J Med Assoc Thai 2014; 97 (8):812

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Predictors of Faster Progression in Chronic Kidney Disease
Sukmark T Mail, Sukmark S

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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