-to-creatinine ratio (ACR) to predict 2- and 5-year risk of kidney failure in populations with eGFR <60 ml/min per 1.73 m 2 . However, the CKD-EPI 2021 creatinine equation for eGFR is now recommended for use but has not been fully tested in the context of KFRE.

Association between Depressive Symptom Trajectory and Chronic Kidney Disease Progression: Findings from the Chronic Renal Insufficiency Cohort Study.

Key Points: Depressive symptoms are largely stable over time among individuals with mild-to-moderate CKD. Low educational attainment, cigarette smoking, and poor quality of life are associated with persistent depressive symptoms. Persistent depressive symptoms are associated with nonlinear and rapid decline in kidney function.

Sleep, cardiovascular risk factors, and kidney function: The Multi-Ethnic Study of Atherosclerosis (MESA).

Objectives: Examine the associations of sleep measures with kidney function changes over time among individuals from a community-based study.

Methods: The sample includes 1657 participants (287 with chronic kidney disease [CKD]) in the Multi-Ethnic Study of Atherosclerosis Sleep Cohort (mean age: 57.7 years, male: 46.

Absence of long-term changes in urine biomarkers after AKI: findings from the CRIC study.

Background: Mechanisms by which AKI leads to CKD progression remain unclear. Several urine biomarkers have been identified as independent predictors of progressive CKD. It is unknown whether AKI may result in long-term changes in these urine biomarkers, which may mediate the effect of AKI on CKD progression.