title: Association between laboratory and clinical risk factors and progression of the predialytic chronic kidney disease.
abstract: BACKGROUND
  Chronic kidney disease (CKD) is a very common condition that has become a public health issue. Knowing more about risk factors associated with the progression of CKD allows therapeutic interventions that may change the natural course of the disease.
  
  
  OBJECTIVE
  To evaluate the impact of clinical and laboratory variables at admission on the outcomes death and need for renal replacement therapy (RRT).
  
  
  METHODS
  A retrospective cohort study comprised of 211 adult patients with stages 3-5 CKD, followed-up for 56.6 ± 34.5 months.
  
  
  RESULTS
  Mean age of patients was 65.4 ± 15.1 years and 63.5% were > 60 years. The main causes of CKD were hypertensive nephrosclerosis (29%) and diabetic kidney disease (DKD) (17%). Most patients (47.3%) were on stage 4 CKD. The mean annual loss of glomerular filtration rate (GFR) was 0.6 ± 2.5 mL/min/1.73 m² (median 0.77 mL/min/1.73 m²) After the adjustments for demographic, clinical and laboratory variables, DKD [relative risk (RR) 4.4; 95% confidence interval (CI), 1.47 to 13.2; p = 0.008] was predictive of RRT; age (RR 1.09; 95% CI, 1.04 to 1.15; p < 0.0001) and the non-treatment with angiotensin receptor blocker (ARB) (RR 4.18, 95% CI, 1.34 to 12.9; p = 0.01) were predictors of death. Renal and patient survival rates were 70.9% and 68.6%, respectively.
  
  
  CONCLUSIONS
  In this study, patients with stage 3-5 CKD treated conservatively showed stabilization of renal function and low mortality, which were impacted by DKD, age and to not using ARB, respectively.
authors.affiliation: Universidade Federal de Juiz de Fora – UFJF.
authors.forename: Angelo Cardoso
authors.initials: AC
authors.lastname: Pereira
authors.forename: Moisés
authors.initials: M
authors.lastname: Carminatti
authors.forename: Natália Maria da Silva
authors.initials: NM
authors.lastname: Fernandes
authors.forename: Luciana Dos Santos
authors.initials: Ldos S
authors.lastname: Tirapani
authors.forename: Ruiter de Souza
authors.initials: Rde S
authors.lastname: Faria
authors.forename: Fabiane Rossi Dos Santos
authors.initials: FR
authors.lastname: Grincenkov
authors.forename: Edson José de Oliveira
authors.initials: EJ
authors.lastname: Magacho
authors.forename: Wander Barros do
authors.initials: WB
authors.lastname: Carmo
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Abrita
authors.forename: Marcus Gomes
authors.initials: MG
authors.lastname: Bastos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019411:Clinical Laboratory Techniques; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors