Investigating the prevalence of traditional and novel chronic kidney disease risk factors in a mixed-aged, non-clinical population

Mullan, Kyle (2016) Investigating the prevalence of traditional and novel chronic kidney disease risk factors in a mixed-aged, non-clinical population. MRes thesis, University of Lincoln.

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Abstract

Chronic kidney disease (CKD) is a common disorder that currently serves as a major global public health issue due to raised risk of cardiovascular disease (CVD), kidney failure, and other complications. With the ever-growing increase of ageing populations and rising global frequency of diabetes and other chronic non-transmissible diseases, present clinical data suggests a corresponding worldwide increase in prevalence of chronic kidney disease and end-stage renal failure (ESRF).
The overall aims of this thesis was to study the prevalence of known traditional and novel CKD related risk factors in a non-clinical population, examine the applicability of several predictive equations in the estimation of GFR for the stratification of CKD, Investigate the relationships between key risk factors amongst different subgroups of the total study population, and Provide evidence in the need for further healthcare screening strategies to help identify early onset CKD.
This project carried out quantitative and qualitative assays to investigate the Incidence of chronic kidney disease risk factors in a non-clinical, mixed-age university population and establish the risk of development of CVD, CKD and type 2 diabetes. Baseline information was reported on a questionnaire and blood serum samples were analysed for biochemical components including blood glucose, cholesterol, triglycerides, creatinine, fructosamine and high sensitive C-reactive protein. Renal status was measured using the Kidney Disease: Improving Global Outcomes (KDIGO) classification. 186 individuals (64% females) were recruited and separated into two age groups (under and over 30 years).
Overall, 39% of participants showed a BMI above 25 with 13% indicating levels above 30. Kidney function data revealed 21% of participants with an estimated glomerular filtration rate below 90ml/min/1.73m2. Preliminary data suggests a significant difference in diastolic blood pressure, body fat percentage and renal function between the two age groups. Regarding biomarkers of CKD, the dominant finding was a strong relationship between the markers of glycaemic control and a reduced eGFR. Likewise, this relationship was also visible in the lipid markers of the study population.
In summary, the findings from this study in combination with previous reports suggest that traditional biochemical risk markers such as those for diabetes and obesity may share an increased relationship with a reduced kidney function. While we did not see a direct correlation between the non-traditional marker, hsCRP, it was possible that this was a consequence of insufficient population numbers.
Investigation of renal equations provided evidence of a greater accuracy in the measurement of estimated kidney function using the newer equation system, CKD-EPI, in comparison to clinically regarded formulas such as Cockcroft-Gault and MDRD.
When evaluated on an additive scale, the modification of these variables by the presence of other risk factors has important clinical and public health implications with respect to CKD case findings and mass screening strategies

Keywords:Epidemiology, Chronic kidney disease
Subjects:L Social studies > L510 Health & Welfare
Divisions:College of Science > School of Life Sciences
ID Code:28675
Deposited On:05 Sep 2017 11:54

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