Journal of Preventive Medicine and Public Health

Special Article

The KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD): A Korean Chronic Kidney Disease Cohort: Kook-Hwan Oh, Sue K. Park, Jayoun Kim, Curie Ahn; J Prev Med Public Health. 2022;55(4):313-320. Published online July 1, 2022; DOI: https://doi.org/10.3961/jpmph.22.031

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Abstract Summary PDF Supplementary Material

The KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD) was launched in 2011 with the support of the Korea Disease Control and Prevention Agency. The study was designed with the aim of exploring the various clinical features and characteristics of chronic kidney disease (CKD) in Koreans, and elucidating the risk factors for CKD progression and adverse outcomes of CKD. For the cohort study, nephrologists at 9 tertiary university-affiliated hospitals participated in patient recruitment and follow-up. Biostatisticians and epidemiologists also participated in the basic design and structuring of the study. From 2011 until 2016, the KNOW-CKD Phase I recruited 2238 adult patients with CKD from stages G1 to G5, who were not receiving renal replacement therapy. The KNOW-CKD Phase II recruitment was started in 2019, with an enrollment target of 1500 subjects, focused on diabetic nephropathy and hypertensive kidney diseases in patients with reduced kidney function who are presumed to be at a higher risk of adverse outcomes. As of 2021, the KNOW-CKD investigators have published articles in the fields of socioeconomics, quality of life, nutrition, physical activity, renal progression, cardiovascular disease and outcomes, anemia, mineral bone disease, serum and urine biomarkers, and international and inter-ethnic comparisons. The KNOW-CKD researchers will elaborate a prediction model for various outcomes of CKD such as the development of end-stage kidney disease, major adverse cardiovascular events, and death.

Summary

Korean summary
KNOW-CKD 코호트 연구는 전국적 규모의 다기관 만성콩팥병 장기 추적 코호트 연구로서 2011년 질병관리청의 후원으로 시작된 연구이다. 이 연구는 우리나라 만성콩팥병의 임상적인 경과와 합병증, 신기능 악화 정도와 심혈관계 사건, 사망 등 주요 사건의 발생 위험 요인들을 규명하고자 기획되었다. 궁극적으로 KNOW-CKD 연구는 말기신부전으로의 진행과 사망, 심혈관계 주요 사건 등 만성콩팥병의 예후 예측 모델을 구축하는 것을 목표로 한다.

Citations

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Kidney Research and Clinical Practice.2024; 43(1): 8. CrossRef
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Journal of Clinical Medicine.2023; 12(6): 2339. CrossRef

Original Articles

Effect of Uric Acid on the Development of Chronic Kidney Disease: The Korean Multi-Rural Communities Cohort Study: Kwang Ho Mun, Gyeong Im Yu, Bo Youl Choi, Mi Kyung Kim, Min-Ho Shin, Dong Hoon Shin; J Prev Med Public Health. 2018;51(5):248-256. Published online September 7, 2018; DOI: https://doi.org/10.3961/jpmph.18.112

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Abstract PDF

Objectives
Several studies have investigated the effects of serum uric acid (SUA) levels on chronic kidney disease (CKD), with discrepant results. The effect of SUA levels on CKD development was studied in the Korean rural population.
Methods
A total of 9695 participants aged ≥40 years were recruited from 3 rural communities in Korea between 2005 and 2009. Of those participants, 5577 who participated in the follow-up and did not have cerebrovascular disease, myocardial infarction, cancer, or CKD at baseline were studied. The participants, of whom 2133 were men and 3444 were women, were grouped into 5 categories according to their quintile of SUA levels. An estimated glomerular filtration rate of <60 mL/min/1.73 m2 at the time of follow-up was considered to indicate newly developed CKD. The effects of SUA levels on CKD development after adjusting for potential confounders were assessed using Cox proportional hazard models.
Results
Among the 5577 participants, 9.4 and 11.0% of men and women developed CKD. The hazard ratio (HR) of CKD was higher in the highest quintile of SUA levels than in the third quintile in men (adjusted HR, 1.60; 95% confidence interval [CI], 1.02 to 2.51) and women (adjusted HR, 1.56; 95% CI, 1.14 to 2.15). Furthermore, CKD development was also more common in the lowest quintile of SUA levels than in the third quintile in men (adjusted HR, 1.83; 95% CI, 1.15 to 2.90). The effect of SUA was consistent in younger, obese, and hypertensive men.
Conclusions
Both high and low SUA levels were risk factors for CKD development in rural Korean men, while only high levels were a risk factor in their women counterparts.

Summary

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Serum Uric Acid Levels and Nephrosclerosis in a Population-Based Autopsy Study: The Hisayama Study
Kenji Maki, Jun Hata, Satoko Sakata, Emi Oishi, Yoshihiko Furuta, Toshiaki Nakano, Yoshinao Oda, Takanari Kitazono, Toshiharu Ninomiya
American Journal of Nephrology.2022; 53(1): 69. CrossRef
Clinical features suggesting renal hypouricemia as the cause of acute kidney injury: a case report and review of the literature
Tommaso Mazzierli, Luigi Cirillo, Viviana Palazzo, Fiammetta Ravaglia, Francesca Becherucci
Journal of Nephrology.2022; 36(3): 651. CrossRef
U-shaped relationship between serum uric acid level and decline in renal function during a 10-year period in female subjects: BOREAS-CKD2
Kazuma Mori, Masato Furuhashi, Marenao Tanaka, Keita Numata, Takashi Hisasue, Nagisa Hanawa, Masayuki Koyama, Arata Osanami, Yukimura Higashiura, Masafumi Inyaku, Megumi Matsumoto, Norihito Moniwa, Hirofumi Ohnishi, Tetsuji Miura
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Journal of Personalized Medicine.2021; 11(5): 415. CrossRef
Detailed association between serum uric acid levels and the incidence of chronic kidney disease stratified by sex in middle-aged adults
Shingo Nakayama, Michihiro Satoh, Yukako Tatsumi, Takahisa Murakami, Tomoko Muroya, Takuo Hirose, Takayoshi Ohkubo, Takefumi Mori, Atsushi Hozawa, Hirohito Metoki
Atherosclerosis.2021; 330: 107. CrossRef
Association between Serum Uric Acid Level and ESRD or Death in a Korean Population
Kipyo Kim, Suryeong Go, Hyung Eun Son, Ji Young Ryu, Hajeong Lee, Nam Ju Heo, Ho Jun Chin, Jung Hwan Park
Journal of Korean Medical Science.2020;[Epub] CrossRef
Renal effects of uric acid: hyperuricemia and hypouricemia
Jung Hwan Park, Yong-Il Jo, Jong-Ho Lee
The Korean Journal of Internal Medicine.2020; 35(6): 1291. CrossRef
Hyperuricemia Predicts Residual Diuresis Decline in Peritoneal Dialysis Patients
Natalia Stapanova, Lyudmyla Snisar, Larysa Lebid
Electronic Journal of General Medicine.2020; 18(1): em270. CrossRef
Genetically Elevated Serum Uric Acid and Renal Function in an Apparently Healthy Population
Ji-Yong Ge, Yuan Ji, Zhen-Yan Zhu, Xun Li
Urologia Internationalis.2020; 104(3-4): 277. CrossRef
Threshold Effects of Serum Uric Acid on Chronic Kidney Disease in US Women without Hypertension and Diabetes: A Cross-Sectional Study
Guiping Hu, Yi Bai, Tian Chen, Shichuan Tang, Lihua Hu
Kidney and Blood Pressure Research.2019; 44(5): 1036. CrossRef

Association of Demographic and Socioeconomic Factors With Risk Factors for Chronic Kidney Disease: Tae Hyun Kim, Min-Jee Lee, Ki-Bong Yoo, Euna Han, Jae-Woo Choi; J Prev Med Public Health. 2015;48(3):170-177. Published online May 15, 2015; DOI: https://doi.org/10.3961/jpmph.15.002

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Abstract PDF

Objectives
The goal of this study was to examine the association of various demographic and socioeconomic factors with risk factors for chronic kidney disease (CKD).
Methods
We used nationally representative pooled data from the Korea National Health and Nutrition Examination Survey (KNHANES), 2007–2013. We estimated the glomerular filtration rate (GFR) using the Modification of Diet in Renal Disease equation. We defined CKD as a GFR <60 mL/min/1.73 m2, and 1304 of the 45 208 individuals included in the KNHANES were found to have CKD by this definition. The outcome variable was whether individual subjects adhered to the CKD prevention and management guidelines recommended by the Korea Centers for Disease Control and Prevention. The guidelines suggest that individuals maintain a normal weight, abstain from alcohol consumption and smoking, manage diabetes and hypertension, and engage in regular exercise in order to prevent and manage CKD.
Results
This study found that individuals with CKD were more likely to be obese and have hypertension or diabetes than individuals without CKD. In particular, male and less-educated CKD patients were less likely to adhere to the guidelines.
Conclusions
Although the prevalence of CKD, as indicated by the KNHANES data, decreased from 2007 to 2013, the prevalence of most risk factors associated with CKD fluctuated over the same time period. Since a variety of demographic and socioeconomic factors are related to the successful implementation of guidelines for preventing and managing CKD, individually tailored prevention activities should be developed.

Summary

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