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Title: | Baseline Characteristics of Patients with Chronic Kidney Disease Stage 3 and Stage 4 in Spain: the MERENA Observational Cohort Study |
Author: | Martínez Castelao, Alberto Górriz, José Luis Portolés, José Alvaro, Fernando de Cases Amenós, A. (Aleix) Luño, José Navarro González, Juan F. Montes, Rafael Cruz Troca, Juan J. de la Natarajan, Aparna Batlle, Daniel |
Keywords: | Malalties del ronyó Nefrologia Espanya Malalties cròniques Formulació clínica Kidney diseases Nephrology Spain Chronic diseases Case formulation |
Issue Date: | 5-Oct-2011 |
Publisher: | BioMed Central |
Abstract: | Background: To obtain information on cardiovascular morbidity, hypertension control, anemia and mineral metabolism based on the analysis of the baseline characteristics of a large cohort of Spanish patients enrolled in an ongoing prospective, observational, multicenter study of patients with stages 3 and 4 chronic kidney diseases (CKD). Methods: Multicenter study from Spanish government hospital-based Nephrology outpatient clinics involving 1129 patients with CKD stages 3 (n = 434) and 4 (n = 695) defined by GFR calculated by the MDRD formula. Additional analysis was performed with GFR calculated using the CKD-EPI and Cockcroft-Gault formula. Results: In the cohort as a whole, median age 70.9 years, morbidity from all cardiovascular disease (CVD) was very high (39.1%). In CKD stage 4, CVD prevalence was higher than in stage 3 (42.2 vs 35.6% p < 0.024). Subdividing stage 3 in 3a and 3b and after adjusting for age, CVD increased with declining GFR with the hierarchy (stage 3a < stage 3b < stage 4) when calculated by CKD-EPI (31.8, 35.4, 42.1%, p 0.039) and Cockcroft-Gault formula (30.9, 35.6, 43.4%, p 0.010) and MDRD formula (32.5, 36.2, 42.2%,) but with the latter, it did not reach statistical significance (p 0.882). Hypertension was almost universal among those with stages 3 and 4 CKD (91.2% and 94.1%, respectively) despite the use of more than 3 anti-hypertensive agents including widespread use of RAS blockers. Proteinuria (> 300 mg/day) was present in more than 60% of patients and there was no significant differences between stages 3 and 4 CKD (1.2 +/- 1.8 and 1.3 +/- 1.8 g/day, respectively). A majority of the patients had hemoglobin levels greater than 11 g/dL (91.1 and 85.5% in stages 3 and 4 CKD respectively p < 0.001) while the use of erythropoiesis-stimulating agents (ESA) was limited to 16 and 34.1% in stages 3 and 4 CKD respectively. Intact parathyroid hormone (i-PTH) was elevated in stage 3 and stage 4 CKD patients (121 +/- 99 and 166 +/- 125 pg/mL p 0.001) despite good control of calcium-phosphorus levels. Conclusion: This study provides an overview of key clinical parameters in patients with CKD Stages 3 and 4 where delivery or care was largely by nephrologists working in a network of hospital-based clinics of the Spanish National Healthcare System. |
Note: | Reproducció del document publicat a: https://doi.org/10.1186/1471-2369-12-53 |
It is part of: | BMC Nephrology, 2011, vol. 12, p. 53 |
URI: | http://hdl.handle.net/2445/126189 |
Related resource: | https://doi.org/10.1186/1471-2369-12-53 |
ISSN: | 1471-2369 |
Appears in Collections: | Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) Articles publicats en revistes (Medicina) |
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