Abstract
Chronic Kidney Disease (CKD) is a global health concern that arises due to multitude of different insults to renal function. Progression of CKD to end stage renal disease (ESRD) is a costly and important clinical event that makes it important to investigate prognosis of earlier stages of CKD. A single centre longitudinal observational study was conducted to identify outcomes of CKD patients and prognostic markers of CKD progressions. All subjects with estimated eGFR between 15 and 59 mL/min/1.73m2 during a 2 year study period (2004-2005) were identified from hospital database. Patients were followed up for 10 years or until ESRD or death, whichever occurred first. A total 621 patients (mean age: 61.09±6.57 years, male: 40%) with CKD stage 3 (n = 438) and stage 4 (n = 183) were included in current study. Annual cumulative decline in eGFR was 3.01±0.40 mL/min/1.73m2. Patients with CKD stage 3 were more likely to progress to ESRD while mortality was more common in CKD stage 4 patients. According to Cox regression analysis, patients with CVD (HR: 2.01, p = 0.02), higher systolic blood pressure (HR: 1.06, p = 0.04), elevated phosphate levels (HR: 1.24, p = 0.01), heavy proteinuria (HR: 3.09, p = 0.03), microscopic hematuria (HR: 2.07, p = 0.02) and diuretics therapy (HR: 2.01, p = 0.01) were more likely to develop ESRD. Prime importance should be given to mild forms of CKD to retard and even reverse CKD progression. Prior knowledge of expected clinical profile and risk factors of disease progression might help clinicians to identify high risk patients, leading to decrease rate of disease progression and mortality.