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Syndrome of rapid-onset end-stage renal disease: a new unrecognized pattern of CKD progression to ESRD.
Ren Fail. 2010; 32(8):954-8.RF

Abstract

By most estimates, we have an increasing worldwide end-stage renal disease (ESRD) epidemic. This is despite at least two decades of intensified reno-protection strategies, including attempts at optimal hypertension management, optimization of diabetic control, smoking cessation efforts, and the extensive application of renin-angiotensin-aldosterone system (RAAS) blockade in both diabetic and nondiabetic chronic nephropathies. The current consensus is that chronic kidney disease (CKD) progression to ESRD is a continuous, progressive, and predictable loss of estimated glomerular filtration rate (eGFR) in CKD patients, inexorably leading to ESRD. Our recent experience in a Mayo Health System Hypertension Clinic, as well as new reports associating ESRD development in CKD patients with episodes of acute kidney injury (AKI), led us to hypothesize that CKD to ESRD progression may not be that predictable, after all. Among a 100 high-risk CKD patient cohort that we have followed up prospectively since 2002, we demonstrated that in 15 of 17 (88%) patients who progressed to ESRD, progression from CKD to ESRD was unpredictable, nonlinear, abrupt, and rapid, and this followed AKI secondary to medical and surgical events. We have coined a new term, the syndrome of rapid-onset end-stage renal disease (SORO-ESRD), to represent this unrecognized syndrome. Larger studies are warranted to confirm our single-center findings. If confirmed to represent a significant proportion of the ESRD population, at least here in the United States, this finding will demand major paradigm shifts in the current concepts of reno-protection and "A-V Fistula first" programs.

Authors+Show Affiliations

College of Medicine, Mayo Clinic, Rochester, Minnesota, USA. onuigbo.macaulay@mayo.edu

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20722563

Citation

Onuigbo, Macaulay A C.. "Syndrome of Rapid-onset End-stage Renal Disease: a New Unrecognized Pattern of CKD Progression to ESRD." Renal Failure, vol. 32, no. 8, 2010, pp. 954-8.
Onuigbo MA. Syndrome of rapid-onset end-stage renal disease: a new unrecognized pattern of CKD progression to ESRD. Ren Fail. 2010;32(8):954-8.
Onuigbo, M. A. (2010). Syndrome of rapid-onset end-stage renal disease: a new unrecognized pattern of CKD progression to ESRD. Renal Failure, 32(8), 954-8. https://doi.org/10.3109/0886022X.2010.502608
Onuigbo MA. Syndrome of Rapid-onset End-stage Renal Disease: a New Unrecognized Pattern of CKD Progression to ESRD. Ren Fail. 2010;32(8):954-8. PubMed PMID: 20722563.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Syndrome of rapid-onset end-stage renal disease: a new unrecognized pattern of CKD progression to ESRD. A1 - Onuigbo,Macaulay A C, PY - 2010/8/21/entrez PY - 2010/8/21/pubmed PY - 2011/2/2/medline SP - 954 EP - 8 JF - Renal failure JO - Ren Fail VL - 32 IS - 8 N2 - By most estimates, we have an increasing worldwide end-stage renal disease (ESRD) epidemic. This is despite at least two decades of intensified reno-protection strategies, including attempts at optimal hypertension management, optimization of diabetic control, smoking cessation efforts, and the extensive application of renin-angiotensin-aldosterone system (RAAS) blockade in both diabetic and nondiabetic chronic nephropathies. The current consensus is that chronic kidney disease (CKD) progression to ESRD is a continuous, progressive, and predictable loss of estimated glomerular filtration rate (eGFR) in CKD patients, inexorably leading to ESRD. Our recent experience in a Mayo Health System Hypertension Clinic, as well as new reports associating ESRD development in CKD patients with episodes of acute kidney injury (AKI), led us to hypothesize that CKD to ESRD progression may not be that predictable, after all. Among a 100 high-risk CKD patient cohort that we have followed up prospectively since 2002, we demonstrated that in 15 of 17 (88%) patients who progressed to ESRD, progression from CKD to ESRD was unpredictable, nonlinear, abrupt, and rapid, and this followed AKI secondary to medical and surgical events. We have coined a new term, the syndrome of rapid-onset end-stage renal disease (SORO-ESRD), to represent this unrecognized syndrome. Larger studies are warranted to confirm our single-center findings. If confirmed to represent a significant proportion of the ESRD population, at least here in the United States, this finding will demand major paradigm shifts in the current concepts of reno-protection and "A-V Fistula first" programs. SN - 1525-6049 UR - https://www.unboundmedicine.com/medline/citation/20722563/Syndrome_of_rapid_onset_end_stage_renal_disease:_a_new_unrecognized_pattern_of_CKD_progression_to_ESRD_ L2 - https://www.tandfonline.com/doi/full/10.3109/0886022X.2010.502608 DB - PRIME DP - Unbound Medicine ER -