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Kidney Week

Abstract: PO0451

Risk Factors of Renal Replacement Therapy in Hospitalized Patients with CKD Stage 4

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Hua, Qiaoli, Department of Nephrology, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
  • Liu, Xusheng, Department of Nephrology, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
  • Zou, Chuan, Department of Dialysis, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
Background

Data on risk factors of renal replacement therapy (RRT) in hospitalized patients with CKD4 may help nephrologists to delay dialysis. The study was designed to describe the risk factors of RRT in CKD4 inpatients.

Methods

Medical records of CKD4 inpatients in Guangdong Provincial Hospital of Chinese Medicine during January, 2010 - January, 2020 were collected. Related indicators such as demography characteristics, laboratory and echocardiography test results, treatments, comorbidities and primary diseases were collected. Patients were followed up till they reached clinical outcomes (RRT) or the end of the study (January, 2020). Patients who were followed up for less than one year were excluded. Descriptive statistics and survival analysis were performed with Cox regression, with 95% CI, considered a value of p <0.05 as statistically significative.

Results

222 CKD4 inpatients [age, 60.00(47.75-72.25) years); female, 55.9%] were enrolled. In a median follow-up of 2.41 years, 199 inpatients (10.6%) started RRT. Among those patients, the median time progression to RRT was 2.10 (1.20-3.58) years. All patients were divided into two groups according to whether progressed to RRT within 2.41 years. For those received RRT within 2.41 years, they had heavier urine protein, urine occult blood and account for a higher proportion of inpatients with diabetes mellitus(63.6%), chronic heart failure (43.6%), diabetic kidney disease (55.5%). Their serum albumin and ejection fraction(EF) were lower(P<0.001). The multivariate Cox proportional hazards models showed that age[hazard ration (HR): 0.986; 95% confidence interval(CI): (0.976-0.995); P=0.004], diabetic kidney disease(DKD) [HR:1.727,95%CI: (1.274-2.391), P=0.001], urinary protein [HR:1.148, 95% CI: (1.094-1.205), P<0.001], serum albumin [HR:0.971,95%CI: (0.949-0.994), P=0.013], LVMI [HR:1.010,95%CI: (1.004-1.016), P=0.002], left ventricular dimension systolic(LVDs) [HR:0.948, 95%CI: (0.910-0.986), P=0.008] and EF [HR:0.970, 95%CI: (0.950-0.990), P=0.004] were independently associated with factors for progression to RRT in CKD4 inpatients.

Conclusion

DKD, urinary protein, LVMI were risk factors that were significantly associated with CKD4 progression to RRT in inpatients. Whereas, serum albumin, LVDs, and EF are protective. The urinary protein, serum albumin and echocardiographic parameters need to be taken seriously for patiens with CKD4.