Predictors of Faster Progression in Chronic Kidney Disease
Theerapon Sukmark MD*,
Supanun Sukmark MD**
Affiliation :
* Division of Nephrology, Department of Medicine, Thungsong Hospital, Nakhon Si Thammarat, Thailand
** Department of Ophthalmology, Thungsong Hospital, Nakhon Si Thammarat, Thailand
Objective : To study the factors associated with faster progression in chronic kidney disease.
Material and Method: A cohort study of CKD stage 2 to 4 patients of the CKD clinic at Thungsong Hospital between 2008
and 2011 was done. At the end of the study, the patients were classified as faster or slower group according to rate of GFR
decline. Apart from descriptive analysis, univariate and multivariate analysis were used to perform correlations analysis
between rate of eGFR decline and each variable.
Results : Two hundred three patients were enrolled and followed-up for three years. The average rate of eGFR decline (SD)
was 2.25 (3.65) mL/min/1.73 m2 per year. In univariate analysis, factors that correlated with rate of eGFR decline were
systolic blood pressure (r = 0.155, p = 0.027), serum albumin (r = -0.172, p = 0.042), serum bicarbonate (r = -0.158,
p = 0.046, age (r = -0.157, p = 0.025), and proteinuria (r = 0.276, p<0.001). Furthermore, logistic regression analysis
revealed the strong predictors of faster progression were systolic blood pressure (OR = 1.025, 95% CI = 1.003-1.047,
p = 0.025) and particularly, proteinuria (OR = 1.887, 95% CI = 1.325-2.688, p<0.001).
Conclusion : Among the factors that associated with faster eGFR decline, only systolic blood pressure and especially,
proteinuria were powerful predictors of faster progression in chronic kidney disease.
Keywords : Predictors, Faster progression, Chronic kidney disease (CKD)
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