Chronic kidney disease (CKD) progression is significantly influenced by modifiable risk factors such as hypertension, diabetes, obesity, dietary habits, and metabolic dysfunction. Emerging biomarkers integrating inflammation and metabolic status offer promising tools for early diagnosis and risk stratification, supporting personalized intervention strategies.
Background
CKD affects over 850 million people globally and is a leading cause of cardiovascular morbidity and mortality. It is increasingly recognized as a systemic disorder involving metabolic, inflammatory, and vascular mechanisms. Many determinants of CKD progression are modifiable, making early identification and targeted intervention critical to reducing disease burden. This editorial synthesizes recent research on epidemiology, pathophysiology, biomarkers, and therapeutic approaches related to CKD progression.
Data Highlights
Study
Key Findings
Li et al.
CKD remains a major global health problem; highest DALYs in low socio-demographic index (SDI) regions (1990-2021)
Lu et al.
Global CKD burden attributable to high sodium intake increased, with rises in mortality and DALYs (1990-2021)
Huang et al.
Marked increase in CKD burden linked to hypertension and dietary factors, especially in older populations and low SDI countries
Wang et al.
Hypertension is an early determinant of CKD, even in younger populations; dietary factors strongly influence CKD associated with type 2 diabetes
Liao et al.
Non-linear association between triglyceride/HDL cholesterol ratio and CKD risk
Zhang et al.
Positive association between triglyceride-glucose index and sarcopenia in CKD patients
Du et al.
Serum uric acid-to-albumin ratio predicts diabetic nephropathy in type 2 diabetes
Fu et al.
Elevated complement C3 linked to vascular calcification in non-dialysis CKD patients
Ma et al.
Systemic immuno-inflammatory index associated with increased all-cause and cardiovascular mortality in CKD
Key Findings
CKD burden is highest in regions with low socio-demographic index and is increasing globally, partly due to high sodium intake and dietary factors.
Hypertension and type 2 diabetes are major modifiable determinants of CKD progression, influenced by diet and metabolic dysfunction.
Metabolic alterations such as insulin resistance, lipid abnormalities, and muscle metabolism dysfunction are closely linked to CKD progression.
Composite biomarkers integrating inflammatory, metabolic, and nutritional indices (e.g., sUAR, Ins60/ApoA ratio, complement C3, SII) improve early diagnosis and risk stratification.
Inflammation and immune dysregulation play critical roles in CKD progression and associated cardiovascular risk.
Maintaining stable hemoglobin and hematocrit levels may be beneficial in slowing CKD progression in advanced stages.
Clinical Implications
Early identification of modifiable risk factors such as hypertension, dietary sodium intake, and metabolic abnormalities is essential for preventing CKD progression. Utilizing composite biomarkers that reflect inflammation and metabolic status can enhance risk stratification and guide personalized treatment strategies. Integrating public health policies with individualized cardiometabolic management may reduce the global CKD burden.
Conclusion
CKD progression is driven by a complex interplay of modifiable lifestyle, metabolic, and inflammatory factors. Advances in biomarker research and understanding of systemic mechanisms offer promising avenues for early intervention and personalized care to mitigate disease progression and cardiovascular complications.
References
Editorial on Modifiable risk factors for chronic kidney disease progression
