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Variability in CKD stage in outpatients followed in two large renal clinics

Tabo Sikaneta1, Mohamed Abdolell, Hulya Taskapan

  • 1Renal Division, Scarborough Hospital, Scarborough, ON, Canada. tabosikaneta@yahoo.ca

International Urology and Nephrology
|March 23, 2011
PubMed

Insights

Chronic kidney disease (CKD) stage variability is common in elderly patients. An improving CKD stage was linked to a lower likelihood of needing dialysis later on.

Area of Science:

  • Nephrology
  • Geriatric Medicine
  • Clinical Epidemiology

Background:

  • Chronic kidney disease (CKD) staging relies on glomerular filtration rate (GFR), but stage can fluctuate between visits.
  • The impact of this CKD stage variability on patient and renal survival is not well understood.
  • Understanding CKD stage dynamics is crucial for accurate prognosis and patient management.

Purpose of the Study:

  • To quantify and categorize CKD stage variability in a large outpatient cohort.
  • To identify clinical and demographic factors associated with CKD stage variability.
  • To correlate CKD stage variability patterns with renal and patient survival outcomes.

Main Methods:

  • Estimated GFRs were used to stage CKD at baseline.
  • CKD stages were categorized as static, improving, worsening, or fluctuating over the observation period.
  • Logistic regression identified factors associated with variability; Cox proportional regression analyzed survival outcomes.

Main Results:

  • CKD stage changed in 40% of 1,262 elderly patients over a 1.1-year period.
  • Improving CKD stages were associated with heavy proteinuria, East Asian ethnicity, diabetes mellitus, and prior acute kidney injury.
  • An improving CKD stage was inversely associated with the subsequent need for dialysis.

Conclusions:

  • CKD stage variability is frequent in elderly outpatients, with 40% showing changes within a year.
  • Improving CKD stage emerged as a significant predictor, indicating a reduced risk of future dialysis.
  • This highlights the prognostic importance of monitoring CKD stage dynamics beyond a single cross-sectional assessment.
Abstract

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