Analysis of factors affecting disease progression and mortality in patient with chronic kidney disease

Chronic kidney disease (CKD) is an emerging public health issue in our country and in the world. Due to its nature, CKD patients progress to end-stage renal disease (ESRD). Patients which progress to ESRD need renal replacement therapies; therefore, ESRD is an important cause of morbidity and mortality, loss of workforce and a significant increase in health expenditures. Diabetes mellitus, hypertension and chronic glomerulonephritis are main causes of CKD. Under multiple risk factors, the rate of CKD progression may change. Although there are several amendable risk factors for progression are known such as diabetes, hypertension, proteinuria, anemia, hyperphosphatemia, obesity, dietary factors, smoking and drug use; there may be other factors previously not demonstrated on the rate of CKD progression. Recognizing and treating factors affecting CKD progression would be beneficial to reduce morbidity and mortality. In this study, we retrospectively evaluated demographic and clinical data and drugs used by CKD patients; we evaluated how these risk factors may contribute to CKD progression rate, progression to ESRD and mortality. In our study, we demonstrated the use of RAS blockers and hyperphosphatemia contribute to CKD progression. In the end of observation period, presence of coronary artery disease and high proteinuria increased the risk of progression to ESRD/RRT; whereas, use of statins and vitamin D supplementation reduced the progression to ESRD/RRT. Mortality was increased with the presence of congestive heart failure, hyperphosphatemia and anemia; use of RAS blockers, vitamin D supplementation and higher albumin levels reduced the risk of mortality in CKD patients.