Factors associated with Rapid decline of Renal function in Patients with CKD stage 3-4 at Kasetsomboon Hospital, Chaiyaphum

Abstract

This retrospective cohort study aimed to identify factors associated with rapid GFR decline in patients with stage 3-4 chronic kidney disease (CKD) who were enrolled in the CKD clinic at Kasetsomboon Hospital in Chaiyaphum province between October 1, 2020 and September 30, 2021. Data used in this study were extracted from an electronic database (medical record: HOSxP) comprising 1,184 patients. Among them, there were 434 participants who met the inclusion and exclusion criteria. The results showed that most of them were females (63.4%) with mean age of 71 years, 94.47% had an underlying diseases including diabetes or hypertension. In the one-year follow-up, 71.89% had no change in the staging of CKD category. Rapid decline of renal function was identified at 68.43% as an estimated glomerular filtration rate (eGFR) loss of ≥4 ml/min/1.73 m² per year. The result of the multiple logistic regression analysis showed that the factor significantly associated with rapid GFR decline was the level of FBS with p-value < 0.05 (OR 2.95, 95% CI 1.23-7.07, p 0.015). It was also found that there were other factors that may contribute to GFR decline with no statistical significance, including sex, age, body mass index, diabetes, hypertension, SBP, HbA1c, Cholesterol, Triglyceride, HDL, LDL, Urine Proteinuria and some NCD medicines.