Outcomes of stage 3-5 chronic kidney disease before end-stage renal disease at a single center in Taiwan

被引:46
作者
Chiu, Yen-Ling [2 ]
Chien, Kuo-Liong [1 ]
Lin, Shuei-Liong [1 ]
Chen, Yung-Ming [1 ]
Tsai, Tun-Jun [1 ]
Wu, Kwan-Dun [1 ]
机构
[1] Natl Taiwan Univ, Natl Taiwan Univ Hosp, Dept Internal Med, Coll Med, Taipei 100, Taiwan
[2] Natl Taiwan Univ, Far Eastern Mem Hosp, Dept Internal Med, Taipei 10764, Taiwan
来源
NEPHRON CLINICAL PRACTICE | 2008年 / 109卷 / 03期
关键词
cardiovascular disease; chronic kidney disease progression; end-stage renal disease;
D O I
10.1159/000145453
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background: Taiwan has the highest incidence of end-stage renal disease ( ESRD) in the world, but little is known about the outcomes of patients with chronic kidney disease ( CKD) before ESRD in Taiwan. This study investigated the rate of renal progression and predictors for ESRD and death in a prospective cohort of patients under usual nephrologic care at a single center. Methods: A total of 433 patients at CKD stage 3-5 short of dialysis were recruited from nephrology clinics. Patients were monitored for up to 36 months or until ESRD, death or loss to follow-up. Glomerular filtration rates ( GFR) were calculated by the Modification of Diet in Renal Disease abbreviated formula. Results: At baseline, mean age was 65.6 years, 61.7% were male, 33.3% were diabetic and 29.1% had cardiovascular diseases (CVD). At the end of followup, 123 patients (28.4%) had advanced to ESRD and 41 (9.5%) had died. Mean annual declines in GFR were 2.24, 4.22, and 3.23 ml/min/1.73 m(2) for stages 3, 4, and 5, respectively. By Cox regression model, patients with CVD, lower BMI and higher systolic BP were more likely to develop ESRD. Older patients with CVD and lower systolic BP were more likely to die. Conclusion: In this CKD cohort, patients were more likely to develop ESRD than cardiovascular death. The rate of GFR decline and predictors of ESRD were comparable to those reported in Western countries. Thus, the high incidence of ESRD in Taiwan may be attributed, at least in part, to lower cardiovascular mortality. Copyright (c) 2008 S. Karger AG, Basel.
引用
收藏
页码:C109 / C118
页数:10
相关论文
共 37 条
[1]   Development and progression of nephropathy in type 2 diabetes: The United Kingdom Prospective Diabetes Study (UKPDS 64) [J].
Adler, AI ;
Stevens, RJ ;
Manley, SE ;
Bilous, RW ;
Cull, CA ;
Holman, RR .
KIDNEY INTERNATIONAL, 2003, 63 (01) :225-232
[2]   Effect of ramipril vs amlodipine on renal outcomes in hypertensive nephrosclerosis - A randomized controlled trial [J].
Agodoa, LY ;
Appel, L ;
Bakris, GL ;
Beck, G ;
Bourgoignie, J ;
Briggs, JP ;
Charleston, J ;
Cheek, D ;
Cleveland, W ;
Douglas, JG ;
Douglas, M ;
Dowie, D ;
Faulkner, M ;
Gabriel, A ;
Gassman, J ;
Greene, T ;
Hall, Y ;
Hebert, L ;
Hiremath, L ;
Jamerson, K ;
Johnson, CJ ;
Kopple, J ;
Kusek, J ;
Lash, J ;
Lea, J ;
Lewis, JB ;
Lipkowitz, M ;
Massry, S ;
Middleton, J ;
Miller, ER ;
Norris, K ;
O'Connor, D ;
Ojo, A ;
Phillips, RA ;
Pogue, V ;
Rahman, M ;
Randall, OS ;
Rostand, S ;
Schulman, G ;
Smith, W ;
Thornley-Brown, D ;
Tisher, CC ;
Toto, RD ;
Wright, JT ;
Xu, SC .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2001, 285 (21) :2719-2728
[3]   Effects of blood pressure level on progression of diabetic nephropathy - Results from the RENAAL study [J].
Bakris, GL ;
Weir, MR ;
Shanifar, S ;
Zhang, ZX ;
Douglas, J ;
van Dijk, DJ ;
Brenner, BM .
ARCHIVES OF INTERNAL MEDICINE, 2003, 163 (13) :1555-1565
[4]   Angiotensin-receptor blockade versus converting-enzyme inhibition in type 2 diabetes and nephropathy [J].
Barnett, AH ;
Bain, SC ;
Bouter, P ;
Karlberg, B ;
Madsbad, S ;
Jervell, J ;
Mustonen, J .
NEW ENGLAND JOURNAL OF MEDICINE, 2004, 351 (19) :1952-1961
[6]   Prevalence of kidney damage in Australian adults: The AusDiab Kidney Study [J].
Chadban, SJ ;
Briganti, EM ;
Kerr, PG ;
Dunstan, DW ;
Welborn, TA ;
Zimmet, PZ ;
Atkins, RC .
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2003, 14 (07) :S131-S138
[7]   Long-term effects of angiotensin-converting enzyme inhibition and metabolic control in hypertensive type 2 diabetic patients [J].
Chan, JCN ;
Ko, GTC ;
Leung, DHY ;
Cheung, RCK ;
Cheung, MYF ;
So, WY ;
Swaminathan, R ;
Nicholls, MG ;
Critchley, JAJH ;
Cockram, CS .
KIDNEY INTERNATIONAL, 2000, 57 (02) :590-600
[8]   Excerpts from the United States Renal Data System 2004 Annual Data Report: Atlas of end-stage renal disease in the United States - Perface [J].
Collins, AJ ;
Kasiske, B ;
Herzog, C ;
Chavers, B ;
Foley, R ;
Gilbertson, D ;
Grimm, R ;
Liu, JN ;
Louis, T ;
Manning, W ;
Matas, A ;
McBean, M ;
Murray, A ;
St Peter, W ;
Xue, J ;
Fan, Q ;
Guo, HF ;
Li, SL ;
Li, SY ;
Roberts, T ;
Snyder, J ;
Solid, C ;
Wang, CC ;
Weinhandl, E ;
Arko, C ;
Chen, SC ;
Dalleska, F ;
Daniels, F ;
Dunning, S ;
Ebben, J ;
Frazier, E ;
Johnson, R ;
Sheets, D ;
Forrest, B ;
Berrini, D ;
Constantini, E ;
Everson, S ;
Frederick, P ;
Eggers, P ;
Agodoa, L .
AMERICAN JOURNAL OF KIDNEY DISEASES, 2005, 45 (01) :V-+
[9]   Prevalence of chronic kidney disease and decreased kidney function in the adult US population: Third National Health and Nutrition Examination Survey [J].
Coresh, J ;
Astor, BC ;
Greene, T ;
Eknoyan, G ;
Levey, AS .
AMERICAN JOURNAL OF KIDNEY DISEASES, 2003, 41 (01) :1-12
[10]  
Diabet Control Complications DCCT Res Grp, 1995, KIDNEY INT, V47, P1703