A Survey About The Risk Factors Of Chronic Kidney Disease And The Relationship With The Progression Of Renal Function

Objective:To explore the risk factors of chronic kidney disease and the correlation of low-density lipoprotein cholesterol (LDL-C) increased and the progression of renal function.Methods:A prospective monocentric cohort study was performed. We collected systolic blood pressure (SBP), diastolic blood pressure (DBP), serum creatinine (Scr), fasting plasma glucose (FBG), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and other indicators of the crowd who had treatment in the outpatient medical center of the First Affiliated Hospital of Xinjiang Medical University from January2009to April2010. And one of the early CKD patients had been followed-up for more than1year. According to the progression of renal function which was defined as the annual decrease of the estimated glomerular filtration rate (eGFR)>4ml·min-1·(1.73m2)-1, initiation of renal replacement therapy, and death associated with renal disease, the object of study was divided into progression group and non-progression group. Multivariate analysis was performed on the progression of renal function to study the correlation of the changes in these indicators and the progression of renal function. Results:he medical crowd had9,722cases, including853cases of CKD patients.Multivariate analysis showed:the age, SBP and FBG were independent risk factors for CKD. The follow-up study had103patients, including non-progression group64cases and progression group39cases. When the end of follow-up, TC, HDL-C and LDL-C of progression group were significantly higher than non-progression group. Compared with baseline, the proportion of the patients whose TC, HDL-C and LDL-C had increased in the progression group was also obviously higher than the non-progression group. ROC curves suggested the clinical cut-off point of the elevated LDL-C which was used to diagnose the progression of renal function was1.075mmol/L (area under the curve:0.718, P<0.001). Multivariate Cox regression analysis showed that the elevated LDL-C was one of the independent factors of the progression of renal function. Cox survival curves were shown the progression of renal function of the crowd whose elevated LDL-C was greater than the clinical cut-off point was significantly higher than the crowd whose elevated LDL-C was less than the clinical cut-off point. The crowd with elevated LDL-C greater than the clinical cut-off point whose renal function had progressed was16cases, accounting for94.1%. The crowd with elevated LDL-C less than the clinical cut-off point whose renal function had progressed was23cases, accounting for26.7%(P=0.036). Conclusions:The age, SBP and FBG were independent risk factors for CKD. Elevated LDL-C greater than the clinical cut-off point is one of the independent risk factors for progression of renal function.The clinical cut-off point is1.075mmol/L.