The progression of chronic kidney disease: A 10-year population-based study of the effects of gender and age

Abstract

The increase in demand for renal replacement therapy makes it important to investigate the prognosis of the earlier stages of chronic kidney disease (CKD). We examined the change in glomerular filtration rate (GFR), and patient and renal survival in CKD stage 3 in the municipality of Tromsø, a well-defined European community with a population of 58,000. All patients with estimated GFR between 30 and 59 ml/min/1.73 m(2) for more than 3 months during a 10-year study period were identified from a complete database of all 248 560 measurements of serum creatinine made in the community in the study period. Change in GFR was estimated for each patient using a multilevel model. A complete follow-up with respect to patient and renal survival was obtained from hospital databases. A total of 3047 patients was included. The median number of measurements of creatinine for each patient was 9, and the median observation time was 44 months. Mean estimated change in GFR was--1.03 ml/min/1.73 m(2)/year. Seventy-three percent of the patients experienced a decline in GFR. The 10-year cumulative incidence of renal failure was 0.04 (95% CI 0.03-0.06) and mortality 0.51 (95% CI 0.48-0.55). Female gender was associated with slower decline in GFR and better patient and renal survival. In this population-based study, the decline in GFR in CKD was slower than in previously studied selected patient groups. A high mortality pre-empted the development of renal failure in many patients. The prognosis of CKD depended strongly on gender.

Risk of ESRD and Death in Patients with CKD Not Referred to a Nephrologist

“…Indeed, according to this study, GPs can be considered as a reference of care for patients in stage 3a without asking for nephrology consultation, because these patients have the same risk as the reference group (Table 4). The clinical characteristics of our patients with CKD stage 3a, in fact, show low prevalence for the main cardiorenal risk factors (i.e., albuminuria, anemia, diabetes, and CAD) with respect to more advanced stages of CKD (3b-5), and therefore, their profile is compatible with nonprogressive CKD (26)(27)(28)(29)(30). However, the suggestion of referring patients with CKD when eGFR is ,45 ml/min per 1.73m 2 is in agreement with the timing of onset of CKD-related metabolic complications (31).…”

Slower Decline of Glomerular Filtration Rate in the Japanese General Population: A Longitudinal 10-Year Follow-Up Study

“…31 (2008) Original Article Slower Decline of Glomerular Filtration Rate in the Japanese General Population: A Longitudinal 10-Year Follow-Up Study Enyu IMAI 1) , Masaru HORIO 2) , Kunihiro YAMAGATA 3) , Kunitoshi ISEKI 4) , Shigeko HARA 5) , Nobuyuki URA 6) , Yutaka KIYOHARA 7) , Hirofumi MAKINO 8) …”

Factors affecting the progression of diabetic nephropathy and its complications: A single-center experience in Saudi Arabia

“…Uncontrolled blood pressure is known to be deleterious, but other factors may become more important once BP is treated 10–15. Several studies have identified age,1617 male gender,17 lower initial glomerular filtration rate (GFR),14–18 first–hospital-visit fasting plasma glucose18 and concomitant presence of retinopathy1920 as important risk factors for GFR decline. The proteinuria itself is a major risk factor for progression of DN 12–151920.…”