chronic renal insufficiency


Summary: Conditions in which the KIDNEYS perform below the normal level for more than three months. Chronic kidney insufficiency is classified by five stages according to the decline in GLOMERULAR FILTRATION RATE and the degree of kidney damage (as measured by the level of PROTEINURIA). The most severe form is the end-stage renal disease (CHRONIC KIDNEY FAILURE). (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002)

Top Publications

  1. Viazzi F, Leoncini G, Conti N, Tomolillo C, Giachero G, Vercelli M, et al. Microalbuminuria is a predictor of chronic renal insufficiency in patients without diabetes and with hypertension: the MAGIC study. Clin J Am Soc Nephrol. 2010;5:1099-106 pubmed publisher
    ..Whether microalbuminuria predicts long-term development of chronic renal insufficiency (CRI) in patients without diabetes and with primary hypertension remains to be documented...
  2. Yaffe K, Ackerson L, Kurella Tamura M, Le Blanc P, Kusek J, Sehgal A, et al. Chronic kidney disease and cognitive function in older adults: findings from the chronic renal insufficiency cohort cognitive study. J Am Geriatr Soc. 2010;58:338-45 pubmed publisher
    ..Cross-sectional. Chronic Renal Insufficiency Cohort Study. Eight hundred twenty-five adults aged 55 and older with CKD...
  3. Prasad P, Tiwari A, Kumar K, Ammini A, Gupta A, Gupta R, et al. Association analysis of ADPRT1, AKR1B1, RAGE, GFPT2 and PAI-1 gene polymorphisms with chronic renal insufficiency among Asian Indians with type-2 diabetes. BMC Med Genet. 2010;11:52 pubmed publisher
    ..amidotransferase-2 (GFPT2), and plasminogen activator inhibitor-1 (PAI-1) genes with chronic renal insufficiency (CRI) among Asian Indians with type 2 diabetes; and to identify epistatic interactionss between genes ..
  4. Weight C, Larson B, Fergany A, Gao T, Lane B, Campbell S, et al. Nephrectomy induced chronic renal insufficiency is associated with increased risk of cardiovascular death and death from any cause in patients with localized cT1b renal masses. J Urol. 2010;183:1317-23 pubmed publisher
    ..that these patients have significant competing risks of death, some of which may be increased by chronic renal insufficiency. Therefore, we compared overall survival, cancer specific survival and cardiac specific survival in ..
  5. Malcolm J, Bagrodia A, Derweesh I, Mehrazin R, DiBlasio C, Wake R, et al. Comparison of rates and risk factors for developing chronic renal insufficiency, proteinuria and metabolic acidosis after radical or partial nephrectomy. BJU Int. 2009;104:476-81 pubmed publisher
    To investigate the incidence of and risk factors for developing chronic renal insufficiency (CRI), proteinuria and metabolic acidosis (MA) in patients treated with radical nephrectomy (RN) or nephron-sparing surgery (NSS)...
  6. DeLoach S, Appel L, Chen J, Joffe M, Gadegbeku C, Mohler E, et al. Aortic pulse pressure is associated with carotid IMT in chronic kidney disease: report from Chronic Renal Insufficiency Cohort. Am J Hypertens. 2009;22:1235-41 pubmed publisher
    ..analysis (PWA), and carotid intima-media thickness (IMT), in a cohort of CKD patients enrolled in the Chronic Renal Insufficiency Cohort (CRIC) study...
  7. Lash J, Go A, Appel L, He J, Ojo A, Rahman M, et al. Chronic Renal Insufficiency Cohort (CRIC) Study: baseline characteristics and associations with kidney function. Clin J Am Soc Nephrol. 2009;4:1302-11 pubmed publisher
    The Chronic Renal Insufficiency Cohort (CRIC) Study was established to examine risk factors for the progression of chronic kidney disease (CKD) and cardiovascular disease (CVD) in patients with CKD...
  8. Soliman E, Prineas R, Go A, Xie D, Lash J, Rahman M, et al. Chronic kidney disease and prevalent atrial fibrillation: the Chronic Renal Insufficiency Cohort (CRIC). Am Heart J. 2010;159:1102-7 pubmed publisher
    ..A total of 3,267 adult participants (50% non-Hispanic blacks, 46% women) with CKD from the Chronic Renal Insufficiency Cohort were included in this study. None of the study participants had been on dialysis...
  9. Portolés J, Castelao A, Gorriz J, Tato A, de Alvaro F. Anemia development and cardiovascular risk management in nonanemic stage 3 chronic kidney disease. Ren Fail. 2009;31:869-75 pubmed publisher
    ..8 +/- 1.1 vs. 0.6 +/- 0.9 g/day). After one year, 12.4% of patients developed anemia. Diabetic patients had a higher cardiovascular risk and limited blood pressure control. The overall control of cardiovascular risk was unsatisfactory. ..

More Information


  1. Young J, Terrin N, Wang X, Greene T, Beck G, Kusek J, et al. Asymmetric dimethylarginine and mortality in stages 3 to 4 chronic kidney disease. Clin J Am Soc Nephrol. 2009;4:1115-20 pubmed publisher
    ..In this cohort of patients with predominantly nondiabetic, stages 3 to 4 chronic kidney disease, there was a strong association of ADMA with prevalent CVD and a modest association with all-cause and CVD mortality. ..
  2. Barreto D, Barreto F, Liabeuf S, Temmar M, Boitte F, Choukroun G, et al. Vitamin D affects survival independently of vascular calcification in chronic kidney disease. Clin J Am Soc Nephrol. 2009;4:1128-35 pubmed publisher
    ..Low 25D levels affected mortality independently of vascular calcification and stiffness, suggesting that 25D may influence survival in CKD patients via additional pathways that need to be further explored. ..
  3. Li S, Rao X, Wang S, Zhang G, Li X, Dai X, et al. Study on the relationship between blood stasis syndrome and clinical pathology in 227 patients with primary glomerular disease. Chin J Integr Med. 2009;15:170-6 pubmed publisher
    ..Based on these observations, the BSS may be used as an indicator of the development of renal diseases. Being positively diagnosed as BSS could indicate the beginning of the chronic phase of the primary glomerular diseases. ..
  4. Costea A, Costea D, David C, Grasa C. Evolution of chronic hypertensive nephropathies treated with ACE inhibitors on patients in pre-dialysis stage. J Med Life. 2010;3:144-8 pubmed
  5. Shi B, Ni Z, Zhou W, Yu Z, Gu L, Mou S, et al. Circulating levels of asymmetric dimethylarginine are an independent risk factor for left ventricular hypertrophy and predict cardiovascular events in pre-dialysis patients with chronic kidney disease. Eur J Intern Med. 2010;21:444-8 pubmed publisher
    ..175, 95%CI[1.070-1.290], P=0.001). Similar to findings in ESRD patients, elevated circulating levels of ADMA may increase the risk of LVH and CV events in pre-dialysis CKD patients. ..
  6. Szeifert L, Hamvas S, Adorjáni G, Novak M. [Mood disorders in patients with chronic kidney disease. Diagnosis, screening and treatment of depression]. Orv Hetil. 2009;150:1723-30 pubmed publisher
    ..In this review, which is the second of a series of reviews on this topic, we provide an overview of the literature concerning the diagnosis, screening and therapy of depressive disorders in patients with chronic kidney disease. ..
  7. Szakaly P. [Clinical value of "zero-hour biopsy"]. Magy Seb. 2009;62:188-98 pubmed publisher
    ..When adequate treatment is not available in time repeated development of chronic renal failure is unavoidable. The aim of my study is, how can we rise the number of transplanted kidney and the quality of them. ..
  8. De Boer I, Kestenbaum B, Shoben A, Michos E, Sarnak M, Siscovick D. 25-hydroxyvitamin D levels inversely associate with risk for developing coronary artery calcification. J Am Soc Nephrol. 2009;20:1805-12 pubmed publisher
    ..Accelerated development of atherosclerosis may underlie, in part, the increased cardiovascular risk associated with vitamin D deficiency. ..
  9. Shehab Eldin W, Zaki A, Gazareen S, Shoker A. Susceptibility to hyperglycemia in patients with chronic kidney disease. Am J Nephrol. 2009;29:406-13 pubmed publisher
    ..2% was lower than the 37% present in the NG group. Increased IR, rather than beta-cell dysfunction, is the primary mechanism of PDM in CKD patients. ..
  10. Bozzetto S, Piccoli A, Montini G. Bioelectrical impedance vector analysis to evaluate relative hydration status. Pediatr Nephrol. 2010;25:329-34 pubmed publisher
    ..This pattern indicates relative dehydration. BIVA represents a useful clinical tool that is able to detect changes in hydration. ..
  11. Mainra R, Elder G. Review article: Managing bone complications after kidney transplantation. Nephrology (Carlton). 2009;14:437-42 pubmed publisher
    ..Consequently, such an approach should be confirmed by studies that include bone biopsy data and an evaluation of patient level outcomes. ..
  12. Kastarinen H, Ukkola O, Kesaniemi Y. Glomerular filtration rate is related to carotid intima-media thickness in middle-aged adults. Nephrol Dial Transplant. 2009;24:2767-72 pubmed publisher
    ..This finding underlines the importance of early detection of subjects with mildly decreased kidney function and the aggressive management of atherosclerotic risk factors in this population. ..
  13. Monhart V. [Treatment of dyslipidemia in patients with metabolic syndrome and chronic kidney disease]. Vnitr Lek. 2009;55:671-8 pubmed
    ..The results of the Czecho-Slovakian pivot study KOLCHRI have demonstrated the efficacy and safety of fenofibrate combined with low dose statin in patients with metabolic syndrome and stage 2-4 chronic kidney disease. ..
  14. Malyszko J. Mechanism of endothelial dysfunction in chronic kidney disease. Clin Chim Acta. 2010;411:1412-20 pubmed publisher
    ..In this review paper mechanism of endothelial dysfunction, including the role of nitric oxide pathway, adipocytokines and hemodialysis-induced endothelial dysfunction is discussed. ..
  15. Kitchen J, Kane D. Non-steroidal anti-inflammatory drug prescriptions in hospital inpatients: are we assessing the risks?. Ir J Med Sci. 2010;179:357-60 pubmed publisher
    ..Thirteen patients had two risks; 7 were on PPI. Six of 19 patients with one risk factor were on PPI. 40.3% had stage 2/3 chronic kidney disease. 35.1% had ischaemic heart disease. NSAIDs and PPIs are often prescribed inappropriately. ..
  16. Lovcić V, Vujić J, Ivanac Janković R, Basic Jukic N, Barisic I, Lovcić P, et al. [Treatment anaemia of chronic kidney disease in predialysis patients (stage 1-4)]. Acta Med Croatica. 2009;63 Suppl 1:11-6 pubmed
    ..Improved cardiac function in those patients reduce morbidity and mortality risk and improve quality of life (QoL) in patients with CKD. ..
  17. Tan A, Hoffman B, Rosas S. Patient perception of risk factors associated with chronic kidney disease morbidity and mortality. Ethn Dis. 2010;20:106-10 pubmed
    ..Access to CKD education needs to be tailored to the health literacy status of each patient. Educational interventional research studies are needed in early-stage CKD to determine impact on clinical outcomes. ..
  18. Westenfeld R, Schafer C, Kruger T, Haarmann C, Schurgers L, Reutelingsperger C, et al. Fetuin-A protects against atherosclerotic calcification in CKD. J Am Soc Nephrol. 2009;20:1264-74 pubmed publisher
    ..In conclusion, fetuin-A inhibits pathologic calcification in both the soft tissue and vasculature, even in the setting of atherosclerosis. ..
  19. Carrillo López N, Román García P, Rodríguez Rebollar A, Fernández Martín J, Naves Diaz M, Cannata Andia J. Indirect regulation of PTH by estrogens may require FGF23. J Am Soc Nephrol. 2009;20:2009-17 pubmed publisher
    ..These results suggest that estrogens regulate PTH indirectly, possibly through FGF23. ..
  20. Jorgetti V. Review article: Bone biopsy in chronic kidney disease: patient level end-point or just another test?. Nephrology (Carlton). 2009;14:404-7 pubmed publisher
    ..In this review we focus on the relevance of bone biopsy and its respective histomorphometric analysis to help nephrologists to evaluate patients with chronic kidney disease. ..
  21. Bruun L, Savage C, Cronin A, Hugosson J, Lilja H, Christensson A. Increase in percent free prostate-specific antigen in men with chronic kidney disease. Nephrol Dial Transplant. 2009;24:1238-41 pubmed publisher
  22. Przybylowski P, Malyszko J, Malyszko J. Chronic kidney disease in prevalent orthotopic heart transplant recipients using a new CKD-EPI formula. Ann Transplant. 2010;15:32-5 pubmed
    ..New CKD-EPI formula seems to more accurate in assessment kidney function that previously used, however, it merits further studied and validation against gold standard of isotope GFR measurement. ..
  23. Abe M, Okada K, Maruyama T, Matsumoto S, Matsumoto K. Blood pressure-lowering and antiproteinuric effect of switching from high-dose angiotensin receptor blockers to normal-dose telmisartan and low-dose hydrochlorothiazide in hypertensive patients with chronic kidney disease. Int J Clin Pharmacol Ther. 2010;48:206-13 pubmed
    ..Further investigation would be required to assess whether the combination of high-dose ARBs and low-dose HCTZ has a greater antiproteinuric effect than the combination of normal-dose telmisartan (40 mg) and low-dose HCTZ (12.5 mg). ..
  24. Mende C. Application of direct renin inhibition to chronic kidney disease. Cardiovasc Drugs Ther. 2010;24:139-49 pubmed publisher
    ..Early data based on urinary protein excretion rates as a surrogate marker for renal function suggest a possibly novel role for aliskiren alone or in combination with ARBs in chronic kidney disease. ..
  25. Turner S, Onalan O, Bickle B. Prevention of death in chronic kidney disease: the role of implantable cardioverter defibrillators. CANNT J. 2009;19:29-36; quiz 37-8 pubmed
    ..This article discusses the ICD as it relates to CKD patients, including care of the patient and possible complications that can be encountered. ..
  26. Chang H, Tung C, Lee P, Lei C, Hsu Y, Chang H, et al. Hyperuricemia as an independent risk factor of chronic kidney disease in middle-aged and elderly population. Am J Med Sci. 2010;339:509-15 pubmed publisher
    ..Hyperuricemia is an independent risk factor for CKD in middle-aged and elderly Taiwanese adults. Thus, an effective screening program that identifies people with hyperuricemia is warranted. ..
  27. Gudbjartsson D, Holm H, Indridason O, Thorleifsson G, Edvardsson V, Sulem P, et al. Association of variants at UMOD with chronic kidney disease and kidney stones-role of age and comorbid diseases. PLoS Genet. 2010;6:e1001039 pubmed publisher
    ..0064), and suggestively with gout. In contrast to CKD, the UMOD variant confers protection against kidney stones when studied in 3,617 Icelandic and Dutch kidney stone cases and 43,201 controls (OR = 0.88, P = 5.7 x 10(-5))...
  28. Campbell R, Sui X, Filippatos G, Love T, Wahle C, Sanders P, et al. Association of chronic kidney disease with outcomes in chronic heart failure: a propensity-matched study. Nephrol Dial Transplant. 2009;24:186-93 pubmed publisher
    ..09-1.40; P = 0.001) and 1.42 (95% CI, 1.16-1.72; P = 0.001). CKD was associated with increased mortality and hospitalization in ambulatory patients with chronic HF, which increased progressively with worsening kidney function. ..
  29. Cirillo P, Gersch M, Mu W, Scherer P, Kim K, Gesualdo L, et al. Ketohexokinase-dependent metabolism of fructose induces proinflammatory mediators in proximal tubular cells. J Am Soc Nephrol. 2009;20:545-53 pubmed publisher
    ..Fructose increased intracellular uric acid, and uric acid induced production of MCP-1 as well. In summary, postprandial concentrations of fructose stimulate redox- and urate-dependent inflammatory mediators in proximal tubular cells. ..
  30. Horio T, Iwashima Y, Kamide K, Tokudome T, Yoshihara F, Nakamura S, et al. Chronic kidney disease as an independent risk factor for new-onset atrial fibrillation in hypertensive patients. J Hypertens. 2010;28:1738-44 pubmed publisher
  31. Fishman M, McLaughlin M, Fuster V. Chronic renal insufficiency, cardiovascular disease and mortality in women: a causal relationship or coincidence?. Womens Health (Lond). 2009;5:617-23 pubmed publisher
  32. Akalin F, Demirel B, Urenden P, Biyikli N. Quadricuspid aortic valve diagnosed by transthoracic echocardiography in childhood. Turk J Pediatr. 2010;52:339-41 pubmed
    ..We herein present an eight-year-old girl found to have a quadricuspid aortic valve during evaluation of chronic renal disease and systemic hypertension. ..
  33. Foley R. Phosphate levels and cardiovascular disease in the general population. Clin J Am Soc Nephrol. 2009;4:1136-9 pubmed publisher
    ..Even as proof-of-concept trials and mechanistic studies are awaited, phosphate levels may be useful for cardiovascular risk stratification in adults without overt kidney disease. ..
  34. Ivancic V, Defoor W, Jackson E, Alam S, Minevich E, Reddy P, et al. Progression of renal insufficiency in children and adolescents with neuropathic bladder is not accelerated by lower urinary tract reconstruction. J Urol. 2010;184:1768-74 pubmed publisher
    Children with chronic renal insufficiency and neuropathic bladder resistant to medical management may require lower urinary tract reconstruction before renal transplantation...
  35. Ojeda N, Grigore D, Alexander B. Intrauterine growth restriction: fetal programming of hypertension and kidney disease. Adv Chronic Kidney Dis. 2008;15:101-6 pubmed publisher
    ..Experimental studies support this observation and indicate that cardiovascular/kidney disease originates in response to fetal adaptations to adverse conditions during prenatal life. ..
  36. Appel L, Wright J, Greene T, Agodoa L, Astor B, Bakris G, et al. Intensive blood-pressure control in hypertensive chronic kidney disease. N Engl J Med. 2010;363:918-29 pubmed publisher
    ..Funded by the National Institute of Diabetes and Digestive and Kidney Diseases, the National Center on Minority Health and Health Disparities, and others.) ..
  37. Nakamura S, Ishibashi Ueda H, Niizuma S, Yoshihara F, Horio T, Kawano Y. Coronary calcification in patients with chronic kidney disease and coronary artery disease. Clin J Am Soc Nephrol. 2009;4:1892-900 pubmed publisher
    ..It was concluded that CAC was present in the intimal plaque of both nonrenal and renal patients. Renal function and traditional risks were linked to initimal calcification. Medial calcification occurred only in CKD patients. ..
  38. Huang C, Ma G, Tao M, Ma X, Liu Q, Feng J. The relationship among renal injury, changed activity of renal 1-alpha hydroxylase and bone loss in elderly rats with insulin resistance or Type 2 diabetes mellitus. J Endocrinol Invest. 2009;32:196-201 pubmed
  39. Agrawal V, Shah A, Rice C, Franklin B, McCullough P. Impact of treating the metabolic syndrome on chronic kidney disease. Nat Rev Nephrol. 2009;5:520-8 pubmed publisher
  40. Landim M, Casella Filho A, Chagas A. Asymmetric dimethylarginine (ADMA) and endothelial dysfunction: implications for atherogenesis. Clinics (Sao Paulo). 2009;64:471-8 pubmed
    ..research studies suggest that the increase in asymmetric dimethylarginine occurs in the context of chronic renal insufficiency, dyslipidemia, high blood pressure, diabetes mellitus, and hyperhomocysteinemy, as well as with other ..
  41. Singh V, Rai N, Pandhija S, Rai A, Rai P. Investigation of common Indian edible salts suitable for kidney disease by laser induced breakdown spectroscopy. Lasers Med Sci. 2009;24:917-24 pubmed publisher
    ..The results of the quantitative elemental analysis of the salts obtained from LIBS measurements are also compared to atomic absorption spectroscopy (AAS)...
  42. Przybylowski P, Malyszko J, Malyszko J. Prevalence of chronic kidney disease is extremely high in heart transplant recipients. Transplant Proc. 2009;41:3239-41 pubmed publisher
    ..Evaluation of renal function is important to select the appropriate technique to reduce cardiovascular risk. A multidisciplinary approach in heart transplant recipients should include a nephrologist. ..
  43. Yi S, Contreras G, Miller E, Appel L, Astor B. Correlates of N-terminal prohormone brain natriuretic peptides in African Americans with hypertensive chronic kidney disease: the African American Study of Kidney Disease and Hypertension. Am J Nephrol. 2009;29:292-8 pubmed publisher
    ..These results suggest that these processes are associated with increased NT-proBNP in CKD and may play a role in the development of heart failure. ..
  44. Gangji A, Brimble K, Margetts P. Association between markers of inflammation, fibrosis and hypervolemia in peritoneal dialysis patients. Blood Purif. 2009;28:354-8 pubmed publisher
    ..The link between inflammation and hypervolemia has not been extensively studied. The aim of this study was to determine if an association exists between hypervolemia and markers of inflammation in PD patients...
  45. George J, Agarwal A. Hydrogen: another gas with therapeutic potential. Kidney Int. 2010;77:85-7 pubmed publisher
  46. Vaziri N, Bai Y, Yuan J, Said H, Sigala W, Ni Z. ApoA-1 mimetic peptide reverses uremia-induced upregulation of pro-atherogenic pathways in the aorta. Am J Nephrol. 2010;32:201-11 pubmed publisher
    ..These abnormalities are attenuated by ApoA-1 mimetic peptide, pointing to its protective effect in CKD. Future studies are needed to explore the effect of these peptides in CKD patients. ..
  47. Anderson S, Halter J, Hazzard W, Himmelfarb J, Horne F, Kaysen G, et al. Prediction, progression, and outcomes of chronic kidney disease in older adults. J Am Soc Nephrol. 2009;20:1199-209 pubmed publisher
    ..Answers to emerging research questions will support the integration of geriatrics and nephrology and thus improve care for older patients at risk for chronic kidney disease. ..
  48. Amini M, Salarifar M, Amirbaigloo A, Masoudkabir F, Esfahani F. N-acetylcysteine does not prevent contrast-induced nephropathy after cardiac catheterization in patients with diabetes mellitus and chronic kidney disease: a randomized clinical trial. Trials. 2009;10:45 pubmed publisher
    ..3%) patients in the placebo group (P = 0.656). There was no detectable benefit for the prophylactic administration of oral NAC over an aggressive hydration protocol in patients with DM and CKD. NCT00808795. ..
  49. Hirsch S. Renin-angiotensin system inhibitors in proteinuric chronic kidney disease. Compr Ther. 2009;35:91-5 pubmed
    ..Renin-angiotensin inhibitors are effective in slowing the progression of chronic proteinuric kidney disease. These medicines should be used in preference to anti-hypertensives that do not provide renoprotection. ..
  50. Jozwiak L, Jaroszynski A, Baranowicz Gaszczyk I, Borowicz E, Ksiazek A. [Pseudo-Bartter syndrome--2 cases]. Przegl Lek. 2010;67:222-4 pubmed
    ..These disorders are called pseudo-Bartter syndrome. In this paper we present 2 cases of pseudo-Bartter syndrome related among to other things to overuse of diuretic drugs. ..
  51. Maccluer J, Scavini M, Shah V, Cole S, Laston S, Voruganti V, et al. Heritability of measures of kidney disease among Zuni Indians: the Zuni Kidney Project. Am J Kidney Dis. 2010;56:289-302 pubmed publisher
    ..2 in 2 or more of 3 spot urine samples or estimated GFR was decreased according to the CRIC (Chronic Renal Insufficiency Cohort) Study criteria. Kidney disease was identified in 192 participants (23.4%)...
  52. Himmelfarb J, Shankland S. Creating research infrastructure and functionality to address chronic kidney disease: the Kidney Research Institute. Semin Nephrol. 2009;29:457-66 pubmed publisher
  53. Fried L, Katz R, Cushman M, Sarnak M, Shlipak M, Kuller L, et al. Change in cardiovascular risk factors with progression of kidney disease. Am J Nephrol. 2009;29:334-41 pubmed publisher
    ..Cardiovascular risk factors and kidney function may change concurrently. This could lead to an increased risk of cardiovascular disease as kidney function worsens. ..