Analysis Of Risk Factors For The Progression Of Chronic Kidney Disease G3?5 Stage Non-dialysis Patients

Objective:To retrospectively investigate the related risk factors for the progression of chronic kidney disease(CKD)G3?5 stage non-dialysis patients.Methods:We reviewed the clinical data of CKD G3?5 hospitalized patients in the National Clinical Research Center of Kidney Disease,Jinling Hospital,from January to December,2014.Survival analysis was performed using Kaplan-Meier method.Log-rank test was used to analysis the difference of survival rate.COX proportional risk model was applied to analysis the impact of various factors on disease progression.Results:189 patients were selected in this study,including 129 males(68.3%)and 60 females(31.7%).The mean age of the study population was 44.7±11.7 years old,and the mean eGFR was 36.8±15.3 ml/(min·1.73m2).There were 67 cases(35.4%)in CKD G3a,55 cases(29.1%)in CKD G3b,44 cases(23.3%)in CKD G4,and 23 cases(12.2%)in CKD G5.The main causes were IgA nephropathy(67 cases,35.4%)and diabetic nephropathy(65 cases,34.4%).The mean follow-up time was 32.6±11.1 months,48 patients(25.4%)in this study occurred endpoint event,cumulative renal survival rate of 1st year,2nd years and 3nd years was respectively 90.1%(95%Cl 90.06-90.14)?84.0%(95%Cl 83.95-84.05)?73.6%(95%CI 73.53-73.67).The monthly decline rate of eGFR in CKD G3a-5nd was 1.06%,1.55%,3.45%and 4.04%respectively.CKD patients with diabetes mellitus entered renal replacement therapy significantly faster than those without diabetes mellitus. Multivariate analysis indicated the stage of CKD,diabetes mellitus(HR=4.35,95%CI 2.10-9.03),uric acid(HR=3.96,95%CI 1.91-8.20),serum phosphorus(HR=0.42,95%CI 0.21-0.87)and urine protein excretion(HR=3.38,95%CI 1.76-6.49)to be the independent risk factors of CKD progression.Conclusion:The higher of the CKD stage,the faster the progression.Positive control of blood glucose,uric acid,serum phosphorus and urine protein excretion was beneficial to long-term survival of the kidney.