Predictores de la velocidad de progresión de la enfermedad renal crónica en estados 3b y 4 en pacientes asistentes a un programa de prevención secundaria en Colombia
Thesis
Introduction: In the past years, the increasing incidence of chronic kidney disease (CKD) has turned this condition into a public health issue. Most studies in patients with CKD report a significant heterogeneity in the progression rates to end-stage renal failure. Establishing the factors associated with the progression of this condition will lead to structuring better care programs.Objective: To determine predictive factors associated with the progression of stage 3b and 4 CKD in patients of a secondary prevention program.Methods: Dynamic retrospective prognostic cohort study on patients diagnosed with stage 3b and 4 CKD, admitted to an RTS clinic (Hospital Militar Central Agency) between January 2010 and May 2015 (n=736 patients). The Gompertz model was applied for the survival analysis, and the slope of the line that best represented the GFR estimates was taken as the rate of progression.Results: The median age was 79.8 years, and the follow-up time provided by the cohort was 2434 people/year. 108 patients underwent dialysis as an outcome, and its incidence was 4.43 events per 100 patient/year (95% CI 3.67-5.35). The rate of progression per year was 1.0019 ml/min/1.73 m2.Conclusion: A slower rate of progression was obtained —which contrast with findings reported on the literature— and was considered as secondary due to the type of population studied, since it has greater accessibility to health services and to prevention programs, thus factors associated with CKD progression are better controlled.
