Association between laboratory and clinical risk factors and progression of the predialytic chronic kidney disease

J Bras Nefrol. 2012 Mar;34(1):68-75.
[Article in English, Portuguese]

Abstract

Introduction: Chronic kidney disease (CKD) is a very common condition that has become a public health issue. Knowing more about risk factors associated with the progression of CKD allows therapeutic interventions that may change the natural course of the disease.

Objective: To evaluate the impact of clinical and laboratory variables at admission on the outcomes death and need for renal replacement therapy (RRT).

Methods: A retrospective cohort study comprised of 211 adult patients with stages 3-5 CKD, followed-up for 56.6 ± 34.5 months.

Results: Mean age of patients was 65.4 ± 15.1 years and 63.5% were > 60 years. The main causes of CKD were hypertensive nephrosclerosis (29%) and diabetic kidney disease (DKD) (17%). Most patients (47.3%) were on stage 4 CKD. The mean annual loss of glomerular filtration rate (GFR) was 0.6 ± 2.5 mL/min/1.73 m² (median 0.77 mL/min/1.73 m²) After the adjustments for demographic, clinical and laboratory variables, DKD [relative risk (RR) 4.4; 95% confidence interval (CI), 1.47 to 13.2; p = 0.008] was predictive of RRT; age (RR 1.09; 95% CI, 1.04 to 1.15; p < 0.0001) and the non-treatment with angiotensin receptor blocker (ARB) (RR 4.18, 95% CI, 1.34 to 12.9; p = 0.01) were predictors of death. Renal and patient survival rates were 70.9% and 68.6%, respectively.

Conclusion: In this study, patients with stage 3-5 CKD treated conservatively showed stabilization of renal function and low mortality, which were impacted by DKD, age and to not using ARB, respectively.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Clinical Laboratory Techniques
  • Cohort Studies
  • Disease Progression
  • Female
  • Humans
  • Kidney Failure, Chronic / diagnosis*
  • Kidney Failure, Chronic / therapy
  • Male
  • Middle Aged
  • Renal Dialysis
  • Retrospective Studies
  • Risk Factors