RICORS2040 : The need for collaborative research in chronic kidney disease

Chronic kidney disease (CKD) is a silent and poorly known killer. The current concept of CKD is relatively young and uptake by the public, physicians and health authorities is not widespread. Physicians still confuse CKD with chronic kidney insufficiency or failure. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. Thus health authorities may consider CKD a non-issue: very few persons eventually need KRT and, for those in whom kidneys fail, the problem is 'solved' by dialysis or kidney transplantation. However, KRT is the tip of the iceberg in the burden of CKD. The main burden of CKD is accelerated ageing and premature death. The cut-off points for kidney function and kidney damage indexes that define CKD also mark an increased risk for all-cause premature death. CKD is the most prevalent risk factor for lethal coronavirus disease 2019 (COVID-19) and the factor that most increases the risk of death in COVID-19, after old age. Men and women undergoing KRT still have an annual mortality that is 10- to 100-fold higher than similar-age peers, and life expectancy is shortened by ~40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth greatest global cause of death by 2040 and the second greatest cause of death in Spain before the end of the century, a time when one in four Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded Centres for Biomedical Research (CIBER) network structure in Spain. Realizing the underestimation of the CKD burden of disease by health authorities, the Decade of the Kidney initiative for 2020-2030 was launched by the American Association of Kidney Patients and the European Kidney Health Alliance. Leading Spanish kidney researchers grouped in the kidney collaborative research network Red de Investigación Renal have now applied for the Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS) call for collaborative research in Spain with the support of the Spanish Society of Nephrology, Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true

Geochemical and Nd isotope compositions of detrital sediments on the north margin of the South China Sea: provenance and tectonic implications

A major re‐organization of regional drainages in eastern Tibet and south‐western China took place in the Cenozoic as deformation from the growing Himalayas and Tibetan Plateau affected an increasingly wider area. The effects of these changes on the regional sediment routing systems is not well constrained. This study examines the geochemical and Nd signatures of sedimentary rocks from the Ying‐Qiong and Nanxiong basins on the northern margin of the South China Sea to constrain and identify any significant changes in sediment source. Upper Cretaceous to Lower Eocene sedimentary rocks in the Nanxiong Basin show higher Th/Sc, La/Sc, Th/Cr and Th/Co ratios and lower Eu/Eu* ratios than PAAS (post‐Archaean Australian Shale), which indicates that Palaeozoic sedimentary rocks of the South China Block were the main basin sediment source. In contrast, Oligocene to Pleistocene sedimentary rocks of the Ying‐Qiong Basin show an abrupt change in these trace‐element ratios between 16·3 and 10·4 Ma, indicating a mid‐Miocene shift in provenance. ɛNd values from the Ying‐Qiong Basin (range = −11·1 to −2·1) reinforce this, with pre‐13·8 Ma sedimentary rocks having average ɛNd of −5·6 (range = −2·1 to −7·4), and post‐13·8 Ma sedimentary rocks having average ɛNd of −9·3 (range = −8·7 to −11·1). During the Oligocene, the centre of rifting transferred south and basins on the north margin of the South China Sea experienced rapid subsidence. Further uplift and erosion then exposed Mesozoic and Cenozoic granites that supplied large amounts of granitic detritus, especially to the Ying‐Qiong Basin. Then a change occurred at ca 13 Ma resulting in less input from local sources (i.e. the fault blocks formed by Mesozoic‐Cenozoic tectonics and magmatism) to an increasing contribution of older continental material, mostly from Indochina to the west of the South China Sea