Renal Epidemiology

Renal epidemiology aims to study frequency, distribution and risk factors of kidney diseases. Our research projects focus on chronic kidney disease (CKD) which is characterized by an irreversibly reduced kidney function, assessed by the glomerular filtration rate (GFR). CKD can be progressive over the course of several years and may end in "end stage renal disease" treated with dialysis or kidney transplantation. Nowadays, CKD is regarded as a public health concern, especially since prevalence and incidence rates of the two largest risk factors, diabetes mellitus and hypertension, are increasing.

Of particular interest is the course of kidney function in older adults. One of the main research questions is, whether the often observed mild to moderate decrease of renal function in the elderly is due to actual disease or simply part of senescence. The Berlin Initiative Study (BIS), a prospective, population-based cohort study, includes 2069 older adults at the age of 70 and older (mean age is 80 at entrance) and has been monitoring renal function as well as many other parameters biannually since the end of 2009.

Another topic in this context is the question of how to assess kidney function, the so called "Glomerular Filtration Rate" (GFR) as correctly as possible. Correct assessment of GFR is important as categorization of the individual into the staging system is based on GFR. The staging system itself has clinical implications such as adequate adjustment of drug dosing, improved decision making when applying contrast media for imaging testing, help in the timing of initiation of RRT, evaluation for kidney donation and the psychological and financial aspect of wrongly labeling someone as having CKD. At older age with such high prevalence of CKD, all these clinical scenarios are highly relevant.

Thus, another aim of the Berlin Initiative Study is to find a research method that determines GFR in older adults as precisely and accurately as possible in everyday clinical practice.

Furthermore, at the Institute of Public Health, a regional center of the nationwide German Chronic Kidney Disease (GCKD) study is located. This major national cohort study in patients with renal impairment aims to better understand the causes, effects and consequences of chronic renal disease.