Factor association for changing stage in Chronic Kidney Disease, Chaiya Hospital, Surat-Thani .

Abstract

              This observation-retrospective study have the objective for analyze the risk factors for changing stage in CKD stage 3-5 (eGFR <60 ml / min / 1.73 sq.m. by CKD EPI equation) of Chaiya Hospital during 2015 to 2018.By the sample collection from the CKD patients stage 3-5 were not received renal replacement therapy prior to study from 1 January 2015 to 31 december 2018, The number of case are all the patients that can passed inclusion and exclusion criteria. Data collection method from the electronic database and medical records of CKD clinic of Chaiya Hospital then fill in the Research Record Form.The basic data, continuous variables and categorized variables data are analyzed and presented in Mean ± SD and the percentage of the relationship between CKD covariates risk factor and progression of renal disease were evaluated by using Pearson correlation and multiple regression analysis.
              Result of the study, from total N=213 cases, We have CKD stage3 133 cases (62.44%), CKD stage 4 60 cases (28.17%) and CKD stage5 20 cases (9.39%). Pearson correlation analysis between covariates risk factor and progression of renal failure found that ; age, body mass index (BMI), diastolic pressure level (DBP), Serum uric level, Low density lipoprotein cholesterol (LDL), Triglyceride level, High density lipoprotein cholesterol (HDL) were not association with the glomerular filtration rate (GFR) declination but systolic blood pressure (SBP), fasting blood glucose (FBS), Hemoglobin A1C levels are significant negatively correlated with glomerular filtration rate (GFR). (r =-.173, p=.012) (r =-.171, p=.012) (r =-.253, p=.000) and hematocrit (Hct) levels have a significant
positive correlation with renal filtration rate. (r = .223, p = .001). And the study was analyzed by using Multiple Regression Analysis. It was found that hematocrit was positively correlated with CKD progression. HbA1C and SBP were negatively correlated with CKD progression by statistically significant. Finally we got unstandardized regression equation to predict glomerular filtration rate as eGFR = 49.333-2.181 (A1C) +. 809 (Hct) -. 221 (SBP) and standardized
regression equation as eGFR = -.261(A1C)+.245(Hct)-.180(SBP) This research suggest that CKD patients should be screening of high blood pressure and controlling hypertension from the beginning.Control the accumulated sugar level (HbA1C) and treat patients with anemia by the standard recommendation from Thai Kidney Disease Association. This study has some limitations, firstly Is a retrospective study,the second is a short-term study of about 6 months.