Factors Associated with Chronic Kidney Disease Stage 3-4 Patients Progression in Prachuapkhirikhan Hospital

Abstract

Objective: The objective was to study the factors associated with renal impairment and to predict the likelihood of renal impairment among patients with chronic kidney disease stage 3 and 4 in the outpatient department of PrachuapKhiriKhan Hospital.

            Methods: In this analytical retrospective research design, data were collected from January2020 to December 2021. A total of 349 participants were enrolled in the study. Patients were divided into 2 groups: the first group, the group with slow progression of renal function decline, which was a decrease in renal function of less than 5 ml/min/1.73 sq.m per year, totaling 221 people, representing 63.3%. The second group, the group with rapid decline of renal function, had a decrease in renal function of more than 5 ml/min/1.73 sq.m per year, with 128 people representing 36.7%.

Result: The presence of proteinuria of more than 3 grams per day was found to be the most strongly associated factor for rapid renal impairment, increasing the risk by 34.24 times. Cardiovascular disease combined with chronic kidney disease increased the risk of renal impairment by 17.54 times. Diabetes that was poorly controlled increased the risk of renal impairment. When all factors that were associated with renal function decline were analyzed with multiple logistic regression to predict the risk of patients having a rapid decline in renal function in the future, they were: the presence of proteinuria, having cardiovascular disease, uncontrolled blood pressure, urinary tract infection, and glomerulonephritis. The highest risk factor was proteinuria, which increased risk by 21.366 times. The second place was having cardiovascular disease, which significantly increased the chance by 20.021 times with 87.7 percent prediction accuracy.

Conclusion: The presence of proteinuria, having cardiovascular disease, uncontrolled blood pressure, urinary tract infection, and glomerulonephritis are predicted as the risk of patients in CKD stage 3 and 4 having a rapid decline in renal function in the future.