RT Journal Article
T1 PTH levels and not serum phosphorus levels are a predictor of the progression of kidney disease in elderly patients with advanced chronic kidney disease
A1 Toapanta Gaibor, Nestor Gabriel
A1 Nava Perez, Nathasha Carolina
A1 Martinez Echevers, Yeleine
A1 Montes Delgado, Rafael
A1 Guerrero Riscos, Maria Angeles
K1 Chronic kidney disease
K1 Advanced chronic kidney disease
K1 Predialysis
K1 Bone mineral metabolism
K1 Progression of kidney disease
K1 Serum phosphorus
K1 Elderly patients
K1 Stage renal-disease
K1 Phosphate
K1 Creatinine
K1 Mortality
K1 Risk
AB Background: At present, there is a high incidence of elderly patients with advanced chronic kidney disease (CKD) and it is important to know the long term progression and the factors that influence it.Objectives: To analyse the progression of advanced CKD in elderly patients and the influence of bone-mineral metabolism.Methods: Retrospective study of 125 patients >= 70 years of age with CKD stages 4-5 who started follow-up from January 1, 2007 to December 31, 2008, showing the progression of CKD (measured by the slope of the regression line of the estimated glomerular filtration rate [eGFR] by MDRD-4) over 5 years.Results: Progression in the entire group (median and 25th and 75th percentiles): -1.15 (-2.8/0.17) ml/min/1.73 m(2)/year, CKD-4: -1.3 (-2.8/0.03) ml/min/1.73 m(2)/year, CKD-5: -1.03 (-3.0/0.8) ml/min/1.73 m(2)/year; the slope of the regression line was positive in 35 patients (28%: CKD does not progress) and negative in 90 patients (72%: CKD progresses). Negative correlation (Spearman) (slower progression): PTH, albumin/Cr ratio and daily Na excretion (all baseline measurements). No correlation with eGFR, serum P, urinary P excretion, protein intake and intake of P (all baseline measurements). In the linear regression analysis (dependent variable: slope of progression): albuminuria and PTH (both at baseline measurements) influenced this variable independently. Logistic regression (progresses vs. does not progress): PTH, albuminuria and eGFR (all at baseline measurements) influenced significantly.Conclusions: In our group of elderly patients, impairment of renal function is slow, particularly in CKD-5 patients. Albuminuria and PTH at baseline levels are prognostic factors in the evolution of renal function. (C) 2016 Sociedad Espanola de Nefrologia. Published by Elsevier Espana, S.L.U.
PB Soc espanola nefrologia dr rafael matesanz
SN 0211-6995
YR 2017
FD 2017-03-01
LK https://hdl.handle.net/10668/27254
UL https://hdl.handle.net/10668/27254
LA es
DS RISalud
RD Apr 5, 2025