Chronic Kidney Disease a Recipe for Kidney Failure? Not Necessarily

Not all cases are unstoppable, and some can get betterHighlights• Chronic kidney disease doesn’t always lead to kidney failure, and in some cases, kidney function can improve.• In this study, 10% of patients did not experience progressive kidney dysfunction, and 3% demonstrated clearly improved kidney function.• 60 million people globally have chronic kidney disease.

Newswise — Washington, DC (March 8, 2012) — Not all patients with chronic kidney disease (CKD) are destined for kidney failure, according to a study appearing in an upcoming issue of the Journal of the American Society Nephrology (JASN). The findings provide hope that the kidney health of some CKD patients can improve.

Approximately 60 million people globally have chronic kidney disease, which is often assumed to be an unstoppable and progressive condition that leads to kidney failure and the need for long-term dialysis or a kidney transplant. At present, there is no convincing evidence that kidney function can actually improve in patients with CKD.

To see if kidney function can indeed improve in some patients with CKD, Bo Hu, PhD (Cleveland Clinic), Astor Brad, PhD (University of Wisconsin-Madison), and their colleagues evaluated the kidney health of African Americans with CKD over an average of 11 years. “The unique design of the study, with repeated measurements of kidney function, allowed us to investigate this with more rigor than has been possible in other studies,” said Dr. Hu.

Of 949 CKD patients in the study who had at least three follow-up measurements of kidney function, 94 (10%) did not develop progressive kidney dysfunction, and 31 (3%) demonstrated clearly improved kidney function. Patients with low blood pressure were most likely to experience improved kidney function.

“This analysis of long-term follow-up of patients with CKD provides strong evidence for the first time that some patients with CKD improve over an extended period of time,” said Dr. Hu.

Study co-authors include Crystal Gadegbeku, MD (University of Michigan, Ann Arbor); Michael Lipkowitz, MD (Georgetown University School of Medicine); Stephen Rostand, MD (University of Alabama, Birmingham); Julia Lewis, MD (Vanderbilt University); Jackson Wright, MD (Case Western Reserve University); Lawrence Appel, MD, Brad C. Astor, PhD (University of Wisconsin School of Medicine and Public Health); Tom Greene, PhD (University of Utah, Salt Lake City); and Jennifer Gassman (Cleveland Clinic); for theAfrican American Study of Kidney Disease and Hypertension Group.

Disclosures: • Julia Lewis: Ownership interest: Lilly, Nephrogenix, Pharmanet; Research funding: Keryx, Lilly, Pharmanet, Astra Zeneca; Honoraria: Amira, Astra Zeneca; Patents and Inventions: Duke University. • Lawrence J. Appel: Honoraria: Unilever, Culinary Institute of America, American Heart Association; Scientific Advisor or Membership: American Heart Association. • Jackson T. Wright: Consultancy Agreements: Take Care Health and CVRx; Honoraria: Noven Pharmaceuticals and NiCox Pharmaceuticals; Scientific Advisor or Membership: NHLBI JNC-8 Panel, Board of Directors for Northeast Ohio Neighborhood Health and Assoc of Black Cardiologists, Editorial Board for Journal of Hypertension • Tom H. Greene: Consultancy Agreements: Amgen Cormedix Nephrogenex Lilly Keryx; Honoraria: Amgen Cormedix Nephrogenex Lilly Keryx.

The article, entitled “Kidney Function Can Improve in Patients with Hypertensive CKD,” will appear online at http://jasn.asnjournals.org/ on March 8, 2012, doi: 10.1681/ASN.2011050456.

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Founded in 1966, and with more than 13,500 members, the American Society of Nephrology (ASN) leads the fight against kidney disease by educating health professionals, sharing new knowledge, advancing research, and advocating the highest quality care for patients.

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