Associação entre fatores de risco clínicos e laboratoriais e progressão da doença renal crônica pré-dialítica

Abstract

Introduction: Chronic kidney disea - se (CKD) is a very common condition that has become a public health issue. Knowing more about risk factors as - sociated with the progression of CKD allows therapeutic interventions that may change the natural course of the disease. Objective: To evaluate the im - pact of clinical and laboratory variables at admission on the outcomes death and need for renal replacement therapy (RRT). Methods: A retrospective cohort study comprised of 211 adult patients with stages 3-5 CKD, followed-up for 56.6 ± 34.5 months. Results: Mean age of patients was 65.4 ± 15.1 years and 63.5% were > 60 years. The main causes of CKD were hypertensive nephroscle - rosis (29%) and diabetic kidney disease (DKD) (17%). Most patients (47.3%) were on stage 4 CKD. The mean annual loss of glomerular filtration rate (GFR) was 0.6 ± 2.5 mL/min/1.73 m 2 (median 0.77 mL/min/1.73 m 2 ) After the adjust - ments for demographic, clinical and la - boratory variables, DKD [relative risk (RR) 4.4; 95% confidence interval (CI), 1.47 to 13.2; p = 0.008] was predicti - ve of RRT; age (RR 1.09; 95% CI, 1.04 to 1.15; p < 0.0001) and the non-treat - ment with angiotensin receptor blocker (ARB) (RR 4.18, 95% CI, 1.34 to 12.9; p = 0.01) were predictors of death. Renal and patient survival rates were 70.9% and 68.6%, respectively. Conclusion: In this study, patients with stage 3-5 CKD treated conservatively showed stabiliza - tion of renal function and low mortality, which were impacted by DKD, age and to not using ARB, respectively.