Obesity, Diabetes and Chronic Kidney Disease: Insights into an Evolving Epidemic

Abstract

Chronic Kidney Disease or CKD is defined as a persistent reduction in renal function over 3 months period along with biochemical or structural abnormalities or an absolute estimated glomerular filtration (eGFR) rate < 60 ml/min/1.73 m2 over 3 months with or without abnormalities. In practice, precise knowledge of the GFR is not required and CKD can be adequately monitored by eGFR using estimating equations. CKD is an important confounder in the outcomes of several diseases, particularly Diabetes Mellitus (DM), Cardiovascular Diseases (CVD) and Obesity. There is paucity of data using CKD as a primary outcome variable in randomized clinical trials, as a result most guidelines in this area are based on secondary analysis, observational studies or have inadequate sample sizes. The prevalence of CKD is important not only at an individual level to guide clinicians for proper management of their other illnesses but also at a population level for the purposes of all-inclusiveness in the design of clinical trials. The inclusion of individuals with CKD in emerging studies will allow us to address whether or not CKD plays a vital confounding role on many disease outcomes.

In order to get a good grasp on the epidemiology of CKD, an epidemiology collaborative equation called CKD-EPI equation is most widely utilized. This equation has its strength in being validated in several populations and estimates glomerular filtration rate (GFR) based on several demographic factors and serum creatinine. The National Health and Nutrition Examination Survey (NHANES) conducted by the National Center for Health Statistics (NCHS) collects health data on noninstitutionalized individuals in the United States via interviews, laboratory tests and examinations [1] has given us the needed information on the Epidemiology of CKD in the US. These surveys utilize CKD-EPI equation to quantify the statistical data on CKD trends.

Keywords: Chronic Kidney Disease, Diabetes, Epidemiology, Obesity.

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