Risk factors for progression in KDOQI stage 3 Chronic Kidney Disease (PROGRESER study)

Introduction: The PROGRESER study is a multicentre, prospective, observational, 3-year follow-up study of a cohort of patients with stage 3 chronic kidney disease (CKD) from different nephrology departments of hospitals in the Spanish healthcare system. The primary study objective was to analyse ris...

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Autores: Martínez-Castelao, A, Teruel, JLG, Marco, LD, Garrigós, E, Fernández-Fresnedo, G, Garuz, EE, Guldris, SC, Coloma, JA, Pérez-Monteoliva, NRR, de la Rosa, RJE, Iglesias, LJN, Arduán, AO, Navarro-González, JF
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Recursos:INCLIVA
Repositorio:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
OAI Identifier:oai:incliva.fundanetsuite.com:p18746
Acesso em linha:https://incliva.portalinvestigacion.com/publicaciones/18746
Access Level:acceso abierto
Palavra-chave:Chronic kidney disease
Diabetes mellitus
Diabetic kidney disease
Progression
Cardiovascular risk
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spelling Risk factors for progression in KDOQI stage 3 Chronic Kidney Disease (PROGRESER study)Martínez-Castelao, ATeruel, JLGMarco, LDGarrigós, EFernández-Fresnedo, GGaruz, EEGuldris, SCColoma, JAPérez-Monteoliva, NRRde la Rosa, RJEIglesias, LJNArduán, AONavarro-González, JFChronic kidney diseaseDiabetes mellitusDiabetic kidney diseaseProgressionCardiovascular riskIntroduction: The PROGRESER study is a multicentre, prospective, observational, 3-year follow-up study of a cohort of patients with stage 3 chronic kidney disease (CKD) from different nephrology departments of hospitals in the Spanish healthcare system. The primary study objective was to analyse risk factors for CKD progression, identifying possible differences between patients with and without diabetes mellitus (DM). The secondary objective was to analyse the factors associated with hospitalizations and mortality. Patients and methods: A total of 462 patients (342 men and 120 women; mean age 66.5 +/- 11.5 years) were recruited from 25 participating sites in Spain. Clinical, epidemiological and analytical data were recorder in an electronic register each six months. Biological samples were obtained and frozen for a biobank record at baseline and at 18 and 36 months. Results: The initial mean glomerular filtration rate estimated by MDRD and after that reestimated by CKD-EPI was 43.9 +/- 7.9 mL/min/1.73 m(2); and 29 +/- 6,8 mL/min/1,73 m(2) at 3 years. 27.3% of patients had microalbuminuria and 22.5% had macroalbuminuria. Two-thirds of the patients (66.2%) presented renal damage progression according to the study criteria (decrease of more than 15% in eGFR over the baseline value). 38.7% presented a reduction in eGFR >= 30%; 20.3% had a reduction in eGFR >= 40%; 10.4% had a reduction >= 50% and 6.9% had a reduction >= 57%. Of the 199 diabetics, 134 (67.3%) suffered renal damage progression. Of the 263 non-diabetics, 172 (65.3%) presented progression (P = .456). 27.3% of patients had microalbuminuria and 22.5% proteinuria. The study found that CKD progression to a higher stage was not greater in diabetic compared to non-diabetic patients. Multivariate analysis revealed that the presence of arterial hypertension bordered on significance as a progression factor in non-diabetic patients (P = .07), and that, in diabetic patients, lower calcium levels and elevated intact parathyroid hormone levels at baseline were associated with progression. Conclusion: In our study we have not found new factors for progression of renal damage, different from the yet well known traditional factors. DM per se was not a differential factor for progression in relation with non DM patients. Progression of renal damage in patients with CKD-3 KDOQI may be interpreted in a multifactorial context. The search for new biomarkers, different from traditional ones, is necessary to establish new therapeutic strategies to prevent the progression of CKD.SOC ESPANOLA NEFROLOGIA DR RAFAEL MATESANZ2024info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://incliva.portalinvestigacion.com/publicaciones/18746NEFROLOGIAISSN: 02116995ISSNe: 19892284ISSNl: 20132514reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVAinstname:INCLIVAEspañolinfo:eu-repo/semantics/openAccessoai:incliva.fundanetsuite.com:p187462026-06-07T16:35:31Z
dc.title.none.fl_str_mv Risk factors for progression in KDOQI stage 3 Chronic Kidney Disease (PROGRESER study)
title Risk factors for progression in KDOQI stage 3 Chronic Kidney Disease (PROGRESER study)
spellingShingle Risk factors for progression in KDOQI stage 3 Chronic Kidney Disease (PROGRESER study)
Martínez-Castelao, A
Chronic kidney disease
Diabetes mellitus
Diabetic kidney disease
Progression
Cardiovascular risk
title_short Risk factors for progression in KDOQI stage 3 Chronic Kidney Disease (PROGRESER study)
title_full Risk factors for progression in KDOQI stage 3 Chronic Kidney Disease (PROGRESER study)
title_fullStr Risk factors for progression in KDOQI stage 3 Chronic Kidney Disease (PROGRESER study)
title_full_unstemmed Risk factors for progression in KDOQI stage 3 Chronic Kidney Disease (PROGRESER study)
title_sort Risk factors for progression in KDOQI stage 3 Chronic Kidney Disease (PROGRESER study)
dc.creator.none.fl_str_mv Martínez-Castelao, A
Teruel, JLG
Marco, LD
Garrigós, E
Fernández-Fresnedo, G
Garuz, EE
Guldris, SC
Coloma, JA
Pérez-Monteoliva, NRR
de la Rosa, RJE
Iglesias, LJN
Arduán, AO
Navarro-González, JF
author Martínez-Castelao, A
author_facet Martínez-Castelao, A
Teruel, JLG
Marco, LD
Garrigós, E
Fernández-Fresnedo, G
Garuz, EE
Guldris, SC
Coloma, JA
Pérez-Monteoliva, NRR
de la Rosa, RJE
Iglesias, LJN
Arduán, AO
Navarro-González, JF
author_role author
author2 Teruel, JLG
Marco, LD
Garrigós, E
Fernández-Fresnedo, G
Garuz, EE
Guldris, SC
Coloma, JA
Pérez-Monteoliva, NRR
de la Rosa, RJE
Iglesias, LJN
Arduán, AO
Navarro-González, JF
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Chronic kidney disease
Diabetes mellitus
Diabetic kidney disease
Progression
Cardiovascular risk
topic Chronic kidney disease
Diabetes mellitus
Diabetic kidney disease
Progression
Cardiovascular risk
description Introduction: The PROGRESER study is a multicentre, prospective, observational, 3-year follow-up study of a cohort of patients with stage 3 chronic kidney disease (CKD) from different nephrology departments of hospitals in the Spanish healthcare system. The primary study objective was to analyse risk factors for CKD progression, identifying possible differences between patients with and without diabetes mellitus (DM). The secondary objective was to analyse the factors associated with hospitalizations and mortality. Patients and methods: A total of 462 patients (342 men and 120 women; mean age 66.5 +/- 11.5 years) were recruited from 25 participating sites in Spain. Clinical, epidemiological and analytical data were recorder in an electronic register each six months. Biological samples were obtained and frozen for a biobank record at baseline and at 18 and 36 months. Results: The initial mean glomerular filtration rate estimated by MDRD and after that reestimated by CKD-EPI was 43.9 +/- 7.9 mL/min/1.73 m(2); and 29 +/- 6,8 mL/min/1,73 m(2) at 3 years. 27.3% of patients had microalbuminuria and 22.5% had macroalbuminuria. Two-thirds of the patients (66.2%) presented renal damage progression according to the study criteria (decrease of more than 15% in eGFR over the baseline value). 38.7% presented a reduction in eGFR >= 30%; 20.3% had a reduction in eGFR >= 40%; 10.4% had a reduction >= 50% and 6.9% had a reduction >= 57%. Of the 199 diabetics, 134 (67.3%) suffered renal damage progression. Of the 263 non-diabetics, 172 (65.3%) presented progression (P = .456). 27.3% of patients had microalbuminuria and 22.5% proteinuria. The study found that CKD progression to a higher stage was not greater in diabetic compared to non-diabetic patients. Multivariate analysis revealed that the presence of arterial hypertension bordered on significance as a progression factor in non-diabetic patients (P = .07), and that, in diabetic patients, lower calcium levels and elevated intact parathyroid hormone levels at baseline were associated with progression. Conclusion: In our study we have not found new factors for progression of renal damage, different from the yet well known traditional factors. DM per se was not a differential factor for progression in relation with non DM patients. Progression of renal damage in patients with CKD-3 KDOQI may be interpreted in a multifactorial context. The search for new biomarkers, different from traditional ones, is necessary to establish new therapeutic strategies to prevent the progression of CKD.
publishDate 2024
dc.date.none.fl_str_mv 2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://incliva.portalinvestigacion.com/publicaciones/18746
url https://incliva.portalinvestigacion.com/publicaciones/18746
dc.language.none.fl_str_mv Español
language_invalid_str_mv Español
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv SOC ESPANOLA NEFROLOGIA DR RAFAEL MATESANZ
publisher.none.fl_str_mv SOC ESPANOLA NEFROLOGIA DR RAFAEL MATESANZ
dc.source.none.fl_str_mv NEFROLOGIA
ISSN: 02116995
ISSNe: 19892284
ISSNl: 20132514
reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
instname:INCLIVA
instname_str INCLIVA
reponame_str r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
collection r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812429

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