Family history of kidney disease strongly linked to increased CKD risk

In this large population-based family study recently published in the American Journal of Kidney Diseases, researchers investigated the familial aggregation of CKD by comparing the risk of chronic kidney disease (CKD) in individuals with an affected first-degree relative to that in the general population.

Chronic kidney disease is defined by reduced estimated glomerular filtration rate (eGFR) and/or increased albuminuria, and is associated with an increased risk of cardiovascular disease (CVD) and progression to end stage kidney disease (ESKD). Chronic kidney disease (CKD) is recognized as a global public health problem1, with prevalence ranging between 3.3% and 17.3% in adult European populations.

Participants with an affected first-degree relative were observed to have a threefold higher risk of CKD compared to that in the general population, independent of BMI, hypertension, diabetes, hypercholesterolemia, history of cardiovascular disease (CVD), and smoking status.

Familial aggregation of CKD was assessed by calculating the recurrence risk ratio (RRR), using adapted Cox proportional hazards models. Heritability of continuous kidney-related traits was estimated using linear mixed models and defined as the ratio of the additive genetic variance to total phenotypic variance. All models were adjusted for age, sex, and known risk factors for kidney disease.

The authors of this study observed a 1.56 fold higher risk in those with an affected spouse, suggesting that shared environmental factors and/or assortative mating play a role. Heritability of eGFR was considerable (44%), whereas heritability of UAE was moderate (20%). Heritability of kidney related markers and serum electrolytes ranged between 20 and 50%. These results indicate an important role for genetic factors in modulating susceptibility to kidney disease in the general population.