Profile of estimated glomerular filtration rate in non-dialysis pati-ents: challenge for the preventive approach

Authors

  • Fernanda Marcelino de Rezende e Silva
  • João Victor Marques Guedes
  • Grace Fernanda Severino Nunes
  • André de Oliveira Baldoni
  • Vinícius Silva Belo
  • Alba Otoni

DOI:

https://doi.org/10.55905/oelv21n8-100

Keywords:

kidney diseases, renal insufficiency, chronic, kidney function tests, glomerular filtration rate, health care surveys

Abstract

Aims: To evaluate the estimated glomerular filtration rate (eGFR) profile of chronic renal patients on conservative treatment during five years. Methods: A retrospective cohort study developed in a nephrology outpatient clinic in a city in the state of Minas Gerais, Brazil. All adults and elderly people with non-dialytic chronic kidney disease (CKD) with a follow-up of six months to five years (n=64) were included, having attended at least two consultations, with determination of eGFR by the CKD-EPI equation and serum creatinine. For data collection, the medical records were used, with eGFR as the outcome variable. Clinical and sociodemographic data were considered exposure variables. To analyze the associations, multiple linear regression was used. Kruskal Wallis test was used to compare eGFR values over the years of study. Results: 64 patients were followed up, with a median time to admission to renal replacement therapy of 5 years and 25 days, and the 75th percentile of eight years and three months. In multiple models, there were no significant associations between exposure variables and eGFR. No pattern of eGFR profile was observed for all stages of CKD. A loss of ascending renal function over five years was found. Conclusions: At the end of follow-up, no patient remained in stages 1, 2, and 3 of CKD. Non-dialytic CKD stage 5 maintained a stable line over five years and stage 4 showed an ascending curve in the fifth year, indicating an increase in the number of patients in this stage due to worsening renal function.

References

KOVESDY, C.P. Epidemiology of chronic kidney disease: an update 2022. Kidney Int. v.12, n.1, p. 7-11, 2022.

MARIANI, L.; STENGEL, B.; COMBE, C.; MASSY, Z.A.; REICHEL, H.; FLISER, D. et al. The CKD Outcomes and Practice Patterns Study (CKDopps): Rationale and Methods. Am J Kidney Dis. v. 68, n. 3, p. 402-413, 2016.

CREWS, D.C.; BELLO, A.K.; SAADI, G.; World Kidney Day Steering Committee. Burden, access, and disparities in kidney disease. Braz J Med Biol Res. v. 52, n. 3, 2019.

PINHO, N.A.; SILVA, G.V.; PIERIN, A.M.G. Prevalência e fatores associados à doença renal crônica em pacientes internados em um hospital universitário na cidade de São Paulo, SP, Brasil. J. Bras. Nefrol. v. 37, n. 1, p. 91-97, 2015.

JAGER, K.J.; KOVESDY, C.; LANGHAM, R.; ROSENBERG, M.; JHA, V.; ZOCCALI, C. A single number for advocacy and communication-worldwide more than 850 million individuals have kidney diseases. Kidney Int. v. 96, n. 5, p. 1048-1050, 2019.

KNYSAK, M.; MOCZULSKA, B.; STOMPÓR, T. What is the prognostic value of reduced eGFR? Pol Merkur Lekarski. v. 24, n. 49, p. 13-18, 2021.

KIDNEY DISEASE: IMPROVING GLOBAL OUTCOMES (KDIGO). CKD Work Group. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int (Suppl). v.3, p. 1-150, 2013.

BRASIL. Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Atenção Especializada e Temática. Diretrizes Clínicas para o Cuidado ao paciente com Doença Renal Crônica – DRC no Sistema Único de Saúde/ Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Atenção Especializada e Temática. – Brasília: Ministério da Saúde. p. 37, 2014.

DELGADO, C.; BAWEJA, M.; CREWS, D.C.; ENEANYA, N.D.; GADEGBEKU, C.A.; INKER, L.A. et al. A Unifying Approach for GFR Estimation: Recommendations of the NKF-ASN Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Disease. JASN. v. 32, p. 2994–3015, 2021.

DELGADO, C.; BAWEJA, M.; CREWS, D.C.; ENEANYA, N.D.; GADEGBEKU, C.A.; INKER, L.A. et al. A Unifying Approach for GFR Estimation: Recommendations of the NKF-ASN Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Disease. Am J Kidney Dis. v. 79, n. 2, p. 268-288, 2022.

LI, L.; ASTOR, B.C.; LEWIS, J.; HU, B.; APPEL, L.J.; LIPKOWITZ, M.S. et al. Longitudinal progression trajectory of GFR among patients with CKD. Am J Kidney Dis. v. 59, n. 4, p. 504-512, 2012.

MALTA, M.; CARDOSO, L.O.; BASTOS, F.I.; MAGNANINI, M.M.F.; SILVA, C.M.F.P. Iniciativa STROBE: subsídios para a comunicação de estudos observacionais. Rev Saúde Pública. v.44, p. 559-565, 2010.

LEVEY, A.S.; STEVENS, L.A.; SCHMID, C.H.; ZHANG, Y.L.; CASTRO, A.F.; FELFMAN, H.I. et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. v.150, p. 604–612, 2009.

PINTO, S.W.; LIMA, H.N.; ABREU, T.T.; OTONI, A.; NOGUEIRA, P.C.K.; SESSO, R. Twenty-year Follow-up of Patients With Epidemic Glomerulonephritis due to Streptococcus zooepidemicus in Brazil. Kidney Int Rep. v. 7, n. 9, p. 2029-2038, 2022.

MALMGREN, L.; MCGUIGAN, F.E.; BERGLUNDH, S., WESTMAN, K.; CHRISTENSSON, A.; ÅKESSON, K. Declining Estimated Glomerular Filtration Rate and Its Association with Mortality and Comorbidity Over 10 Years in Elderly Women. Nephron. v.130, p. 245-255, 2015.

GLASSOCK, R.; DENIC, A.; RULE, A.D. Quando os rins envelhecem: um ensaio em nefro-geriatria. J Bras Nefrol. v. 39, n. 1, p. 59-64, 2017.

AITKEN, G.R.; RODERICK, P.J.; FRASER, S.; MINDELL, J.S.; O'DONOGHUE, D.; DAY, J. et al. Change in prevalence of chronic kidney disease in England over time: comparison of nationally representative cross-sectional surveys from 2003 to 2010. BMJ Open. v. 4, n. 1, p. 1-12, 2014.

GAMA, R.M.; GRIFFITHS, K.; VINCENT, R.P. et al. Performance and pitfalls of the tools for measuring glomerular filtration rate to guide chronic kidney disease diagnosis and assessment. J Clin Pathol. v. 76, n. 7, p. 442-449, 2023.

TANGRI, N.; FERGUSON, T.; KOMENDA, P. Pro: Risk scores for chronic kidney disease progression are robust, powerful and ready for implementation. Nephrology Dialysis Transplantation. v. 32, n. 5, p. 748-751, 2017.

PEETERS, M.J.; VAN ZUILEN, A.D.; VAN DEN BRAND, J.A.; BOTS, M.L.; BLANKESTIJN, P.J.; WETZELS, J.F. et al. Validation of the kidney failure risk equation in European CKD patients. Nephrol Dial Transplant. v. 28, n. 7, p. 1773-1779, 2013.

Published

2023-08-25

How to Cite

e Silva, F. M. de R., Guedes, J. V. M., Nunes, G. F. S., Baldoni, A. de O., Belo, V. S., & Otoni, A. (2023). Profile of estimated glomerular filtration rate in non-dialysis pati-ents: challenge for the preventive approach. OBSERVATÓRIO DE LA ECONOMÍA LATINOAMERICANA, 21(8), 9701–9716. https://doi.org/10.55905/oelv21n8-100

Issue

Section

Articles

Most read articles by the same author(s)