Application of Markov model in studying graded prognosis of chronic kidney disease / 第二军医大学学报

ABSTRACT

Objective: To evaluate the progression of chronic kidney disease (CKD) in CKD patients and to establish a Markov model for graded prognosis of CKD. Methods: A total of 272 CKD patients were retrospectively investigated. A Markov model consisting of six states (CKD1 stage, CKD2 stage, CKD3 stage, CKD4 stage, CKD5 stage as well as death/ end-stage renal disease [ESRD] stage) was established. Results: The mean follow-up period was 2.0 years. Transition rates from CKD1 stage to CKD2 stage, from CKD2 stage to CKD3 stage, from CKD3 stage to CKD4 stage, from CKD4 stage to CKD5 stage and from CKD5 stage to death/ESRD stage were 9.2%/year, 10.9%/year, 13.2%/year, 16.1%/year, and 47.1%/year, respectively. The Markov model estimated that the mean duration of CKD1 stage, CKD2 stage, CKD3 stage, CKD4 stage, CKD5 stage and death/ESRD stage in our cohort were 11.1 years, 7.8 years, 5.4 years, 2.5 years and 1.0 years, respectively. The mean renal survival time or dialysis free period was 27.8 years. Conclusion: Evaluation of severity and the treatment of CKD patients should be done according to the prognoses of CKD patients at different stages.