Analysis of the factors of survival to renal replacement therapy in patients with chronic kidney disease
Background. The relationship between chronic kidney disease (CKD) and cardiovascular diseases is important and is characterized by the presence of numerous adverse factors compared with patients with cardiovascular disease alone. The purpose of the study is to evaluate the incidence of risk factors for cardiovascular complications, nephrological risk factors and their combination in patients with CKD stage IV–V, who survived to the stage of renal replacement therapy. Materials and methods. Retrospectively, we have analyzed medical records (for 2 years) of 42 patients (12 (28.6 %) men, 30 (71.4 %) women) with CKD stage IV–V, who by the time of medical records analysis did not receive renal replacement therapy. All patients underwent the following measurements: body mass index, blood pressure, heart rate, complete blood count and biochemical blood test, the level of residual diuresis. To determine glomerular filtration rate (GFR), we used Chronic Kidney Disease Epidemiology Collaboration equation. Statistical processing of research materials was performed by means of Statistica v. 6.1 software package (Statsoft Inc., USA). Results. The mean age of patients was 47.6 ± 11.6 years. The study showed that patients with CKD, who survived to renal replacement therapy, had daily diuresis more than 500 ml, heart rate less than 90 bpm. Systolic blood pressure in such patients was maintained with drugs at the level of not less than 160 mmHg. The level of total cholesterol more than 4.5 mmol/l and body mass index more than 25 kg/m2 were also characteristic features. We found a direct correlation between GFR and total cholesterol (r = 0.32, p = 0.04), GFR and hemoglobin (r = 0.39, p = 0.01) and a direct correlation between GFR and the amount of residual urine (r = 0.32, p = 0.04). Conclusions. The most significant factors of survival of a patient with CKD before renal replacement therapy are: young age (under 40 years), presence of residual urine (daily diuresis more than 500 ml/day), absence of diabetes mellitus. The control of anemia and systolic blood pressure < 160 mmHg are of particular importance.
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Levey AS, Atkins R, Coresh J, et al. Chronic kidney disease as a global public health problem: approaches and initiatives - a position statement from Kidney Disease Improving Global Outcomes. Kidney Int. 2007 Aug;72(3):247-59. doi: 10.1038/sj.ki.5002343.
Kuryata AV, Frolova EA. Lipidnyj obmin i kardiovaskuljarnyj ryzyk u hvoryh na hronichnu hvorobu nyrok : monografija [Lipid exchange and cardiovascular risk in patients with chronic kidney disease: monograph]. Dnіpro: Gerda; 2013.112 p. (in Ukrainian).
Couser WG, Remuzzi G, Mendis S, Tonelli M. The contribution of chronic kidney desease to the global burden of major noncommunicable disease. Kidney Int. 2011 Dec;80(12):1258-70. doi: 10.1038/ki.2011.368.
Ene-Iordache B, Perico N, Bikbov B, et al. Chronic kidney disease and cardiovascular risk in six regions of the world (ISN-KDDC): a cross-sectional study. Lancet Glob Health. 2016 May;4(5):e307-19. doi: 10.1016/S2214-109X(16)00071-1.
Kolesnyk MO, Lapchins'ka II, Tashchuk VK, et al. Kardiovaskuljarni uskladnennja u hvoryh na hronichnu hvorobu nyrok [Cardiovascular complications in patients with chronic kidney disease]. Kyiv: Polіgraf plius; 2010. 224 p. (in Ukraine).
Ministry of Нealth of Ukraine. Order № 280/44 dated May 11, 2011. On the approval of the standard and unified clinical protocols for the provision of medical care in the specialty Nephrology. Available from: http://old.moz.gov.ua/ua/portal/dn_20110511_280.html. Accessed: May 11, 2011. (in Ukrainian).
Kidney Disease: Improving Global Outcomes (KDIGO). Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int Suppl. 2013 Jan;3(1):1-150. doi: 10.1038/kisup.2012.76.
Kidney Disease: Improving Global Outcomes (KDIGO) Anemia Work Group. KDIGO Clinical Practice Guideline for Anemia in Chronic Kidney Disease. Kidney Int Suppl. 2012 Aug;2(4):1-150. doi: 10.1038/kisup.2012.37.
Kuryata AV, Frolova EA. Morphofunctional state of myocardium and its damages under influencing of anemia treatment by the erythropoiesis-stimulating agents in patients on maintenance hemodialysis. Ukrainian Journal of Nephrology and Dialysis. 2011;(32):39-48. (in Russian).
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