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Kidney Week

Abstract: PUB373

CKD of Unknown Cause: Call Me by My Name Initiative

Session Information

Category: CKD (Non-Dialysis)

  • 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Bohlke, Maristela, Universidade Catolica de Pelotas, Pelotas, RS, Brazil
  • Barcellos, Arthur Böhlke, PUC-RS, Porto Alegre, Brazil
  • Mendez Poma, Samy Ailey, Universidade Catolica de Pelotas, Pelotas, RS, Brazil
  • Dutra Leite Nunes, Gustavo, Universidade Catolica de Pelotas, Pelotas, RS, Brazil
  • Kohn, Eduardo Ribes, Univerzita Palackeho v Olomouci, Olomouc, Olomouc Region, Czechia
Background

Hypertension has been reported as the leading cause of chronic kidney failure (CKF) in Brazil. The USRDS reports hypertension as the second cause of CKF. The ERA-EDTA Registry attributed 17% of the cases of CKF in Europe to hypertension in 2014 and 10% in 2019, with a proportional increase in CKF of unknown cause (CKFun). (Fig.1)

Methods

We conducted a comprehensive review of the medical records for 210 patients with CKF who received KRT at a university hospital in southern Brazil. These patients were monitored from the early stages of kidney disease at the university’s outpatient clinic and underwent a thorough workup, including kidney biopsy.

Results

We found diabetic kidney disease as the leading cause of CKF in Brazil. Only two patients were classified as hypertensive CKF.

Conclusion

The nephrology community has long recognized that hypertension is a less common cause of CKF than previously thought. Reporting CKFun as hypertensive nephrosclerosis masks the reality that we often do not know the cause of CKF, precluding public funding for its full workup (biopsy and genetic evaluation) and treatment and postponing advances to the desirable precision medicine. We intend to call for a joint action to improve the precision of the Registries on CKD worldwide, acknowledging a larger CKDun prevalence.

Figure 2: Primary kidney disease in 210 KRT patients (2020)

Digital Object Identifier (DOI)