• editor@ijmra.in
  • ISSN[Online] : 2643-9875  ||  ISSN[Print] : 2643-9840

Volume 07 Issue 03 March 2024

Exploring Risk Factors Involved in The Progression of Chronic Kidney Disease: A Prospective Study in A Quaternary Care Hospital - Chennai.
1Melina.I.Sahay, 1Jagedeshwaran.V, 1Mohamed Mohideen.M.I, 1Monish kumar.K, 1Lakshman, 2Dr.Sriram.D.K, 1Dr. Melvin George
1Department of Clinical Research, Hindu Mission Hospital, Tambaram, Chennai, 600045, Tamilnadu, India.
2Department of Diabetology and Endocrinology, Hindu Mission Hospital, Tambaram, Chennai, 600045, Tamilnadu, India.
Corresponding Author: Dr.Melvin George
DOI : https://doi.org/10.47191/ijmra/v7-i03-11

Google Scholar Download Pdf
ABSTRACT:

Purpose: The study investigates the rising prevalence of chronic kidney disease (CKD) and its associated challenges, including co-morbidities and uncertain prognosis. Patients often face disease progression without clear identification of those at high risk for rapid advancement to end-stage renal disease. Conducted in a hospital setting, the research examines a cohort of adults with CKD to determine the rate of progression from early to advanced stages and identify predictors of rapid advancement.

Methods: Patients meeting inclusion/exclusion criteria provided written consent before screening. The Modification of Diet in Renal Disease (MDRD-4) equation determined eGFR, and staging was based on admission results. Data were categorized into early and advanced stages according to eGFR values. Demographic details, clinical features, risk factors, comorbidities, laboratory results, and other supportive care information were extracted from hospital records. The collected data were analyzed to identify risk factors influencing CKD progression.

Results: A comparative analysis of baseline characteristics revealed that age, gender, and BMI significantly contributed to the development of end-stage kidney disease. Key factors such as serum creatinine, serum uric acid, eGFR, random blood sugar, and fluid intake showed statistical significance in the progression of kidney disease. The risk of end-stage CKD was notably elevated with smoking, alcohol consumption, and increased fluid intake.

Conclusion: The study demonstrated a significant association between CKD progression and parameters such as age, BMI, habits like alcohol intake and smoking, as well as clinical factors including serum creatinine, serum uric acid, eGFR, and random blood sugar. Patients with diabetes, coronary artery disease (CAD), and anemia exhibited a more accelerated decline in renal function. These factors can be modified through appropriate treatment.

KEYWORDS:

Chronic kidney disease, estimated glomerular filtration rate, end-stage renal disease, Modification of Diet in Renal Disease, CKD progression, Risk factors.

REFERENCES
1) Lv JC, Zhang LX. Prevalence and disease burden of chronic kidney disease. Renal Fibrosis: Mechanisms and Therapies. 2019:3-15.

2) Dare AJ, Fu SH, Patra J, Rodriguez PS, Thakur JS, Jha P, Million Death Study Collaborators. Renal failure deaths and their risk factors in India 2001–13: nationally representative estimates from the Million Death Study. The Lancet Global Health. 2017 Jan 1;5(1):89-95.

3) National Kidney Foundation- DOQI Clinical Practice Guidelines on Chronic Kidney Disease. Executive summary. Am J Kidney Dis 2002; 39 (2) suppl 1: S1.

4) Tsai WC, Wu HY, Peng YS, Ko MJ, Wu MS, et.al., Risk factors for development and progression of chronic kidney disease: a systematic review and exploratory meta-analysis. Medicine. 2016 Mar;95(11).

5) GBD Chronic Kidney Disease Collaboration. Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017Lancet 2020; 395: 709–733.

6) Go AS, Yang J, Tan TC, Cabrera CS, Stefansson BV, Greasley PJ, Ordonez JD. Contemporary rates and predictors of fast progression of chronic kidney disease in adults with and without diabetes mellitus. BMC nephrology. 2018 Dec;19(1):1-3.

7) Obi Y, Kimura T, Nagasawa Y, Yamamoto R, Yasuda K et.al., Impact of age and overt proteinuria on outcomes of stage 3 to 5 chronic kidney disease in a referred cohort. Clinical Journal of the American Society of Nephrology. 2010 Sep 1;5(9):1558-65.

8) Silva GB, Bentes AC, Daher ED, Matos SM. Obesity and kidney disease. Brazilian Journal of Nephrology. 2017 Jan; 39:65--9

9) Gao B, Zhu L, Pan Y, Yang S, Zhang L, Wang H. Ocular fundus pathology and chronic kidney disease in a Chinese population. BMC nephrology. 2011 Dec;12(1):1-5.

10) Murtagh FE, Marsh JE, Donohoe P, Ekbal NJ, Sheerin NS, Harris FE. Dialysis or not? A comparative survival study of patients over 75 years with chronic kidney disease stage 5. Nephrology Dialysis Transplantation. 2007 Jul 1;22(7):1955-62.

11) Kresina TF. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland. Immune Modulating Agents. 1997 Oct 17:221.

12) Neugarten J, Acharya A, Silbiger SR. Effect of gender on the progression of nondiabetic renal disease: a meta-analysis. Journal of the American Society of Nephrology. 2000 Feb 1;11(2):319-29

13) Xu R, Zhang LX, Zhang PH, Wang F, Zuo L, Wang HY. Gender differences in age-related decline in glomerular filtration rates in healthy people and chronic kidney disease patients. BMC nephrology. 2010 Dec;11(1):1-7.

14) Keane WF, Zhang Z, Lyle PA, Cooper ME, de Zeeuw D, et.al., Risk scores for predicting outcomes in patients with type 2 diabetes and nephropathy: the RENAAL study. Clinical journal of the American Society of Nephrology. 2006 Jul 1;1(4):761-7.

15) Srivastava A, Kaze AD, McMullan CJ, Isakova T, Waikar SS. Uric acid and the risks of kidney failure and death in individuals with CKD. American Journal of Kidney Diseases. 2018 Mar 1;71(3):362-70.

16) Bundy JD, Bazzano LA, Xie D, Cohan J, Dolata J, et.al., Self-reported tobacco, alcohol, and illicit drug use and progression of chronic kidney disease. Clinical Journal of the American Society of Nephrology. 2018 Jul 6;13(7):993-1001.

17) United States Renal Data System: United States Renal Data System 2018 Annual Data Report. Available at: https://www.usrds.org/ annual-data-report/previous-adrs/. Accessed October 10, 2020

18) Ricardo AC, Yang W, Sha D, Appel LJ, Chen J, et,al., Sex-related disparities in CKD progression. Journal of the American Society of Nephrology. 2019 Jan 1;30(1):137-46.

19) Dubey RK, Jackson EK. Estrogen-induced cardiorenal protection: potential cellular, biochemical, and molecular mechanisms. American Journal of Physiology-Renal Physiology. 2001 Mar 1;280(3):F365-88.

20) Anderson AH, YangW, Townsend RR, Pan Q, Chertow GM, et.al., Chronic Renal Insufficiency Cohort Study Investigators: Time-updated systolic blood pressure and the progression of chronic kidney disease: A cohort study. Ann Intern Med 162: 258–265, 2015

21) Ricardo AC, Anderson CA, Yang W, Zhang X, Fischer MJ, et.al., CRIC Study Investigators: Healthy lifestyle and risk of kidney disease progression, atherosclerotic events, and death in CKD: Findings from the Chronic Renal Insufficiency Cohort (CRIC) Study. Am J Kidney Dis 65: 412–424, 2015

22) Lu JL, Kalantar-Zadeh K, Ma JZ, Quarles LD, Kovesdy CP: Association of body mass index with outcomes in patients with CKD. J Am Soc Nephrol 25: 2088–2096, 2014

23) Regalado M, Yang S, Wesson DE. Cigarette smoking is associated with augmented progression of renal insufficiency in severe essential hypertension. American Journal of Kidney Diseases. 2000 Apr 1;35(4):687-94.

24) Hallan SI, Ritz E, Lydersen S, Romundstad S, Kvenild K, Orth SR. Combining GFR and albuminuria to classify CKD improves prediction of ESRD. Journal of the American Society of Nephrology. 2009 May 1;20(5):1069-77.

25) Young BA, Katz R, Boulware LE, Kestenbaum B, de Boer IH, et.al., Risk factors for rapid kidney function decline among African Americans: the Jackson Heart Study (JHS). American Journal of Kidney Diseases. 2016 Aug 1;68(2):229-39.

26) Chien KL, Lin HJ, Lee BC, Hsu HC, Lee YT, Chen MF. A prediction model for the risk of incident chronic kidney disease. The American journal of medicine. 2010 Sep 1;123(9):836-46.

27) Hoefield RA, Kalra PA, Baker P, Lane B, New JP, et.al., Factors associated with kidney disease progression and mortality in a referred CKD population. American journal of kidney diseases. 2010 Dec 1;56(6):1072-81.

28) De Nicola L, Minutolo R, Chiodini P, Borrelli S, Zoccali C, et.al., The effect of increasing age on the prognosis of non-dialysis patients with chronic kidney disease receiving stable nephrology care. Kidney international. 2012 Aug 2;82(4):482-8.

29) Evans M, Fryzek JP, Elinder CG, Cohen SS, McLaughlin JK, Nyrén O, Fored CM. The natural history of chronic renal failure: results from an unselected, population-based, inception cohort in Sweden. American Journal of Kidney Diseases. 2005 Nov 1;46(5):863-70.

30) Whelton PK, Carey RM, Aronow WS, Casey DE Jr., Collins KJ, et.al., 2017 ACC/AHA/AAPA/ABC/ACPM/ AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: Executive summary: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension 71: 1269–1324, 2018.
Volume 07 Issue 03 March 2024

There is an Open Access article, distributed under the term of the Creative Commons Attribution – Non Commercial 4.0 International (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/), which permits remixing, adapting and building upon the work for non-commercial use, provided the original work is properly cited.


Our Services and Policies

Authors should prepare their manuscripts according to the instructions given in the authors' guidelines. Manuscripts which do not conform to the format and style of the Journal may be returned to the authors for revision or rejected.

The Journal reserves the right to make any further formal changes and language corrections necessary in a manuscript accepted for publication so that it conforms to the formatting requirements of the Journal.

International Journal of Multidisciplinary Research and Analysis will publish 12 monthly online issues per year,IJMRA publishes articles as soon as the final copy-edited version is approved. IJMRA publishes articles and review papers of all subjects area.

Open access is a mechanism by which research outputs are distributed online, Hybrid open access journals, contain a mixture of open access articles and closed access articles.

International Journal of Multidisciplinary Research and Analysis initiate a call for research paper for Volume 07 Issue 12 (December 2024).

PUBLICATION DATES:
1) Last Date of Submission : 26 December 2024 .
2) Article published within a week.
3) Submit Article : editor@ijmra.in or Online

Why with us

International Journal of Multidisciplinary Research and Analysis is better then other journals because:-
1 : IJMRA only accepts original and high quality research and technical papers.
2 : Paper will publish immediately in current issue after registration.
3 : Authors can download their full papers at any time with digital certificate.

The Editors reserve the right to reject papers without sending them out for review.

Authors should prepare their manuscripts according to the instructions given in the authors' guidelines. Manuscripts which do not conform to the format and style of the Journal may be returned to the authors for revision or rejected. The Journal reserves the right to make any further formal changes and language corrections necessary in a manuscript accepted for publication so that it conforms to the formatting requirements of the Journal.

Indexed In
Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar