Risk factor analysis for a rapid progression of chronic kidney disease.

Autor:	Vestergaard AHS; Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark., Jensen SK; Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark., Heide-Jørgensen U; Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark., Frederiksen LE; Cardiovascular, Renal and Metabolism, Medical Department, BioPharmaceuticals, AstraZeneca, Copenhagen, Denmark., Birn H; Departments of Clinical Medicine and Biomedicine, Aarhus University, Aarhus, Denmark.; Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark., Jarbøl DE; Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark., Søndergaard J; Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark., Persson F; Steno Diabetes Center Copenhagen, Herlev, Denmark., Thomsen RW; Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark., Christiansen CF; Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark.
Jazyk:	angličtina
Zdroj:	Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association [Nephrol Dial Transplant] 2024 Jun 28; Vol. 39 (7), pp. 1150-1158.
DOI:	10.1093/ndt/gfad271
Abstrakt:	Background: Chronic kidney disease (CKD) is a growing global health concern. Identifying individuals in routine clinical care with new-onset CKD at high risk of rapid progression of the disease is imperative to guide allocation of prophylactic interventions, but community-based data are limited. We aimed to examine the risk of rapid progression, kidney failure, hospitalization and death among adults with incident CKD stage G3 and to clarify the association between predefined risk markers and rapid CKD progression. Methods: Using plasma creatinine measurements for the entire Danish population from both hospitals and primary care, we conducted a nationwide, population-based cohort study, including adults in Denmark with incident CKD stage G3 in 2017-2020. We estimated 3-year risks of rapid progression (defined by a confirmed decline in estimated glomerular filtration rate of ≥5 mL/min/1.73 m2/year), kidney failure, all-cause hospitalization and death. To examine risk markers, we constructed a heat map showing the risk of rapid progression based on predefined markers: albuminuria, sex, diabetes and hypertension/cardiovascular disease. Results: Among 133 443 individuals with incident CKD stage G3, the 3-year risk of rapid progression was 14.6% [95% confidence interval (CI) 14.4-14.8]. The 3-year risks of kidney failure, hospitalization and death were 0.3% (95% CI 0.3-0.4), 53.3% (95% CI 53.0-53.6) and 18.1% (95% CI 17.9-18.4), respectively. In the heat map, the 3-year risk of rapid progression ranged from 7% in females without albuminuria, hypertension/cardiovascular disease or diabetes, to 46%-47% in males and females with severe albuminuria, diabetes and hypertension/cardiovascular disease. Conclusion: This population-based study shows that CKD stage G3 is associated with considerable morbidity in a community-based setting and underscores the need for optimized prophylactic interventions among such patients. Moreover, our data highlight the potential of using easily accessible markers in routine clinical care to identify individuals who are at high risk of rapid progression. (© The Author(s) 2024. Published by Oxford University Press on behalf of the ERA.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu