Kidney Week

Abstract: FR-PO0261

Phenotypic Clustering Reveals Distinct CKD Metabolic and Complication Profiles

Session Information

• CKD: Omics, Systemic Stressors, and Targeted Pharmacotherapy
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2201 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Jintanapramote, Kavita, Bhumibol Adulyadej Hospital, Bangkok, Thailand

Kavita Jintanapramote, MD

• Srithongkul, Thatsaphan, Mahidol University Faculty of Medicine Siriraj Hospital, Bangkok, Thailand

Thatsaphan Srithongkul, MD

• Trakarnvanich, Thananda, Faculty of Medicine Vajira Hospital, Bangkok, Thailand

Thananda Trakarnvanich, MD

• Sangsuk, Juthamash, Chiangkham Hospital, Phayao, Thailand

Juthamash Sangsuk, MD

• Asawamethapant, Sirirat, Sisaket Hospital, Mueang Sisaket District, Thailand

Sirirat Asawamethapant, MD

• Kittrakulrat, Jathurong, Prapokklao Hospital, Chanthaburi, Thailand

Jathurong Kittrakulrat, MD

• Sapsitthikul, Tossaporn, Samutprakarn Hospital, Mueang Samut Prakan District, Thailand

Tossaporn Sapsitthikul, MD

• Varothai, Narittaya, Phramongkutklao College of Medicine, Bangkok, Thailand

Narittaya Varothai, MD

• Anutrakulchai, Sirirat, Khon Kaen University Faculty of Medicine, Khon Kaen, Thailand

Sirirat Anutrakulchai, MD, PhD

• Boonyakrai, Chanchana, Taksin Hospital, Bangkok, Thailand

Chanchana Boonyakrai, MD, DrMed

• Noppakun, Kajohnsak, Chiang Mai University Faculty of Medicine, Chiang Mai, Thailand

Kajohnsak Noppakun, MD, PhD

• Phutrakool, Phanupong, Chulalongkorn University Faculty of Medicine, Bangkok, Thailand

Phanupong Phutrakool, PhD

• Kittanamongkolchai, Wonngarm, Chulalongkorn University Faculty of Medicine, Bangkok, Thailand

Wonngarm Kittanamongkolchai, MD

• Kanjanabuch, Talerngsak, Chulalongkorn University Faculty of Medicine, Bangkok, Thailand

Talerngsak Kanjanabuch, MD

• Ophascharoensuk, Vuddhidej, Chiang Mai University Faculty of Medicine, Chiang Mai, Thailand

Vuddhidej Ophascharoensuk, MD

• Susantitaphong, Paweena, Chulalongkorn University Faculty of Medicine, Bangkok, Thailand

Paweena Susantitaphong, MD, PhD

Group or Team Name

• THAI-CKD

Background

Chronic kidney disease (CKD) is heterogeneous, and conventional staging may not fully capture metabolic abnormalities and complication burden. We aimed to identify clinically distinct CKD phenotypes using unsupervised clustering in a nationwide Thai cohort.

Methods

The Thai CKD Project is an ongoing prospective multicenter cohort enrolling 3,371 adults with CKD stages G3-G5 from 41 hospitals across Thailand. K-means clustering was performed using demographic, kidney function, and metabolic variables, including age, sex, eGFR, albuminuria, body mass index, HbA1c, systolic blood pressure (SBP), lipid profile, uric acid, and diabetes status. CKD complications were compared across phenotypes.

Results

Four distinct CKD phenotypes were identified. The mild CKD phenotype demonstrated preserved eGFR, low albuminuria, and the lowest complication burden. The elderly CKD phenotype was characterized by older age, female predominance, higher SBP, and high anemia (27.3%) and secondary hyperparathyroidism (SHPT) (63.1%) despite lower albuminuria.
The advanced proteinuric CKD phenotype demonstrated severe albuminuria, dyslipidemia, hyperuricemia, and the highest burden of metabolic acidosis (30.5%), hyperphosphatemia (11.6%), and SHPT (68.9%). The diabetic-metabolic CKD phenotype was characterized by obesity, diabetes, hypertriglyceridemia, poor glycemic control, and cardiometabolic features despite controlled LDL cholesterol levels. Complication prevalence differed significantly across phenotypes (p<0.001 for most comparisons).

Conclusion

Phenotype-based clustering identified meaningful CKD subgroups with distinct metabolic and complication profiles beyond eGFR severity alone. These findings support phenotype-oriented approaches for CKD risk stratification and individualized complication monitoring.

Acknowledgment

This study was supported by the Health Systems Research Institute (HSRI) [Grant number 67-085] and the Ratchadapisek Sompoch Research Fund, Chulalongkorn University [Grant number RA66_CRC_002]. Additional support was provided by AstraZeneca, Boehringer Ingelheim, Apexela, Bayer, Kirin, and Novo Nordisk.

Funding

• Commercial Support – AstraZeneca, Boehringer Ingelheim, Apexela, Bayer, Kirin, and Novo Nordisk.