Clinical Outcomes and of Risk Factors of Decline in Renal Function in CKD Patients at Surin Hospital
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Abstract
Background: Chronic Kidney Disease Clinic of Surin Hospital was retrospectively analyzed diabetic and hypertensive nephropathy in order to provide better care and to slow the progression of rend impairment in patients with chronic kidney disease (CKD) by using multidisciplinary approach. The informations obtained will be useful in developing the standard of care in these patients.
Objective: To study clinical outcomes and risk factors of deterioration in renal function of CKD patients at Surin Hospital
Study design: Cross-sectional retrospective analytical study
Populations: All CKD patients who had regular follow-up at Chronic Kidney Disease Clinic of Surin Hospital from January 1st, 2007 to December 31st, 2008 were enrolled. Definition and classification of renal impairment were according to K/DOQI 2002 guidelines. Data analysis: Statisical analysis of descriptive data presented in frequency, mean percentile, standard deviation. Independent t-test and Chi-square test and Logistic regression analysis
Results: Using 316 patients, 174 (54.4%) were female. Mean age was 58.2 + 16.6 years. Nearly half of these (45.3%) lived in the urban area. Most patients were classified as CKD stage 3-5 (93.0% and 89.5% calculated by MDRD and Cockroft & Gault formula respectively). Patients who were able to achieve the target goals in control of systolic blood pressure, diastolic blood pressure, fasting plasma glucose, serum cholesterol and serum triglyceride recommended by American Diabetes Association (ADA) guideline 2006 were 36.1%, 71.5%, 21.5%, 94% and 94% respectively. One hundred and ninety four cases (82.3%) required more than three groups of antihypertensive drugs to achieve the target. Eighty eight patients (27.85%) had decline in renal function within 1 year. Risk factors of decline in renal function included systolic blood pressure more than 137 mmHg, diastolic blood pressure more than 78 mmHg, fasting plasma glucose more than 131 mg% and age over 50 years.
Conclusions: Blood pressure and fasting plasma glucose have important impacts on the deterioration of renal function in CKD patients at Surin Hospital. More aggressive measures to control the blood pressure and fasting plasma glucose should be emphasized.
Key words: Chronic Kidney Disease (CKD), Renal functioa Clinical outcomes, Risk factors
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References
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