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/
Bénédicte Stengel Inserm Research Director Joint research unit 1018 "Center for Research in Epidemiology and Population Health" (Inserm / Université Paris-Sud/UVSQ) benedicte.stengel@inserm.fr +33 1 45 59 50 39
Press contact presse@inserm.fr Access the Inserm press room
Risk profile, quality of life and care of patients with moderate and advanced CKD. The French Chronic Kidney Disease – Renal Epidemiology and Information Network (CKD-REIN) Cohort Study Bénédicte Stengel,1 Marie Metzger,1 Christian Combe,2,3 Christian Jacquelinet,1,4 Serge Briançon,5,6 Carole Ayav,5 Denis Fouque,7 Maurice Laville,7 Luc Frimat,6,8 Christophe Pascal,9 Yves-Edouard Herpe,10,11 Pascal Morel,12 Jean-François Deleuze,13 Joost P Schanstra,14,15 Céline Lange,1,4 Karine Legrand,5,6 Elodie Speyer,1 Sophie Liabeuf, 1,11 Bruce M Robinson,16 Ziad A Massy. 1,17 1 CESP Centre for Research in Epidemiology and Population Health, Univ Paris-Saclay, Univ Paris Sud, UVSQ, UMRS 1018, F-94807, Villejuif, France 2 Service de Néphrologie Transplantation Dialyse Aphérèse, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France 3 Inserm, U1026, Univ Bordeaux Segalen, Bordeaux, France 4 Agence de la Biomédecine, Saint-Denis, France 5 University Hospital of Nancy, Department of Clinical Epidemiology, INSERM CIC-EC 1433, Vandoeuvre-lès-Nancy, France 6 Université de Lorraine, Université Paris-Descartes, Apemac, EA 4360, Nancy, France 7 Department of Nephrology, Centre Hospitalier Lyon Sud, Univ Lyon, UCBL, Carmen, F-69495 Pierre-Bénite, France 8 Nephrology Department, CHU de Nancy, Vandoeuvre-lès-Nancy 9 Jean Moulin Lyon 3 university, The Institute for Education and Research in Health Care and Social Service, Lyon, France 10 Biobanque de Picardie, Amiens, France 11 Department of clinical pharmacology, Centre Hospitalier Universitaire, Amiens, France 12 Etablissement français du Sang, Bourgogne Franche Comté, F-25000 Besançon, France 13 Centre National de Recherche en Génomique Humaine, (CNRGH), Institut de Biologie François Jacob, CEA, Evry, France 14 Inserm U1048, Institut of Cardiovascular and Metabolic Disease, Toulouse, France. 15 Université Toulouse III Paul-Sabatier, Toulouse, France. 16Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States 17 Nephrology Department, CHU Ambroise Paré, Boulogne, France. Nephrology Dialysis Transplantation https://doi.org/10.1093/ndt/gfy058
