Kidney Disease: Three Studies At-a-Glance

The aim of this large meta-analysis was to determine whether the purported relationship between CKD and stroke risk remained independent after controlling for traditional risk factors such as blood pressure (BP). Researchers found that while CKD patients had a 36% increased risk of stroke vs patients without CKD, BP control or burden is a potentially important confounder of the association between CKD and stroke risk. They noted more comprehensive studies are needed to explore these relationships further.

Does CKD Predict Stroke Risk Independent of BP? CKD is strongly associated with stroke and low glomerular filtration rate (GFR) appears to be a risk factor independent of cardiovascular (CV) risk factors in epidemiological studies, but there has been no systematic assessment of the impact of more complete adjustment for BP on the association between CKD and stroke. Researchers aimed to determine if this relationship remains independent after adjusting for traditional risk factors. They conducted a systematic review of cohort studies and RCTs that reported stroke incidence in adults according to baseline eGFR. 

In this database analysis, researchers found that patients with end-stage renal disease (ESRD) are at a 3-fold increased risk of syphilis vs the general population. “We would suggest that neurosyphilis should be considered in the differential diagnosis of confusion in dialysis patients with appropriate risk factors, and that screening for syphilis in this cohort is indicated,” Weathers and co-authors stated in the study. 

Syphilis in the US ESRD Population. Untreated syphilis and neurosyphilis have serious negative clinical consequences. ESRD patients may be at high risk for syphilis because of a higher incidence of risk factors (eg, HIV) vs the general population. Despite these risk factors, the incidence of syphilis in the ESRD population has not been reported, so researchers conducted the first study to investigate syphilis incidence and risk factors using the USRDS. They analyzed incident ESRD patients and determined incidence and risk factors for syphilis based on ICD-9 codes. Linear modeling was used to quantify RR of disease when controlling for demographics and other clinical risk factors. 

In this systematic review, a healthy dietary pattern was linked to a 30% reduction in incidence of CKD, and a 23% reduction in incidence of albuminuria. These results add evidence that diets rich in vegetables, fruits, fish, nuts, legumes, and whole grains may have benefits that include reduced risk of chronic diseases. According to researchers, however, RCTs are now needed to confirm whether or not adherence to a healthy diet reduces the burden of CKD.

Can a Healthy Diet Reduce Incidence of CKD? Diet is a key modifiable risk factor in CKD progression, however, whether a healthy diet protects against CKD incidence is unknown. Researchers of this systematic review and meta-analysis aimed to evaluate the link between a healthy diet and CKD incidence. Cohort studies of people without CKD that also reported the primary outcome were included; primary exposure was dietary patterns. Evidence was assessed using GRADE and the Newcastle-Ottawa scale.