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Non-traditional barriers to participation in pharmacologic chronic kidney disease clinical trials
(Springer Science and Business Media LLC, 2025)
Cojuc-Konigsberg, Gabriel
;
Braverman-Poyastro, Alan
;
Canaviri-Flores, Vianca Anabel
;
Fuentes Cepeda, Alejandra de las
;
Rodríguez-Paniagua, Briana Mariette
Background: The Agenda for Sustainable Development agenda prioritizes access to care for non-communicable diseases, including chronic kidney disease (CKD), and sustainable cities and communities. City-level health may impact local research capacity and subsequent participation in randomized controlled trials (RCTs). We identified city-level barriers to CKD RCT participation in the cities from the Global Observatory of Healthy and Sustainable Cities (GOHSC). Methods: We conducted a cross-sectional study of 214 drug CKD RCTs (2003–2023) with participants spanning 146 GOHSC sites. We queried open datasets to retrieve relevant financial, urban, healthcare, and nephrology-related indicators. We designed a CKD research capacity scale incorporating six variables: population-weighted RCTs, sites per sqkm, funding, site span, facility type, RCTs per site. We classified research capacity as absent (0–1 points), insufficient (2–4), fair (6–7), good (7–8), or excellent (9–10) and compared indicators between research capacity categories. Results: Of the included cities, Odense had the highest population-weighted RCT count (7.01 RCTs per 100,000 population), and Mexico City had the lowest (0.06 RCTs per 100,000 population). Cities with good or excellent research capacity had higher health expenditures, nephrologists, and dialysis centers per million population than cities with absent or insufficient research capacity. In cities with good or excellent research capacity, the most prevalent type of insurance coverage for CKD was public, whereas mixed financing was the most frequent type in cities with absent or insufficient research capacity. Among the identified non-traditional barriers to CKD RCT participation, daily living score, access to public transport, access to open spaces, and access to a fresh food market were higher in cities with good or excellent research capacity, compared to those with lower research capacity scores. Conclusions: We found differences in CKD research capacity across the cities included in the GOHSC Study Collaboration, which may be affected by financial, socio-demographic, healthcare, and nephrology-related barriers. Local, regional, and international initiatives should address distinctive local variations to enhance CKD research capacity. ©The authors ©Springer
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Development and validation of a questionnaire to assess the health related Social Capital for Chronic Kidney Disease among Mexican adolescents
(Public Library of Science (PLoS), 2025)
Quiñones-Villalobos, Carolina
;
Prado-Aguilar, Carlos Alberto
;
Obrador, Gregorio
;
Arreola-Guerra, José Manuel
;
Padilla-López, Jannett
Background: Social Capital on health has been studied widely, to date there is no valid and reliable questionnaire that measure it in Chronic Kidney Disease (CKD). Objective: To develop, validate and assess the reliability of Social Capital related to CKD questionnaire for Mexican adolescents. Methods: An instrumental study was employed to validate a questionnaire that assesses the cognitive and structural domains of Social Capital related to CKD. The questionnaire was generated by operationalization of the constructs and validated by assessing the content, face validity, criteria and construct validity. Reliability was assessed through the Cronbach´s alpha. Results: The content validity of the questionnaire was confirmed through Kendall’s W of 0.925 (p = 0.01) and its face validity was evaluated by four focus groups. A principal component analysis on a sample of 281 adolescents indicated that 72.78% of the variance was explained by the cognitive domain and 83.20% by the structural domain. A confirmatory analysis returned a chi-squared value of 142.99 (p = 0.05), a CFI of 0.97, a TLI of 0.96, a RMSEA of 0.040 and a SRMR of 0.07 for the cognitive domain. Similarly, a chi-squared of 408.296 (p < 0.001), a CFI of 0.98, a TLI of 0.97, a RMSEA 0.03 and a SRMR of 0.06 were returned for the structural domain. The validity of the criteria was assessed through a Pearson’s correlation for both the cognitive and structural domains. There was a mild-to-strongly significant correlation (p ≤ 0.001) among items and dimensions within each domain, with correlation coefficients ranging from 0.23 to 0.83. As a determinant of the reliability of the questionnaire, the Cronbach’s alpha was 0.84 and 0.94 for the cognitive and structural domain, respectively. Conclusions: A valid and reliable questionnaire has been developed to measure the influence of Social Capital on health in relation to CKD among Mexican adolescents. ©The authors ©Public Library of Science (PLoS) ©PLOS One.
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Epidemiology of Kidney Disease in the Elderly
(Springer Nature Switzerland, 2024)
Obrador, Gregorio
Concomitant with population aging, kidney disease incidence and prevalence among the elderly is growing globally. The prevalence of chronic kidney disease (CKD) increases with age and is higher in women than in men. Impaired kidney function in older people is associated with adverse outcomes. Older people are more likely to die than to reach kidney replacement therapy. Discontinuation of maintenance dialysis is frequent and a leading cause of death. Kidney transplant recipients in recent years are older than in the past on average. Conservative kidney management is an alternative therapy for end-stage kidney disease, and is especially suited for older patients with multiple comorbid conditions. Elderly patients have many risk factors for developing acute kidney injury, increasing the risk of chronic kidney disease, kidney failure, and mortality. The prevalence of glomerular diseases in the elderly is growing and faces significant diagnostic and therapeutic challenges. © The author © Springer.

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