Navigating the complexities of end-stage kidney disease (ESKD) from risk factors to outcome: insights from the UK Biobank cohort
Abstract Background The global prevalence of end-stage kidney disease (ESKD) is increasing despite optimal management of traditional risk factors such as hyperglycaemia, hypertension, and dyslipidaemia. This study examines the influence of cardiorenal risk factors, socioeconomic status, and ethnic a...
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2025-04-01
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| Online Access: | https://doi.org/10.1186/s12882-025-04090-7 |
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| author | Debasish Kar Richard Byng Aziz Sheikh Mintu Nath Bedowra Zabeen Shubharthi Kar Shakila Banu Mohammad Habibur Rahman Sarker Navid Khan Durjoy Acharjee Shafiqul Islam Victoria Allgar José M. Ordóñez-Mena Aya El-Wazir Soon Song Ashish Verma Umesh Kadam Simon de Lusignan |
| author_facet | Debasish Kar Richard Byng Aziz Sheikh Mintu Nath Bedowra Zabeen Shubharthi Kar Shakila Banu Mohammad Habibur Rahman Sarker Navid Khan Durjoy Acharjee Shafiqul Islam Victoria Allgar José M. Ordóñez-Mena Aya El-Wazir Soon Song Ashish Verma Umesh Kadam Simon de Lusignan |
| author_sort | Debasish Kar |
| collection | DOAJ |
| description | Abstract Background The global prevalence of end-stage kidney disease (ESKD) is increasing despite optimal management of traditional risk factors such as hyperglycaemia, hypertension, and dyslipidaemia. This study examines the influence of cardiorenal risk factors, socioeconomic status, and ethnic and cardiovascular comorbidities on ESKD outcomes in the general population. Methods This cross-sectional study analysed data from 502,408 UK Biobank study participants recruited between 2006 and 2010. Multivariable logistic regression models were fitted to assess risk factors for ESKD, with results presented as adjusted odds ratio (aOR) and 95% confidence intervals (95% CI). Results A total of 1191 (0.2%) of the study participants reported ESKD. Diabetes increased ESKD risk by 62% [1.62 (1.36–1.93)], with early-onset diabetes (before age 40) conferring higher odds compared to later-onset (after age 40) [2.26 (1.57–3.24)]. Similarly, early-onset hypertension (before age 40), compared to later onset (after age 40), increased ESKD odds by 73% [1.73 (1.21–2.44)]. Cardiovascular comorbidities, including stroke, hypertension, myocardial infarction and angina, were strongly associated with ESKD [5.97 (3.99–8.72), 5.35 (4.38–6.56), 4.94 (3.56–6.78), and 4.89 (3.47–6.81)], respectively. Males were at 22% higher risk of ESKD than females [1.22 (1.04–1.43)]. Each additional year of diabetes duration increased ESKD odds by 2% [1.02 (1.01–1.03)]. Non-white ethnicity, compared to white and socioeconomically most deprived, compared to the least deprived quintiles, were at 70% and 83% higher odds of ESKD. Each unit of HbA1c rise increased the odds of ESKD by 2%. Compared to microalbuminuria, macroalbuminuria increased the odds of ESKD by almost 10-fold [9.47 (7.95–11.27)] while normoalbuminuria reduced the odds by 73% [0.27 (0.22–0.32)]. Conclusions Early onset of diabetes and hypertension, male sex, non-white ethnicity, deprivation, poor glycaemic control, and prolonged hyperglycaemia are significant risk factors for ESKD. These findings highlight the complexity of ESKD and the need for multifactorial targeted interventions in high-risk populations. Clinical trial number Not applicable. |
| format | Article |
| id | doaj-art-9421b4720e6340a4b9fd0de5b7dca7f0 |
| institution | OA Journals |
| issn | 1471-2369 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
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| series | BMC Nephrology |
| spelling | doaj-art-9421b4720e6340a4b9fd0de5b7dca7f02025-08-20T01:51:38ZengBMCBMC Nephrology1471-23692025-04-0126111110.1186/s12882-025-04090-7Navigating the complexities of end-stage kidney disease (ESKD) from risk factors to outcome: insights from the UK Biobank cohortDebasish Kar0Richard Byng1Aziz Sheikh2Mintu Nath3Bedowra Zabeen4Shubharthi Kar5Shakila Banu6Mohammad Habibur Rahman Sarker7Navid Khan8Durjoy Acharjee9Shafiqul Islam10Victoria Allgar11José M. Ordóñez-Mena12Aya El-Wazir13Soon Song14Ashish Verma15Umesh Kadam16Simon de Lusignan17Community and Primary Care Research Group, University of PlymouthCommunity and Primary Care Research Group, University of PlymouthNuffield Department of Primary Care Health Sciences, University of OxfordInstitute of Applied Health Sciences, University of AberdeenBADAS Paediatric Diabetes Care and Research Centre, Bangladesh Institute for Research and Rehabilitation in Diabetes, Endocrinology and Metabolic Disorders (BIRDEM)Sylhet MAG Osmani Medical CollegeInternational Centre for Diarrhoeal Disease Research (ICDDRB)International Centre for Diarrhoeal Disease Research (ICDDRB)Sylhet MAG Osmani Medical CollegeDhaka Medical CollegeUniversity of Professionals (BUP)Community and Primary Care Research Group, University of PlymouthNuffield Department of Primary Care Health Sciences, University of OxfordCentre of Excellence in Molecular and Cellular Medicine, Suez Canal UniversityDiabetes and Endocrinology, Sheffield Teaching Hospital NHS Foundation TrustDepartment of Nephrology, Boston UniversityUniversity of ExeterNuffield Department of Primary Care Health Sciences, University of OxfordAbstract Background The global prevalence of end-stage kidney disease (ESKD) is increasing despite optimal management of traditional risk factors such as hyperglycaemia, hypertension, and dyslipidaemia. This study examines the influence of cardiorenal risk factors, socioeconomic status, and ethnic and cardiovascular comorbidities on ESKD outcomes in the general population. Methods This cross-sectional study analysed data from 502,408 UK Biobank study participants recruited between 2006 and 2010. Multivariable logistic regression models were fitted to assess risk factors for ESKD, with results presented as adjusted odds ratio (aOR) and 95% confidence intervals (95% CI). Results A total of 1191 (0.2%) of the study participants reported ESKD. Diabetes increased ESKD risk by 62% [1.62 (1.36–1.93)], with early-onset diabetes (before age 40) conferring higher odds compared to later-onset (after age 40) [2.26 (1.57–3.24)]. Similarly, early-onset hypertension (before age 40), compared to later onset (after age 40), increased ESKD odds by 73% [1.73 (1.21–2.44)]. Cardiovascular comorbidities, including stroke, hypertension, myocardial infarction and angina, were strongly associated with ESKD [5.97 (3.99–8.72), 5.35 (4.38–6.56), 4.94 (3.56–6.78), and 4.89 (3.47–6.81)], respectively. Males were at 22% higher risk of ESKD than females [1.22 (1.04–1.43)]. Each additional year of diabetes duration increased ESKD odds by 2% [1.02 (1.01–1.03)]. Non-white ethnicity, compared to white and socioeconomically most deprived, compared to the least deprived quintiles, were at 70% and 83% higher odds of ESKD. Each unit of HbA1c rise increased the odds of ESKD by 2%. Compared to microalbuminuria, macroalbuminuria increased the odds of ESKD by almost 10-fold [9.47 (7.95–11.27)] while normoalbuminuria reduced the odds by 73% [0.27 (0.22–0.32)]. Conclusions Early onset of diabetes and hypertension, male sex, non-white ethnicity, deprivation, poor glycaemic control, and prolonged hyperglycaemia are significant risk factors for ESKD. These findings highlight the complexity of ESKD and the need for multifactorial targeted interventions in high-risk populations. Clinical trial number Not applicable.https://doi.org/10.1186/s12882-025-04090-7Chronic kidney diseaseDiabetesEnd-stage kidney disease (ESKD)Renal replacement therapy (RRT) |
| spellingShingle | Debasish Kar Richard Byng Aziz Sheikh Mintu Nath Bedowra Zabeen Shubharthi Kar Shakila Banu Mohammad Habibur Rahman Sarker Navid Khan Durjoy Acharjee Shafiqul Islam Victoria Allgar José M. Ordóñez-Mena Aya El-Wazir Soon Song Ashish Verma Umesh Kadam Simon de Lusignan Navigating the complexities of end-stage kidney disease (ESKD) from risk factors to outcome: insights from the UK Biobank cohort BMC Nephrology Chronic kidney disease Diabetes End-stage kidney disease (ESKD) Renal replacement therapy (RRT) |
| title | Navigating the complexities of end-stage kidney disease (ESKD) from risk factors to outcome: insights from the UK Biobank cohort |
| title_full | Navigating the complexities of end-stage kidney disease (ESKD) from risk factors to outcome: insights from the UK Biobank cohort |
| title_fullStr | Navigating the complexities of end-stage kidney disease (ESKD) from risk factors to outcome: insights from the UK Biobank cohort |
| title_full_unstemmed | Navigating the complexities of end-stage kidney disease (ESKD) from risk factors to outcome: insights from the UK Biobank cohort |
| title_short | Navigating the complexities of end-stage kidney disease (ESKD) from risk factors to outcome: insights from the UK Biobank cohort |
| title_sort | navigating the complexities of end stage kidney disease eskd from risk factors to outcome insights from the uk biobank cohort |
| topic | Chronic kidney disease Diabetes End-stage kidney disease (ESKD) Renal replacement therapy (RRT) |
| url | https://doi.org/10.1186/s12882-025-04090-7 |
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