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Copyright belongs to The Arab Society of Nephrology and Renal Transplantation (ASNRT)
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Natural History of Chronic Kidney Disease Stages 2-4
Abstract
Introduction: Chronic kidney disease (CKD) is a worldwide problem. The majority of patients in stage 3-5 CKD progress relentlessly to end stage renal disease (ESRD). This study aimed to measure the rate of decline in kidney function among a group of CKD patients and to examine risk factors associated with disease progression.
Methods: This is a retrospective study of 300 CKD patients in stages 2-4, that were randomly selected from patients who were on regular follow up in Sheffield kidney institute (SKI), Sheffield, UK, up to June 2007. Patients whose estimated glomerular filtration rate (GFR) declined by more than 1 ml/min/year according to the MDRD formula during a 5-year follow up period were classified as progressors. Baseline parameters that may be associated with a more rapid decline in GFR were evaluated.
Results: Males constituted 57.7% of the study population, one third of patients were older than 65 years of age, 93% were white and 39.7% were diabetic. The study showed that 52.7% of patients had a progressive course of CKD. Gender, old age, ethnicity and diabetic status were not significantly different between progressors and non-progressors. Progressors tended to have higher 24-hour urinary protein excretion (2.6 ± 3.6 versus 1.8 ± 3.5 g/dl) and higher blood pressures measurements at baseline that did not reach statistical significance. The slope of reciprocal serum creatinine (1/S. Cr) was significantly and negatively correlated with systolic blood pressure (SBP). It was also significantly and negatively correlated to baseline serum creatinine.
Conclusion: Almost half the patients had a rate of decline in estimated GFR that exceeded 1 ml/min/year and were classified as progressors.
Key words: CKD progression; ESRD; progressors; non-progressors.
Methods: This is a retrospective study of 300 CKD patients in stages 2-4, that were randomly selected from patients who were on regular follow up in Sheffield kidney institute (SKI), Sheffield, UK, up to June 2007. Patients whose estimated glomerular filtration rate (GFR) declined by more than 1 ml/min/year according to the MDRD formula during a 5-year follow up period were classified as progressors. Baseline parameters that may be associated with a more rapid decline in GFR were evaluated.
Results: Males constituted 57.7% of the study population, one third of patients were older than 65 years of age, 93% were white and 39.7% were diabetic. The study showed that 52.7% of patients had a progressive course of CKD. Gender, old age, ethnicity and diabetic status were not significantly different between progressors and non-progressors. Progressors tended to have higher 24-hour urinary protein excretion (2.6 ± 3.6 versus 1.8 ± 3.5 g/dl) and higher blood pressures measurements at baseline that did not reach statistical significance. The slope of reciprocal serum creatinine (1/S. Cr) was significantly and negatively correlated with systolic blood pressure (SBP). It was also significantly and negatively correlated to baseline serum creatinine.
Conclusion: Almost half the patients had a rate of decline in estimated GFR that exceeded 1 ml/min/year and were classified as progressors.
Key words: CKD progression; ESRD; progressors; non-progressors.
