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Predictive factors associated with increased progression to dialysis in early chronic kidney disease (stage 1-3)

Nao Nohara1, Hiroaki Io1, Mayumi Matsumoto1

  • 1Division of Nephrology, Department of Internal Medicine, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.

Clinical and Experimental Nephrology
|December 29, 2015
PubMed

Insights

Higher left ventricular mass index (LVMI) and urinary protein, along with lower hemoglobin, predict dialysis progression in early chronic kidney disease (CKD). Echocardiography can identify high-risk CKD patients.

Area of Science:

  • Nephrology
  • Cardiology
  • Medical Imaging

Background:

  • Echocardiographic parameters are linked to dialysis progression in advanced chronic kidney disease (CKD) stages 3-5.
  • Early CKD (stages 1-3) progression factors require further investigation.

Purpose of the Study:

  • To assess physical, biochemical, and echocardiographic predictors of dialysis progression in early CKD patients.
  • To identify early indicators for intervention in CKD management.

Main Methods:

  • Retrospective analysis of 272 early CKD patients (stages 1-3) from 2001-2010.
  • Echocardiography performed at Juntendo University Hospital.
  • Renal endpoint defined as initiation of dialysis.

Main Results:

  • Progression to dialysis associated with higher left ventricular mass index (LVMI), urinary protein, systolic blood pressure, and antihypertensive drug use.
  • Lower albumin and hemoglobin levels also correlated with dialysis progression.
  • Cox regression identified LVMI (HR 1.018), urinary protein, and hemoglobin as independent predictors of dialysis progression.

Conclusions:

  • Elevated LVMI and urinary protein, with reduced hemoglobin, are associated with faster progression to dialysis in early CKD.
  • Echocardiography-derived LVMI may serve as a valuable tool for identifying high-risk early CKD patients requiring closer monitoring and intervention.
Abstract

Keywords:
AnemiaEarly chronic kidney disease (CKD) stageEchocardiographyLeft ventricular mass index (LVMI)

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