One-year follow-up mortality of patients with stage 4 chronic kidney disease

Abstract

Introducion: Chronic Kidney Disease (CKD) is associated with an increased morbidity and mortality. There are few published reports on outcomes in non-dialysis CKD patients in Latin-America. Objective: Our objective was to retrospectively assess in a cohort certain outcomes of CKD stage 4 with respect to different morbidities, mortality rate ami renal replacement therapy onset in one year of follow-up. Results: We identidied 154 patients,
median follow-up time: 12 months, females 48%. Median age: 81 years (interquartile rande 74-85). Comorbilities: stroke 9.7% (5.5-15.7); coronary heart disease 25.3% (18.7-33); diabetes 26.6% (19.8-34.3); lipid disorders 55.8% (47.6-63.8); hypertension 93.5% (88.4-96.8); congestive heart failure 31.8% (24.6-39.8); tobacco 30.5% (23.4-38.4); overweight/obesity 27.9% (21.0-35.7). Mortality rate: 10.6 (6.71-17.88). General annual hospitalization rate: 16.44 (11.02-24.52); in cardiovascular unit: 10.27 (9.16-17.04); in kidney failure unit: 2.05 (0.66-6.37). The rate of renal replacement therapy onset was: 2.73 (1.08-7.29). The only independent variables with statistical significance for death in a one way analysis were chronic heart failure and atrial fibrillation, although these did not stand for multivariate analysis. Conclusions: CKD stage 4 patients are very old and present different comorbidities. In one year of follow-up, one out of 37 may initiative dialysis, one out of 9 may die within a year, while one out of 6 may require hospital admission mainly due to cardiovascular disease. The present results are important because there are few publications on this topic in Latin-America, and could be used as baseline reference for future programs.