Even a slight decrease in kidney function raises health risks in young adults.

A study of more than 8 million adults in Ontario, Canada suggests that even a modest loss of kidney function is associated with increased health risks. The study could lead to better approaches to preventing chronic kidney disease and related conditions, particularly in younger adults.

The research team examined ICES health record data from 2008 to 2021 for every Ontario adult aged 18-65 who had at least one blood test for kidney function, but no history of kidney disease. They found that 18% of those in the 18-39 age group had kidney function that was modestly below normal levels, but not low enough to be diagnosed with chronic kidney disease. Individuals in this “grey zone” faced a modestly increased risk of kidney failure, death, and cardiovascular events such as heart attack.

For example, in young adults (age 18-39), a 20-30% loss in kidney function was associated with a 1.4-fold increase in death, a 1.3-fold increase in a cardiac event, and a 6-fold increase in the risk of kidney failure. However, the absolute risk of any of these events was still low at less than 2 per 1000.

While the test for kidney function (blood creatine) is relatively inexpensive and readily available, the researchers are not suggesting routine testing for all individuals at this time. However, if an individual has had a kidney test that shows a modest reduction in function, it can be a catalyst for a conversation with a healthcare provider. All individuals can also reduce their risk of kidney disease by eating a healthy diet with lower salt, exercising regularly, and limiting alcohol intake.

Reference: Associations between modest reductions in kidney function and adverse outcomes in young adults: retrospective, population-based cohort study. Junayd Hussain, Nicholas Grubic, Ayub Akbari, Mark Canney, Meghan J Elliott, Pietro Ravani, Peter Tanuseputro, Edward G Clark, Gregory L Hundemer, Tim Ramsay, Navdeep Tangri, Greg A Knoll, Manish M Sood. BMJ 2023;381:e075062.