Identifying Predictors for Rapid Kidney Function Deterioration among Chronic Kidney Disease Patients in Thailand Settings of Real-life Practice

Chronic kidney disease (CKD) and progression to end-stage renal disease (ESRD) are major public health problems around the world. In Asia, the incidence of ESRD is increasing and consuming more health expenditures. Prevention of ESRD is essential.

This study aims to assess for factors associated with a rapid decline of estimated glomerular filtration rate(eGFR) among the Thai CKD population.

This was a retrospective cohort study of 1,263 CKD patients in a tertiary university hospital from July 2013 to December 2021. Patients were categorized into 2 groups based on their annual rate of eGFR decline: the rapid group (>5 ml/min/1.73 m² /year) and the non-rapid group (≤5 ml/min/1.73 m² /year). All baseline and follow-up variables were assessed to identify predictors of rapid eGFR decline.

The median rate of eGFR decline was 3.0 ml/min/1.73m²/year in the non-rapid group (362 patients) and 6.6 ml/min/1.73m²/year in the rapid group (901 patients). Patients in the rapid group had a longer median follow-up time than in the non-rapid group (7.7 years versus 7.1 years respectively). In multivariate logistic analysis, diabetic mellitus, high baseline serum total carbon dioxide (TCO2), NSAID usage, and ACEI usage predicted rapid eGFR decline, but serum albumin during follow-up protected rapid eGFR decline.

The main predictors for rapid kidney function deterioration were diabetic mellitus, high serum TCO2 during follow-up, NSAID usage, and ACEI usage. Serum albumin during follow-up protected kidney function.