Assessment of kidney failure risk equation among chronic kidney disease patients: A cross-sectional study

Abstract

Background: Patients with chronic kidney disease (CKD) are at increased risk for kidney failure, cardiovascular events, and both cause mortality. Accurate models are needed to predict and identify patients at risk of progression to kidney failure which may facilitate more optimal nephrology care.
 Objective: This study assessed the kidney failure risk equation among CKD patients to predict when they need to start renal replacement therapy.
 Materials and methods: Total of 38 CKD patients were recruited from the renal unit of the Cape Coast Teaching Hospital. Estimated glomerular filtration rate (eGFR) and albumin creatinine ratio were measured from each patient. Information on age, gender, body mass index, blood pressure, cause of CKD and type of medication on were obtained from the patient’s medical records. The 4-variable Kidney Failure Risk Equation (KFRE) was used to assess the risk of progression to kidney failure among the participants. The KFRE uses 4-variables (age, sex, estimated GFR, albumin).
 Results: For both 2-year and 5-year risk of progression, serum creatinine and ACR increases as the risk increases from participants with low risk of progression through to high risk. Mean eGFR decreased from participants with low risk of progression through to those with high risk. Serum creatinine and ACR positively correlated with both 2-year and 5-year risk progression. eGFR, on the other hand, negatively correlated with both 2-year and 5-year risk progression. Participants with high 2- year and 5-year risk were on Linopril/Calcitonin/Atorvostatin drug combination, while participants with low and intermediate risks for both 2-year and 5-year were on lisinopril only.
 Conclusion: KFRE was able to discriminate which participants have low, intermediate and high 2-year and 5-year risk of progression to end stage kidney failure and which participants need to start renal replacement therapy.