Clinical features and risk factors of the kidney function progression in elderly patients with stage 3-4 chronic kidney disease
10.3760/cma.j.issn.0254-9026.2018.06.006
- VernacularTitle:老年慢性肾脏病3-4期患者的临床特点及影响肾功能进展的相关危险因素分析
- Author:
Yanjing ZHANG
1
;
Jihong YANG
;
Xiaohong FU
;
Hua WU
;
Jing JIA
;
Xuefei JIA
;
Yu QIAO
;
Meng WANG
;
Ming LI
;
Lei QIU
;
Hong SHI
;
Huan XI
;
Yao WANG
Author Information
1. 100730,北京医院国家老年医学中心老年医学部肾内科
- Keywords:
Chronic kidney disease;
Glomerular filtration rate;
Risk factor
- From:
Chinese Journal of Geriatrics
2018;37(6):631-635
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical features of elderly patients with stage 3-4 chronic kidney disease ( CKD ) and to analyze the risk factors of the kidney function progression. Methods This was a cross-sectional study. The clinic data of elderly patients (≥60 years) with stable clinical manifestation in Beijing Hospital from January ,2014 to December ,2015 was collected.Based upon the eGFR derived from Cockcroft-Gault (CG) equation ,all patients were divided into groups of CKD 3a group ,CKD 3b group and CKD 4 group ,respectively. Moreover ,patients were separated into the old group (＜ 80 years) and the very old group (≥80 years) based on the age. The demographic features ,primary diseases history ,body mass index (BMI) ,blood routine ,urine routine , blood biochemistry ,Cystatin C and iPTH were recorded.Logistic regression analysis of kidney function progression was also conducted. Results One-hundred and eighty-three cases were enrolled with a mean age of(80 ± 9)years.Along with the descent of kidney function ,the age ,levels of proteinuria and iPTH gradually ascended (F＝ 12.352 ,5.910 ,5.910 ;P＝ 0.000 ,0.003 ,0.003 ,respectively) and the BMI and serum albumin gradually descended (F＝9.758 ,11.088 ;P＝0.000 ,0.000 ,respectively).In addition ,compared to the old group ,very old group was associated with decreased level of eGFR [(37.1 ± 9.9) ml·min－1·1.73 m －2vs. (44.0 ± 12.0) ml·min－1·1.73 m －2,t＝ －4.280 ,P＝0.000] and increasedlevelofCystatinC[(1.71±0.84)mg/L vs. (1.40±0.69)mg/L ,t＝3.484 ,P＝0.001].The Logistic regression analysis indicated that the proteinuria was an independent risk factor for the progression of kidney function ( OR ＝3.856 ,P＝0.004). Conclusions As the gradually descended of the eGFR level in elderly patients with stage 3-4 CKD ,age ,proteinuria and iPTH gradually ascended ,BMI and serum albumin descended ,respectively. The level of eGFR decreased and CystatinC increased significantly with the increasing age. Proteinuria was an independent risk factor for progression of the kidney function.
