Analysis of Early Kidney Damage in Hospitalized Patients with Chronic Kidney Disease: A Multicenter Study

Abstract

Background: To identify the risk factors for early kidney damage in hospitalized Chinese patients with chronic kidney disease (CKD). Methods: A total of 12 multicenter cross-sectional studies were conducted between January 2005 and January 2006 in Chinese CKD patients with estimated glomerular filtration rate (eGFR) equal to or more than 30 mL/min/1.73 m² in Shanghai. CKD was defined according to the K/DOQI guideline. GFR was estimated by the simplified modification of diet in renal disease equation. The demographic, clinical, and laboratory data were collected through a questionnaire and analyzed among eligible patients stratified by three different CKD groups (CKD stages 1, 2, and 3). The relevant clinical and laboratory risk factors for early kidney damage with a GFR < 90 mL/min/1.73 m² were determined by logistic regression. Results: A total of 822 CKD patients were enrolled in this study. There were significant differences in age and gender among patients with CKD stages 1, 2, and 3. The prevalence of hypertension, cardiovascular disease, cerebral vascular disease, anemia, and hyperuricemia increases when the eGFR declines. Logistic analysis showed that age, hypertension, anemia, and hyperuricemia were independently associated with early kidney damage. Conclusions: In CKD patients, we have identified only age, hypertension, anemia, and hyperuricemia as the risk factors for early kidney damage. Risk factors should be managed to prevent accelerated kidney damage in CKD patients.

• CKD
• kidney damage
• inpatients

ACKNOWLEDGMENTS

This work was supported by grants from the Leading Academic Discipline Project of Shanghai Health Bureau (05III001 and 2003ZD002) and Shanghai Leading Academic Discipline Project (T0201). We thank the doctors from Shanghai No. 9 People’s Hospital, Xinhua Hospital, Shanghai No. 10 People’s Hospital, Shanghai Changzheng Hospital, Shanghai Huadong Hospital, Shanghai Shuguang Hospital, and Yangpu Hospital for their support. We also thank Drs. Bo Fu from the Biostatistics Group and ARC Epidemiology Unit, School of Medicine, University of Manchester, United Kingdom, and Jie Zhu, Mathematics and Science College, Shanghai Normal University, for their statistical assistance. We thank all those who participated in this study for their important contribution.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.