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A paper published in the journal Nephrology Dialysis Transplantation discusses the importance of diagnostic evaluations for adult patients with recurrent kidney stones. The study found that only a minority of adult patients (2.9%) had a genetic or Mendelian reason for kidney stone formation. However, it emphasizes the necessity of diagnostic evaluations in adults with recurrent nephrolithiasis to prevent complications such as kidney failure. The paper also highlights the need for personalized and cost-effective diagnostic procedures, such as collecting consecutive 24-hour urine samples, to detect stone risk factors. Overall, the study underscores the global healthcare problem of nephrolithiasis and the importance of early diagnosis and treatment. [Extracted from the article]

Background Chronic kidney disease (CKD) is a significant contributor to global morbidity and mortality. This study investigated disparities in age, sex and socio-economic status in CKD and updated global prevalence estimates through systematic review and meta-analysis. Methods Five databases were searched from 2014 to 2022, with 14 871 articles screened, 119 papers included and data analysed on 29 159 948 participants. Random effects meta-analyses were conducted to determine overall prevalence, prevalence of stages 3–5 and prevalence in males and females. Influences of age, sex and socio-economic status were assessed in subgroup analyses and risk of bias assessment and meta-regressions were conducted to explore heterogeneity. Results The overall prevalence of CKD was 13.0% [95% confidence interval (CI) 11.3–14.8] and 6.6% (95% CI 5.6–7.8) for stages 3–5. The prevalence was higher in studies of older populations (19.3% for stages 1–5, 15.0% for stages 3–5) and meta-regression demonstrated an association of age, body mass index, diabetes and hypertension with prevalence of stages 3–5. The prevalence of CKD stages 1–5 was similar in males and females (13.1% versus 13.2%), but the prevalence of stages 3–5 was higher in females (6.4% versus 7.5%). Overall prevalence was 11.4%, 15.0% and 10.8% in low-, middle- and high-income countries, respectively; for stages 3–5, prevalence was 4.0%, 6.7% and 6.8%, respectively. Included studies were at moderate–high risk of bias in the majority of cases (92%) and heterogeneity was high. Conclusion This study provides a comprehensive assessment of CKD prevalence, highlighting important disparities related to age, sex and socio-economic status. Future research should focus on targeted screening and treatment approaches, improving access to care and more effective data monitoring, particularly in low- and middle-income countries. [ABSTRACT FROM AUTHOR]

Background This paper compares the most recent data on the incidence and prevalence of kidney replacement therapy (KRT), kidney transplantation rates, and mortality on KRT from Europe to those from the United States (US), including comparisons of treatment modalities (haemodialysis (HD), peritoneal dialysis (PD), and kidney transplantation (KTx)). Methods Data were derived from the annual reports of the European Renal Association (ERA) Registry and the United States Renal Data System (USRDS). The European data include information from national and regional renal registries providing the ERA Registry with individual patient data. Additional analyses were performed to present results for all participating European countries together. Results In 2021, the KRT incidence in the US (409.7 per million population (pmp)) was almost 3-fold higher than in Europe (144.4 pmp). Despite the substantial difference in KRT incidence, approximately the same proportion of patients initiated HD (Europe: 82%, US: 84%), PD (14%; 13%, respectively), or underwent pre-emptive KTx (4%; 3%, respectively). The KRT prevalence in the US (2436.1 pmp) was 2-fold higher than in Europe (1187.8 pmp). Within Europe, approximately half of all prevalent patients were living with a functioning graft (47%), while in the US, this was one third (32%). The number of kidney transplantations performed was almost twice as high in the US (77.0 pmp) compared to Europe (41.6 pmp). The mortality of patients receiving KRT was 1.6-fold higher in the US (157.3 per 1000 patient years) compared to Europe (98.7 per 1000 patient years). Conclusions The US had a much higher KRT incidence, prevalence, and mortality compared to Europe, and despite a higher kidney transplantation rate, a lower proportion of prevalent patients with a functioning graft. [ABSTRACT FROM AUTHOR]