Chronic renal failure risk factors

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aarti Narayan, M.B.B.S [2]

Overview

It is important to identify patients at risk for developing chronic renal disease, even in patients with a normal serum creatinine levels. Chronic renal failure, requiring dialysis or organ transplant, can often be prevented with early detection and treatment.

Risk factors

The kidneys are able to recover from many insults without necessary progression to CKD and end-stage renal disease (ESRD).
Several factors have been shown to increase the risk of progression.
The most studied model of progression to CKD is diabetic nephropathy (DN).
Studies have linked the risk of progression to CKD in DN to the following risk factors:
- Hypertension
- Poorly controlled diabetes
- High urinary protein excretion (proteinuria/albuminuria).^[1]^[2]^[3]^[4]
Other risk factors:
- Chronic NSAID use^[5]
- Cigarette smoking in diabetic patients.^[6]
- Pre-existing cardiovascular disease including:
  - Stroke
  - Angina
  - Claudication
  - Transient ischemic attack
  - Coronary angioplasty or bypass
  - Recognized or silent myocardial infarction^[7]

References

↑ Leehey DJ, Kramer HJ, Daoud TM, Chatha MP, Isreb MA (2005). “Progression of kidney disease in type 2 diabetes – beyond blood pressure control: an observational study”. BMC Nephrol. 6: 8. doi:10.1186/1471-2369-6-8. PMC 1180831. PMID 15985177.
↑ Staples A, Wong C (2010). “Risk factors for progression of chronic kidney disease”. Curr Opin Pediatr. 22 (2): 161–9. doi:10.1097/MOP.0b013e328336ebb0. PMC 2948868. PMID 20090523.CS1 maint: PMC format (link)
↑ Breyer JA, Bain RP, Evans JK, Nahman NS, Lewis EJ, Cooper M; et al. (1996). “Predictors of the progression of renal insufficiency in patients with insulin-dependent diabetes and overt diabetic nephropathy. The Collaborative Study Group”. Kidney Int. 50 (5): 1651–8. PMID 8914032.
↑ Hovind P, Rossing P, Tarnow L, Smidt UM, Parving HH (2001). “Progression of diabetic nephropathy”. Kidney Int. 59 (2): 702–9. doi:10.1046/j.1523-1755.2001.059002702.x. PMID 11168952.
↑ Murray MD, Black PK, Kuzmik DD, Haag KM, Manatunga AK, Mullin MA; et al. (1995). “Acute and chronic effects of nonsteroidal antiinflammatory drugs on glomerular filtration rate in elderly patients”. Am J Med Sci. 310 (5): 188–97. PMID 7485222.
↑ Orth SR, Schroeder T, Ritz E, Ferrari P (2005). “Effects of smoking on renal function in patients with type 1 and type 2 diabetes mellitus”. Nephrol Dial Transplant. 20 (11): 2414–9. doi:10.1093/ndt/gfi022. PMID 16046507.
↑ Elsayed EF, Tighiouart H, Griffith J, Kurth T, Levey AS, Salem D; et al. (2007). “Cardiovascular disease and subsequent kidney disease”. Arch Intern Med. 167 (11): 1130–6. doi:10.1001/archinte.167.11.1130. PMID 17563020.

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[pmid15985177-1] Leehey DJ, Kramer HJ, Daoud TM, Chatha MP, Isreb MA (2005). “Progression of kidney disease in type 2 diabetes – beyond blood pressure control: an observational study”. BMC Nephrol. 6: 8. doi:10.1186/1471-2369-6-8. PMC 1180831. PMID 15985177.

[pmid20090523-2] Staples A, Wong C (2010). “Risk factors for progression of chronic kidney disease”. Curr Opin Pediatr. 22 (2): 161–9. doi:10.1097/MOP.0b013e328336ebb0. PMC 2948868. PMID 20090523.CS1 maint: PMC format (link)

[pmid8914032-3] Breyer JA, Bain RP, Evans JK, Nahman NS, Lewis EJ, Cooper M; et al. (1996). “Predictors of the progression of renal insufficiency in patients with insulin-dependent diabetes and overt diabetic nephropathy. The Collaborative Study Group”. Kidney Int. 50 (5): 1651–8. PMID 8914032.

[pmid11168952-4] Hovind P, Rossing P, Tarnow L, Smidt UM, Parving HH (2001). “Progression of diabetic nephropathy”. Kidney Int. 59 (2): 702–9. doi:10.1046/j.1523-1755.2001.059002702.x. PMID 11168952.

[pmid7485222-5] Murray MD, Black PK, Kuzmik DD, Haag KM, Manatunga AK, Mullin MA; et al. (1995). “Acute and chronic effects of nonsteroidal antiinflammatory drugs on glomerular filtration rate in elderly patients”. Am J Med Sci. 310 (5): 188–97. PMID 7485222.

[pmid16046507-6] Orth SR, Schroeder T, Ritz E, Ferrari P (2005). “Effects of smoking on renal function in patients with type 1 and type 2 diabetes mellitus”. Nephrol Dial Transplant. 20 (11): 2414–9. doi:10.1093/ndt/gfi022. PMID 16046507.

[pmid17563020-7] Elsayed EF, Tighiouart H, Griffith J, Kurth T, Levey AS, Salem D; et al. (2007). “Cardiovascular disease and subsequent kidney disease”. Arch Intern Med. 167 (11): 1130–6. doi:10.1001/archinte.167.11.1130. PMID 17563020.

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