The Long Lead-Up to Chronic Kidney Disease

Kidney disease risk factors appeared three decades before it was diagnosed

(RxWiki News) Serious illness does not always strike suddenly. Sometimes, it comes at the end of long road marked by other health problems. Kidney disease often is preceded by other avoidable health problems.

In a recent study, obesity, high blood pressure, diabetes and a bloodstream overloaded with heart-damaging fats were risk factors that appeared as many as 30 years before chronic kidney disease was diagnosed.

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Caroline Fox, MD, MPH, of the National Heart, Lung and Blood Institute's Framingham Heart Study and Harvard Medical School, was this study’s lead author. The Framingham study began in 1948 with 5,209 participants, aged 30 through 62 and residing Framingham, MA. Their children and grandchildren have since been added to this long-term study of health conditions that affect the cardiovascular system.

Dr. Fox and her team of investigators compared the health of 441 participants in the Framingham study who developed chronic kidney disease and the health of 882 Framingham study participants who did not develop chronic kidney disease. Women represented roughly half of all the study participants. On average, study participants were 69 years old. All study participants were white.

Compared to those who did not develop chronic kidney disease, study participants diagnosed with chronic kidney disease were 76 percent more likely to have had high blood pressure three decades before the kidney disease diagnosis, the researchers found.

Also, those who developed chronic kidney disease were 71 percent more likely to be obese than those who did not develop kidney disease. Those with kidney disease also were 43 percent more likely to have had high levels of triglycerides, harmful fats in the bloodstream.

Twenty years before being diagnosed with chronic kidney disease, those patients were 38 percent more likely to have had high blood pressure than those who did not develop chronic kidney disease. Twenty years prior to being diagnosed, those with kidney disease also were 35 percent more likely to have had higher triglyceride levels and three times more likely to have had diabetes than those never diagnosed with kidney disease.

Roughly 10 years before diagnosis, those with kidney disease were 66 percent more likely to have diabetes than those who did not have a kidney disease diagnosis.

"This research shows that these risk factors are present long before the disease is diagnosed. This is important because it suggests that we should be addressing these risk factors earlier in life to potentially prevent future disease," Dr. McMahon said in a press statement.

The more a person had longstanding risk factors for chronic kidney disease, the more likely they were to develop the disease, the researchers wrote.

Symptoms of chronic kidney disease include frequent urination, exhaustion, lack of energy, sleeplessness, ankle and foot swelling, dry and itchy skin, eye puffiness and loss of appetite. In its early stages, there often are no obvious symptoms of chronic kidney disease.

While diabetes, overweight and hypertension are the main risk factors for chronic kidney disease, they are not the only risk factors. Such autoimmune disorders as lupus, a history of too-frequent urination and certain genetic diseases may also lead to chronic kidney disease.

Roughly 26 million people in the United States and 60 million worldwide have been diagnosed with chronic kidney disease.

This study was published online June 26 in the Journal of the American Society of Nephrology.

These researchers had access to the National Heart, Lung and Blood Institute's Framingham Heart Study.

The study's four-person research team reported that it had no financial investments or involvements that might shape study design, outcomes or analysis.

Review Date: 
June 25, 2014