Predicting Factors for Rapid Progressive Chronic Kidney Disease in Primary Glomerular Disease Patients with Moderate-to-Severe Stage.

Jun Tan,Wei Zheng,Hao Zhang,Yan Liu,Minghui Yang,Shikun Yang,Yoshiyuki Morishita

doi:10.1155/2020/3796792

Abstract

Objective To investigate the predictive factors associated with rapid progressive chronic kidney disease (CKD) in patients with primary glomerular disease (PGD). Methods Baseline data, clinical biochemistry, laboratory data, and imaging data were collected from 112 PGD patients in CKD stages 3 and 4 who were hospitalized at the Third Xiangya Hospital. Patients were divided into rapid progression group (Group R) and no rapid progression group (NR) according to the definition of rapid progression of CKD. Results The age, systolic blood pressure (SBP), serum β2-microglobulin (sβ2-MG), urinary α1-microglobulin (uα1-MG), and cardiothoracic ratio (CTR) of the R group were significantly higher than the NR group. However, the size of the kidney, high-dense lipoprotein (HDL), hemoglobin (Hb), and hematocrit of the R group were significantly lower than the NR group (P < 0.05). Binary logistic regression analysis showed that baseline CTR, SBP, size of the kidney, and HDL were independent risk factors for rapid progression of PGD. At the end of follow-up, CTR and SBP of group R were higher than the NR group, and the size of the kidney and HDL of group R were lower than the NR group. Conclusion Increased baseline CTR and SBP and decreased baseline HDL and renal volume could be the predictors of rapid progression in patients of PGD at the CKD stages 3 and 4.

Highlights

A meta-analysis of 100 articles indicated that the average global prevalence rate of chronic kidney disease (CKD) is about 13.4%, among which the prevalence rate of CKD stages 1-5 is 3.5%, 3.9%,7.6%, 3.5%, and 0.1%, respectively [1]
This study is aimed at identifying risk factors and predictors of rapid progression of CKD caused by primary glomerular disease (PGD)
Over 30% reduction of estimated glomerular filtration rate (eGFR) in 2 years was chosen as an endpoint for the rapid progression of CKD caused by PGD, and the patients were divided into rapid progression group (R) and no rapid progression group (NR)

Summary

Introduction

A meta-analysis of 100 articles indicated that the average global prevalence rate of chronic kidney disease (CKD) is about 13.4%, among which the prevalence rate of CKD stages 1-5 is 3.5%, 3.9%,7.6%, 3.5%, and 0.1%, respectively [1]. The majority of CKD patients are in stages 3 and 4. PGD is one of the common causes of end-stage renal disease (ESRD). ESRD patients would need renal replacement treatment, which brings patients and society economical and psychological burden. Genetic, and epigenetic variants are risk factors of rapid progression of CKD [4, 5]. Up to now, no biomarkers are available as predictors of rapid progression of CKD caused by PGD, which can help physicians perform more strict education and rigorous treatment in patients at the initial stage to avoid the unexpected consequence

Methods

Results

Conclusion