Preserving Kidneys to Avoid Dialysis

How can we preserve renal function in people with a chronic kidney disease? Can dialysis be avoided or delayed? To answer these questions and many others, Inserm and Université Paris-Sud have set up the CKD-REIN¹ cohort study, led by Bénédicte Stengel. Today it has produced its first results. According to the study, conducted with more than 3,000 patients, several priorities may improve the management of kidney disease. These priorities include improving blood pressure monitoring, providing more nutritional advice, and raising awareness among patients and health care professionals about the risk of medicine overdose.

This research has been published in Nephrology Dialysis Transplantation

Our kidneys have several functions. The first is to remove toxic waste produced by the body. The second is to maintain the amount of water and minerals (sodium, potassium) required for the body to function properly. The third is to produce the hormones, enzymes, and vitamins needed to control blood pressure, and to produce red blood cells and vitamin D. When the kidneys function poorly, a disruption in these processes can lead to high blood pressure, anemia, heart problems, and brittle bones. In addition, medicines accumulate in the body, increasing the risk of overdose. These complications are what make the disease so serious.

Today in France, one out of 1,000 people (85,000 people in all) undergoes dialysis or transplant due to kidneys that no longer function properly. These are major treatments that are restrictive for patients and very costly for the health care system. For the first time in France, a cohort study called CKD-REIN (Chronic Kidney Disease – Renal Epidemiology and Information Network) is being conducted on a national scale to address these key issues for chronic kidney disease. More than 3,000 patients have been included and will be monitored for five years to identify the determining factors of chronic kidney disease progression, and to identify which clinical practices are the most effective at preserving kidney function and avoiding or delaying dialysis. The purpose of the study is to establish the scientific bases for optimal patient management, reinforcing prevention and reducing the costs of kidney failure for the health care system.

What are the first takeaways from the CKD-REIN study?

The subjects of the study are patients who have a kidney disease and are monitored by a nephrologist. In reality, the majority of these patients see their nephrologists just once a year. Their general practitioners are those who provide first-line medical care. These patients, at a moderate or advanced stage of the disease, already have numerous complications and take many medications, an average of eight per day. The study points to several priority actions that would improve the management of the disease: improving blood pressure monitoring; providing more professional nutritional advice; and raising awareness among doctors and patients about the risk of acute kidney failure, the ways it can be prevented, and the risk of medicine overdose.

For more information: https://ckdrein.inserm.fr/

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