Prognostic factors for a composite end-point of renal outcomes in patients with chronic kidney disease.
We aimed to investigate prognostic factors for a composite end-point of end-stage renal disease (ESRD) and the progression of renal disease in Japanese patients with chronic renal disease. Using a composite end-point comprising a doubling of serum creatinine (sCr), an increase in sCr level to 6.0 mg/dL, or initiation of dialysis and renal transplantation caused by ESRD, we examined data obtained in a prospective cohort study. The present study consisted of 641 patients who were 20 years of age or older with chronic renal disease caused by diabetic nephropathy, glomerulonephritis, or nephrosclerosis, and who had baseline sCr levels of 5.0 mg/dL or less. The following criteria were examined as prognostic factors: sex; age; elapsed time from initial diagnosis; disease underlying the nephropathy (diabetic or non-diabetic); complications with hypertension, hyperlipidemia, or anemia; baseline sCr level; therapeutic regimen, including use of ACE inhibitors or Ca2+ -channel blockers; and diet. A log-rank test was used for univariate analysis, and Cox regression analysis was used for multivariate analysis. Underlying disease (diabetic or non-diabetic), baseline sCr level, and Ca2+ -channel blocker therapy were significantly related to event incidence. In the present study, we identified underlying disease and baseline sCr level as important prognostic factors for a composite end-point in a predialysis patient population in both the early and middle stages of renal disease. These factors should be considered as balancing variables for randomization in future clinical studies.
Department of Epidemiology and Health Care Research, Kyoto University Graduate School of Medicine, Kyoto, Japan. satoshi_morita@pbh.med.kyoto-u.ac.jp
Satoshi
S
Morita
Shunichi
S
Fukuhara
Tadao
T
Akizawa
Yasushi
Y
Asano
Shozo
S
Koshikawa
Keizo
K
Koide
Kiyoshi
K
Kurokawa
D000368:Aged; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D003404:Creatinine / Q000097:blood*; D003928:Diabetic Nephropathies / Q000150:complications; D018450:Disease Progression; D005260:Female; D005921:Glomerulonephritis / Q000150:complications; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009400:Nephrosclerosis / Q000150:complications; D011379:Prognosis; D011446:Prospective Studies
D002121:Calcium Channel Blockers; D003404:Creatinine