Factors associated with the progression of renal disease one year prior to the start of hemodialysis

ABSTRACT

Chronic kidney disease [CKD] is a worldwide public health problem. The adverse outcome of CKD can often be prevented or delayed through early detection and treatment. Progression of renal failure is characterized by modification of renal structure, which leads to terminal renal insufficiency. Interfering with progression continues to be a major challenge and at the forefront of renal research. Aim of the work is to determine the decrease in creatinine clearance during the year prior to the initiation of hemodialysis [HD] and to identify factors linked to deterioration of kidney functions in order to slow down the progression of renal disease. Subjects and From January 2002 to December 2003 sixty five patients diagnosed with kidney disease were seen at the outpatient clinic of the internal medicine department, El-Minia University Hospital. They were 41 males [63.1%] and 24 females [36.9%]. The progression of the kidney disease was measured by changes in creatinine clearance. creatinine clearance decreased from 20.7 +/- 8.8 ml/min during the year prior to the initiation of HD to 15.8 +/- 7.8 ml/min at the start of dialysis [p<0.001] with a mean decline of 5.5 +/- 3.4 ml/min. It was found that the variables correlated significantly with creatinine clearance were hematocrite value, LDL as well as systolic and diastolic blood pressure. No relation was found between the progression of renal failure and the etiology of CKD. In This study demonstrates the correlation between anemia, dyslipedemia and the progression of chronic renal failure