medRxiv - Nephrology最新文献

{"title":"Total plasma cfDNA methylation in kidney transplant recipients provides insight into acute allograft rejection pathophysiology","authors":"Benjamin L Spector, Boryana S Koseva, Drinnan Sante, Warren A Cheung, Reid S Alisch, Alexander Kats, Phillip Bergmann, Elin Grundberg, Gerald J Wyckoff, Laurel K Willig","doi":"10.1101/2024.08.17.24312147","DOIUrl":"https://doi.org/10.1101/2024.08.17.24312147","url":null,"abstract":"Background: Acute rejection threatens kidney allograft longevity. Cell-free DNA (cfDNA) is a real-time marker of organ injury and immune response. Donor-derived cfDNA (dd-cfDNA) has been leveraged as a biomarker of rejection, however, its reliability as a screening tool is unclear. DNA methylation is an epigenetic marker that informs regulatory element activity. We aim to elucidate differential methylation of total plasma cfDNA derived from pediatric kidney transplant recipients in the presence compared to absence of acute rejection. In doing so, we hope to exploit the property of cfDNA as a real-time biomarker and build on available testing to identify genes and processes participating in acute rejection pathophysiology in kidney transplantation.\u0000Methods: Twenty plasma cfDNA samples from pediatric kidney transplant recipients were collected at the time of allograft biopsy. Using whole genome bisulfite sequencing, differentially methylated CpG residues (≥20% difference in methylation rate, q-value <0.05) were identified in presence (N = 7) vs absence (N = 9) of acute rejection. Separate analyses were performed comparing those with borderline rejection (N = 4) to those with rejection, and to those without rejection. Differentially methylated cytosines were then assessed for gene associations and pathway enrichments.\u0000Results: In the comparison of acute rejection to non-rejection samples, there were 34,356 differentially methylated cytosines corresponding to 1,269 associated genes, and 533 enriched pathways. These numbers were all substantially greater (4-13x) than the comparisons made between acute rejection against those with borderline rejection, and between non-rejection against borderline rejection. Prominently enriched pathways between samples of individuals with and without acute rejection were related to immune cell regulation, inflammatory response, lipid metabolism, and tryptophan-kynurenine metabolism. Conclusions: Our data suggest methylation plays a role in development of or response to acute kidney allograft rejection. Specifically, differentially methylated pathways associated with acute rejection include those related to immune and inflammatory responses.","PeriodicalId":501513,"journal":{"name":"medRxiv - Nephrology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142177793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of vascular access among chronic kidney disease patients on maintenance hemodialysis at Muhimbili National Hospital. A single centre cross-sectional study","authors":"Daniel Msilanga, Jacqueline Shoo, Jonathan Mngumi","doi":"10.1101/2024.08.16.24312124","DOIUrl":"https://doi.org/10.1101/2024.08.16.24312124","url":null,"abstract":"Background: Hemodialysis access profoundly impacts the quality of care for chronic kidney disease (CKD) patients worldwide, with arteriovenous fistulas (AVFs) preferred for superior outcomes. Despite global guidelines, Sub-Saharan Africa, including Tanzania, faces challenges, as it relies heavily on nontunneled central venous catheters (CVCs) due to accessibility and financial constraints. We aimed to describe the pattern of vascular access use among CKD patients on maintenance hemodialysis at Muhimbili National Hospital.\u0000Methods: A cross-sectional study to describe the pattern of vascular access among patients with CKD on maintenance hemodialysis therapy. Descriptive statistics were used to summarize the baseline characteristics and patterns of vascular access.\u0000Results: We analysed 200 study participants, with a mean age of 53.3 (14.5) years. Almost all participants initiated hemodialysis with nontunneled central venous catheters (95.5%). A substantial portion continued to use nontunneled CVCs (25.5%), with some transitioning to tunneled CVCs (39.5%) or AVFs (35%). The mean (SD) duration to use nontunneled CVCs before transitioning to tunneled or AVF were 7.1 (2.1) months. Among patients with multiple nontunneled catheters, catheter dislodgement was the main indication for catheter replacement.\u0000Conclusion:\u0000Our study highlights the prevalent use of nontunneled central venous catheters (CVCs) as the primary vascular access method for CKD patients undergoing hemodialysis at Muhimbili National Hospital, Tanzania. These findings underscore the urgent need for analysis of the cost associated with nontunneled catheter reliance and interventions to improve access to AVFs and enhance vascular access management, ultimately optimizing patient outcomes in resource-limited settings.","PeriodicalId":501513,"journal":{"name":"medRxiv - Nephrology","volume":"10891 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142177765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary extracellular vesicles in healthy individuals: positive correlation between podocyte and tubular vesicles independent of kidney function","authors":"Liang Wu, Carla C. Baan, Derek Reijerkerk, Dennis A. Hesselink, Karin Boer","doi":"10.1101/2024.08.04.24311469","DOIUrl":"https://doi.org/10.1101/2024.08.04.24311469","url":null,"abstract":"Urinary extracellular vesicles (uEVs) are promising non-invasive biomarkers for assessing renal physiology and disease. Focusing specifically on kidney-derived uEVs (kd-uEVs) rather than the overall uEV population may offer a more precise insight into kidney health. However, research distinguishing single kd-uEVs from various nephron segments and their relationship with kidney biology remains limited. Imaging flow cytometry (IFCM) can identify single kd-uEVs by labeling them with CD63 (a uEV marker) in combination with PODXL (a podocyte marker) or AQP2 (a tubular marker). This study investigated the correlations between CD63+ AQP2+ or PODXL+ kd-uEVs and kidney function. CD63+ AQP2+ and CD63+ PODXL+ uEVs were detected in urine compared to negative controls, including urine with detergent treatment or isotype staining and reagent-containing PBS. While no significant association was found between CD63+ AQP2+ or PODXL+ uEV concentration and kidney function, a significant correlation was observed between AQP2+ and PODXL+ uEV concentrations (Rho = 0.789, p < 0.001). This correlation could be explained by the colocalization of AQP2 and PODXL on CD63+ uEVs. In conclusion, our study is the first to demonstrate the colocalization of podocyte and tubular proteins on uEVs.","PeriodicalId":501513,"journal":{"name":"medRxiv - Nephrology","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141949321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with Acute Kidney Injury in COVID-19 Hospitalized Patients in Central Java, Indonesia","authors":"Dwi Lestari Partiningrum, Melissa Angela Chionardes, Nurul Hasanah Yusri, Indra Adhim Karunia Aji, Jonathan Christianto Subagya, Aldrich Kurniawan Liemarto","doi":"10.1101/2024.07.30.24311116","DOIUrl":"https://doi.org/10.1101/2024.07.30.24311116","url":null,"abstract":"Backgroud and Objective: Acute kidney injury (AKI) is a significant complication of COVID-19 infection, with varied incidence rates globally. COVID-19 has exacerbated AKI cases, with a significant portion of patients experiencing kidney damage. This study investigates the prevalence and risk factors associated with AKI among COVID-19 patients in Semarang, Central Java, Indonesia. Methods: Data from 364 hospitalized COVID-19 patients in a hospital in Semarang between March 2020 and September 2021 were analyzed. Statistical analysis using chi-square and logistic regression examined the relationship between AKI and its determinants, with p≤0.05 considered significant. Results: The majority of patients were male, most had no prior medical conditions. Analysis indicated links between AKI and various factors like several physical and supportive examination results. Few comorbidities were found to increase the risk of AKI, followed also by abnormal vital signs except blood pressure, several elevated level of laboratory results, and radiologic pneumonia finding. Conclusion: COVID-19 may harm the kidneys causing AKI. This study highlights the importance of history taking, examination, and laboratory monitoring to detect AKI in COVID-19 patients.","PeriodicalId":501513,"journal":{"name":"medRxiv - Nephrology","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141871443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A study of the visualization of artificial intelligence applications in chronic kidney disease in the literature over the last 20 years","authors":"Yudi Li, ying ding, Yan Xu, Haoji Meng, Hongji Wu, Donglin Li, Yibo Hu","doi":"10.1101/2024.07.10.24310252","DOIUrl":"https://doi.org/10.1101/2024.07.10.24310252","url":null,"abstract":"Chronic kidney disease (CKD) is a global public health problem characterized by persistent kidney damage or loss of kidney function. Previously, the diagnosis of CKD has mainly relied on serum creatinine and estimation of the glomerular filtration rate. However, with the development and progress of artificial intelligence (AI), AI has played different roles in various fields, such as early diagnosis, progression prediction, prediction of associated risk factors, and drug safety and efficacy evaluation. Therefore, research related to the application of AI in the field of CKD has become a hot topic at present. Therefore, this study adopts a bibliometric approach to study and analyze the development and evolution patterns and research hotspots of AI-CKD. English publications related to the field between January 1, 2004, and June 27, 2024, were extracted from the Web of Science Core Collection database. The research hotspots and trends of AI-CKD were analyzed at multiple levels, including publication trends, authors, institutions, countries, references and keywords, using VOSviewer and CiteSpace. The results showed that a total of 203 publications on AI-CKD were included in the study, of which Barbieri Carlo from the University of Milan, Italy, had the highest number of publications (NP=5) and had a high academic impact (H-Index=5), while the USA and its institution, the Mayo Clinic, were the publications. The USA and its Mayo Clinic are the countries and institutions with the highest number of publications, and China is the country with the second highest number of publications, with three institutions attributed to China among the top five institutions. Germany's institution, Fresenius Medical Care, has the highest academic impact (H-index=6). Keyword analysis yielded artificial intelligence, chronic kidney disease, machine learning, prediction model, risk, deep learning, and other keywords with high frequency, and cluster analysis based on the timeline yielded a total of 8 machine learning, deep learning, retinal microvascular abnormality, renal failure, Bayesian network, anemia, bone disease, and allograft nephropathology clusters. This study provides a comprehensive overview of the current state of research and global frontiers of AI-CKD through bibliometric analysis. These findings can provide a valuable reference and guidance for researchers.","PeriodicalId":501513,"journal":{"name":"medRxiv - Nephrology","volume":"81 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141613250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical, immune and genetic risk factors of malaria-associated acute kidney injury in Zambian Children: A study protocol","authors":"chisambo Mwaba, sody munsaka, David mwakazanga, David Rutagwera, owen ngalamika, Suzanna Mwanza, Mignon McCulloch, Evans Mpabalwani","doi":"10.1101/2024.07.10.24310193","DOIUrl":"https://doi.org/10.1101/2024.07.10.24310193","url":null,"abstract":"Background\u0000Acute kidney injury (AKI) affects nearly half of children with severe malaria and increases the risk of adverse outcomes such as death and poor cognitive function. The pathogenesis and predictors of malaria associated acute kidney injury (MAKI) are not fully described. This study aims to determine the clinical, immune, and genetic correlates of risk to AKI in Zambian children admitted with malaria. In addition, we intend to assess a modified renal angina index (mRAI), kidney injury molecule 1 (KIM 1), neutrophil gelatinase-associated lipocalin (NGAL)) and soluble urokinase receptor (suPAR), when done on the first day of admission, for ability to predict AKI 48 hours later (day 3) in children admitted with malaria. Methods\u0000This is an unmatched case-control study, with a case to control ratio of 1:1, in which 380 children with malaria and aged less than 16 years are being recruited from two hospitals in Zambia. Eligible children are recruited after obtaining written informed consent. Recruitment began 6th March,2024 and will continue until July 2025. AKI is defined using the 2012 KIDGO AKI creatinine criteria and cases are defined as children admitted with malaria who develop AKI within 72 hours of admission while controls are children admitted with malaria but with no AKI. Serum creatinine is collected on day 1 within 24hours of admission and then again on Day 3 post admission. Baseline biomarker concentrations will be determined using the Luminex multiplex Elisa system or high-sensitivity ELISA. SPSS version 29 will be used for data analysis. Descriptive statistics and inferential statistical tests will be run as appropriate. A p ≤ 0.05 will be considered as significant. The utility of the renal angina score for predicting MAKI will be assessed using sensitivity, specificity, and estimates of the area under the curve (AUC).","PeriodicalId":501513,"journal":{"name":"medRxiv - Nephrology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141584850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kidney transcriptomics signature of prospective rapid diabetic kidney disease progression","authors":"Dianne Acoba, Anna Levin, Anna Witasp, Kerstin Ebefors, Johan Mölne, Peter J. Greasley, Jenny Nyström, Annika Wernerson, Anna Reznichenko","doi":"10.1101/2024.07.03.24309831","DOIUrl":"https://doi.org/10.1101/2024.07.03.24309831","url":null,"abstract":"Previous cross-sectional transcriptomic studies on diabetic kidney disease (DKD) kidney tissue have shown correlations between gene expression and both disease status and kidney function at time of biopsy, but longitudinal data is scarce. We utilized clinical follow-up data up to five years post-biopsy, linking the transcriptomes of diagnostic kidney biopsies to progression rates and outcomes in 19 DKD patients. Patients were stratified into \"rapid progressors\" and \"non-rapid progressors\" based on clinical parameters (eGFR slope, CKD stage advancement, degree of albuminuria, composite of kidney failure or 40% eGFR decline). Differential expression and pathway enrichment analyses were performed to identify dysregulated genes and pathways associated with rapid progression. We identified 265 genes in glomeruli and tubulointerstitium that were significantly modulated in rapid vs non-rapid DKD progression. Rapid progression-associated genes showed enrichment for well-established (extracellular matrix organization, inflammation) as well as novel pathways in the context of DKD (circadian rhythm, cytoskeleton reorganization, NOTCH signaling). This study illuminates kidney gene expression patterns that may be predictive of rapid progression in DKD and are distinct from those associated with cross-sectional kidney function.","PeriodicalId":501513,"journal":{"name":"medRxiv - Nephrology","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141551368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined pre-dialysis systolic blood pressure and pulse rate assessment for all-cause and cardiovascular mortalities: A nationwide cohort study on patients undergoing haemodialysis","authors":"Nobuhiko Joki, Tatsunori Toida, Kakuya Niihata, Ryohei Inanaga, Kenji Nakata, Masanori Abe, Norio Hanafusa, Noriaki Kurita","doi":"10.1101/2024.06.30.24309750","DOIUrl":"https://doi.org/10.1101/2024.06.30.24309750","url":null,"abstract":"Background and Aims\u0000The prognostic utility of the combined assessment of pre-haemodialysis systolic blood pressure (SBP) and pulse rate (PR) compared with their individual assessment is unclear. This study aimed to determine whether the combined assessment could enhance the prognostic utility in patients on haemodialysis.\u0000Methods\u0000This nationwide cohort study involved patients undergoing maintenance haemodialysis using the Japanese Renal Data Registry database. Exposure was defined as a combination of SBP and PR. Forty-eight levels of exposure groups were created: SBP (six levels; <100, 100-<120, 120-<140, 140-<160 [reference], 160-<180, and ≥180 mmHg) and PR (eight levels; <50, 50-<60, 60-<70 [reference], 70-<80, 80-<90, 90-<100, 100-<110, and ≥110 per minute). The primary and secondary outcomes were one-year all-cause and cardiovascular mortalities, respectively. Multivariate Cox proportional hazards models were used, and multiplicative interactions were assessed to determine the superiority of the combined model over the individual models. Additive interactions were assessed using relative excess risk due to interactions (RERI).\u0000Results\u0000The combined model explained mortality and cardiac mortality better than the individual SBP and PR models (P<0.001 and P<0.002, respectively). A lower SBP was associated with a higher risk of all-cause mortality regardless of the PR. Most categories of lower SBP or higher PR vs. the 120-<140 mmHg and 70-<80/min category had positive RERIs. Similar findings were also observed for cardiac mortality. Conclusions\u0000The combined assessment of pre-dialysis SBP and PR may help in the simple stratification of patients with excess risks that cannot be identified by individual SBP or PR assessment.","PeriodicalId":501513,"journal":{"name":"medRxiv - Nephrology","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141502309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multi-phenotype approach implicates SH2B3 in the genetics of chronic kidney disease","authors":"Kim Ngan Tran, Heidi Sutherland, Andrew Mallett, Lyn Griffiths, Rodney Lea","doi":"10.1101/2024.06.29.24309709","DOIUrl":"https://doi.org/10.1101/2024.06.29.24309709","url":null,"abstract":"Chronic kidney disease (CKD) is a complex condition with diverse underlying causes that lead to a progressive decline in kidney function. Genome-wide association studies (GWASs) have identified numerous genetic loci associated with CKD, yet much of the genetic basis remains unexplained. Part of the reason is that most GWASs have only assessed kidney function via single biomarkers such as estimated glomerular filtration rate (eGFR). This study employs a novel multi-phenotype approach, combinatorial Principal Component Analysis (cPCA), to better understand the genetic architecture of CKD. Utilizing a discovery cohort of white British individuals from the UK Biobank (n=337,112), we analyzed 21 CKD-related phenotypes using cPCA to generate over 2 million composite phenotypes (CPs). More than 46,000 CPs demonstrated superior performance in classifying clinical CKD compared to any single biomarker, and those CPs were most frequently comprised of eGFR, cystatin C, HbA1c, microalbuminuria, albumin, and LDL. GWASs of the top 1,000 CPs revealed seven novel genetic loci, with CST3 and SH2B3 successfully replicated in an independent Irish cohort (n=11,106). Notably, the index SNP of the SH2B3 gene, which encodes a regulator in immune responses and cytokine signaling, is a loss-of-function variant with a combined beta of -0.046 and a p-value of 3.1E-56. These results highlight the effectiveness of a multi-phenotype approach in GWASs and implicate a novel functional variant in SH2B3 in CKD phenotypes.","PeriodicalId":501513,"journal":{"name":"medRxiv - Nephrology","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141517756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High burden of chronic kidney disease of unknown cause among patients receiving renal replacement therapy in Northeast Nigeria: A cross-sectional survey of haemodialysis units.","authors":"Baba Waru Goni, Hamidu Suleiman Kwairanga, Aliyu Abdu, Ibrahim Ummate, Alhaji Abdu, Ahmed Ibrahim Ba'aba, Mohammad Maina Sulaiman, Loskurima Umar, Gana M.L, Aliyu Abdulkadir, Amin Oomatia, Mahmoud Bukar Maina, Neil Pearce, Ben Caplin","doi":"10.1101/2024.06.24.24309383","DOIUrl":"https://doi.org/10.1101/2024.06.24.24309383","url":null,"abstract":"Introduction\u0000Chronic kidney disease (CKD) is emerging as a significant public health concern in northeastern Nigeria, particularly in states such as Yobe and Borno. Despite its increasing impact, there is a lack of data characterizing this public health issue. This study aims to explore the prevalence, spatial distribution, and risk factors for CKD among patients receiving haemodialysis (HD) in the region. Methodology\u0000A cross-sectional survey of HD centres in Yobe, Borno, and Jigawa States of Nigeria was conducted. Questionnaire responses were obtained on demographic, social, and clinical data. Spatial analyses were conducted to determine the geographic distribution of the cases. Results\u0000We identified 376 patients receiving HD services across 4 centres. Of these, 207 (55.1%) were male and the mean age was 46.56 plus/minus 16.4. Most patients reside in urban areas (67.6%). The main pre-dialysis occupations included civil service (100 [26.6%]), agriculture (65 [17.3%]), and trading (58 [15.4%]). 'Hypertension' (195 [51.9%]) was the most common self-reported primary renal disease, followed by unknown causes (70 [18.6%]) and Diabetic Kidney Disease (30 [8%]). Regional analysis demonstrated a particularly high burden of disease in Bade and Jakusko Local Government Areas. Discussion and Conclusion\u0000Spatial analysis suggests the existence of a CKD hotspot geographically associated with communities along the River Yobe, raising the possibility of an important environmental cause of disease. This study also highlights the lack of access to adequate diagnosis and geographical clustering of CKD burden in this region. These findings further reinforce the need for population-representative studies to characterize the burden of CKD alongside strategic healthcare interventions and collaboration among stakeholders aimed at improving access to care.","PeriodicalId":501513,"journal":{"name":"medRxiv - Nephrology","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141502241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}