Risk factors associated with chronic kidney disease progression: Long-term retrospective analysis from Qatar

Ahmed Hamdi; Ashraf Fawzy; Essa Abuhelaiqa; Muhammad Asim; Awais Nuaman; Adel Ashur; Omar Fituri; Mohamad M. Alkadi; Hassan A. Al‐Malki

doi:10.5339/qmj.2022.57

January 1, 2022Qatar medical journalOpen Access

Risk factors associated with chronic kidney disease progression: Long-term retrospective analysis from Qatar

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Why the study?

Recognizing the complex and heterogeneous risk factors associated with CKD progression can enable the identification of high-risk patients for more intensive treatment.

What are the demographic and clinical risk factors associated with chronic kidney disease progression and reaching ESKD or death?

Structured PICO

What are the demographic and clinical risk factors associated with chronic kidney disease progression and reaching ESKD or death?

P

Population

1020 patients with chronic kidney disease (CKD) followed at a tertiary health care center

O

Outcome

End-stage kidney disease (ESKD) or death, and CKD progression (decline of eGFR)composite

Older age, Arab ethnicity, smoking, diabetes, hypertension, higher proteinuria, and non-use of RAS blockers are significant risk factors for CKD progression and ESKD/death in Qatar.

Limitations

Retrospective design

Implication

May identify high-risk CKD patients for intensified monitoring; leaves open need for prospective validation before changing practice.

Abstract

INTRODUCTION: The risk factors influencing the natural course of chronic kidney disease (CKD) are complex and heterogeneous. Recognizing the factors associated with CKD progression can enable the identification of high-risk patients for more intensive treatment. PATIENTS AND METHODS: A retrospective evaluation of CKD patients was performed under follow-up between January 1, 2001 and December 31, 2016 at a tertiary health care center. RESULTS: Among 5370 screened patients, 1020 patients with complete data were included in the analysis. The median follow-up period for the studied patients was 9.3 years. Based on the analysis, 120 (11.8%) patients had reached end-stage kidney disease "ESKD" or death. The study revealed that the risk factors associated with reaching ESKD and/or death using Kaplan-Meier survival curve and log rank test included higher hemoglobin A1c among diabetic patients, higher grade of proteinuria, and non use of renin-angiotensin system blockers. The patients with CKD progression constituted 77.2% of all CKD patients. The study findings indicated that older age, Arab ethnicity, smoking habit, diabetes mellitus and hypertension (presumed as original kidney diseases) are among the significant risk factors associated with a further decline of the estimated glomerular filtration rate (eGFR) and further CKD progression. CONCLUSION: This study summarized the demographic and clinical risk factors associated with CKD progression and patients' outcomes among a unique and heterogeneous population in the state of Qatar. Intensive treatment of modifiable risk factors could be of value in halting the progression of CKD. However, prospective studies are warranted to confirm our findings.