Translational research in nephrology: chronic kidney disease prevention and public health

Abstract

This narrative review evaluates translational research with respect to five important risk factors for chronic kidney disease (CKD): physical inactivity, high salt intake, smoking, diabetes and hypertension. We discuss the translational research around prevention of CKD and its complications both at the level of the general population, and at the level of those at high risk, i.e. people at increased risk for CKD or CKD complications. At the population level, all three lifestyle risk factors (physical inactivity, high salt intake and smoking) have been translated into implemented measures and clear population health improvements have been observed. At the 'high-risk' level, the lifestyle studies reviewed have tended to focus on the individual impact of specific interventions, and their wider implementation and impact on CKD practice are more difficult to establish. The treatment of both diabetes and hypertension appears to have improved, however the impact on CKD and CKD complications was not always clear. Future studies need to investigate the most effective translational interventions in low and middle income countries.

Keywords: CKD; diabetes mellitus; epidemiology; hypertension; physical activity.

Fig. 1.

The nine global voluntary targets from the WHO Global Action Plan for the Prevention and Control of NCDs 2013–2020. Reprinted from Global action plan for the prevention and control of noncommunicable diseases 2013–2020, World Health Organization, Voluntary Global Targets, page 5, Copyright (2013).

Fig. 2.

Ogilvie's translational research framework in the context of chronic kidney disease (adapted from a model by Ogilvie et al. [19]). RRT, renal replacement therapy.