Independent Role of Underlying Kidney Disease on Renal Prognosis of Patients with Chronic Kidney Disease under Nephrology Care

摘要: Primary kidney disease is suggested to affect renal prognosis of CKD patients; however, whether nephrology care modifies this association unknown. We studied patients with stage I-IV treated in a clinic and established diagnosis cause evaluate the risk event (composite end-stage eGFR decline ≥40%) linked specific modified by achievement or maintenance first year therapeutic goals for hypertension (BP ≤130/80 mmHg proteinuria ≥150 mg/24h and/or diabetes ≤140/90 those <150 without diabetes) anemia (hemoglobin, Hb ≥11 g/dL), (≤0.5 g/24h). Survival analysis started after care. 729 (age 64±15 y; males 59.1%; 34.7%; cardiovascular (CVD) 44.9%; hypertensive nephropathy, HTN 53.8%; glomerulonephritis, GN 17.3%; diabetic DN 15.9%; tubule-interstitial TIN 9.5%; polycystic disease, PKD 3.6%). During Nephrology care, therapy was overall intensified most prevalence main generally improved. subsequent follow up (median 3.3 years, IQR 1.9-5.1), 163 events occurred. Cox disclosed higher (Hazard Ratio 5.46, 95% Confidence Intervals 2.28–10.6) (1.28,2.99–3.05), versus (reference), independently age, gender, CVD, BMI, stage, use RAS inhibitors each three goals. No interaction found on progression between diagnostic categories month-12 (P=0.737), as control BP (P=0.374), (P=0.248) (P=0.590). Therefore, under should be considered conjunction factors refine stratification.