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

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Abstract

Background

It has been reported that echocardiographic parameters are independently associated with the progression to dialysis in patients with chronic kidney disease (CKD) (stages 3–5). The objective of the present study was to evaluate whether physical, biochemical, and echocardiographic parameters are associated with the progression to dialysis in early CKD (stage 1–3) patients.

Methods

This retrospective study enrolled 272 CKD patients who underwent echocardiography at the time of diet education, renal biopsy, and the examination of kidney injuries at Juntendo University Hospital, Tokyo, Japan, from 2001 to 2010. All of these CKD patients were classified into stages 1–3. The study patients received regular follow-up at our outpatient clinic in our division. The renal end point was defined as commencement of dialysis.

Results

Patients with progression to dialysis were significantly associated with higher levels of left ventricular mass index (LVMI), urinary protein, systolic blood pressure, many kinds of anti-hypertensive drugs, and lower levels of albumin and hemoglobin. In a Cox proportional hazard regression analysis, LVMI [hazard ration (HR) 1.018; 95 % confidence interval (CI) 1.007–1.029; p = 0.002], urinary protein and hemoglobin were independently associated with factors for progression to dialysis in early CKD patients.

Conclusion

This study of patients in early CKD demonstrated that higher LVMI and urinary protein and that lower levels of hemoglobin in blood were associated with progression to dialysis. LVMI evaluated by echocardiography may identify a high risk of progression to dialysis in early CKD patients.

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Acknowledgments

The authors of this manuscript declare that they have complied with the Principles of Ethical Publishing present in the Declaration Helsinki and that the study protocol was approved by a local ethics committee.

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Authors and Affiliations

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

    Nao Nohara, Hiroaki Io, Mayumi Matsumoto, Masako Furukawa, Kozue Okumura, Junichiro Nakata, Yoshio Shimizu, Satoshi Horikoshi & Yasuhiko Tomino

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  1. Nao Nohara
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  2. Hiroaki Io
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  3. Mayumi Matsumoto
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  4. Masako Furukawa
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  7. Yoshio Shimizu
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  9. Yasuhiko Tomino
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Correspondence to Yasuhiko Tomino.

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Nohara, N., Io, H., Matsumoto, M. et al. Predictive factors associated with increased progression to dialysis in early chronic kidney disease (stage 1–3) patients. Clin Exp Nephrol 20, 740–747 (2016). https://doi.org/10.1007/s10157-015-1210-3

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  • DOI: https://doi.org/10.1007/s10157-015-1210-3

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