Studies of novel risk factors associated with chronic kidney disease in ethically diverse, high risk populations

Jesky, Mark David (2018). Studies of novel risk factors associated with chronic kidney disease in ethically diverse, high risk populations. University of Birmingham. Ph.D.

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Abstract

Chronic Kidney Disease (CKD) is common and often has a major impact on the health of those affected. In this thesis I have focused on areas of uncertainty that may have major implications for patient care.

Firstly, I assessed the determinants of increased mortality in a multi-ethnic primary care population. Secondly, I investigated the differential progression of CKD between ethnicities. Thirdly, I assessed if tryptase, as a marker of mast cell activation, could be used to stratify risk in CKD. Finally, I investigated the impact of CKD on health related quality of life (HRQL) and the association between HRQL and clinical end-points.

I found that: (i) comorbidity has a profound impact at a population level on survival in CKD; (ii) albuminuria is the principle modifiable risk factor for progression to end-stage renal disease (ESRD) in people of South Asian ethnicity; (iii) serum tryptase is an independent prognostic factor for ESRD in patients with CKD receiving treatment with an ACEi or ARB; and (iv) Low HRQL is common in CKD and reduced HRQL is associated with a higher risk for death.

The findings from this thesis contribute to the understanding of CKD in ethnically diverse, high-risk populations and form the basis for further studies.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

Supervisor(s):