Outcomes of stage 1-5 chronic kidney disease in Mainland China.
OBJECTIVE
This study aims to quantify and compare the risks of death and end stage renal disease (ESRD) in a prospective cohort of patients with chronic kidney disease (CKD) stages 1-5 under renal management clinic at Peking University Third Hospital and to evaluate the risk factors associated with these two outcomes.


METHODS
This was a prospective cohort study. Finally, 1076 patients at CKD stage 1-5 short of dialysis were recruited from renal management clinic. Patients were monitored for up to Dec, 2011 or until ESRD and death. Glomerular filtration rate was estimated (eGFR) according to the using the CKD Epidemiology Collaboration (CKD-EPI) formula.


RESULTS
At the end of follow-up, 111 patients (10.1%) developed ESRD (initiated dialysis or kidney transplantation (ESRD)) and 24 patients (2.2%) had died. There were more ESRD occurrence rate in patients with baseline diabetic nephropathy, lower eGFR, hemoglobin <100 g/L and 24 h urinary protein excretion ≥ 3.0 g. By multivariate Cox regression model, having heavy proteinuria and CKD stage were the risk factors of ESRD. For all-cause mortality, the most common cause was cardiovascular disease, followed by infectious disease and cancer. But we failed to conclude any significant variable as risk factors for mortality in multivariate analysis.


CONCLUSIONS
Our study indicated that baseline diabetic nephropathy, lower hemoglobin level, lower baseline GFR and heavy proteinuria were the risk factors of ESRD. In this CKD cohort, patients were more likely to develop ESRD than mortality, and cardiovascular mortality was the leading cause of death, and then followed by infectious diseases and cancer in this population.
Department of Nephrology, Peking University Third Hospital , Beijing , China.
Xuan
X
Lai
Ai-Hua
AH
Zhang
Shao-Yan
SY
Chen
Lian
L
He
Chun-Yan
CY
Su
Min-Hua
MH
Fan
Tao
T
Wang
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death; D002681:China / Q000453:epidemiology; D003928:Diabetic Nephropathies / Q000150:complications; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007239:Infections / Q000401:mortality; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality; D011446:Prospective Studies; D011507:Proteinuria / Q000150:complications; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000209:etiology / Q000401:mortality*; D012307:Risk Factors
D006454:Hemoglobins