Aetiology of chronic kidney disease and risk factors for disease progression in Chinese subjects: A single-centre retrospective study in Beijing

Abstract

Aim: To assess the aetiological factors of chronic kidney disease (CKD) and factors associated with disease progression. Methods: Single-centre retrospective study evaluating thorough electronic medical records of patients diagnosed with CKD at Peking University People's Hospital (April 2010-April 2015). The objectives were to identify the aetiological factors of CKD in Chinese patients and risk factors associated with CKD progression. Results: Of 15 425 CKD patients, 12 380 had aetiology recorded. The leading aetiologies associated with CKD were chronic glomerulonephritis (CGN; 36.8%), hypertensive nephropathy (HTN; 28.5%) and diabetic nephropathy (DN; 27.1%). CGN was most common in patients with early stage disease (stages 1-2); DN and HTN were common in advanced-stages (stages 3-4). In a longitudinal subcohort of 2923 patients with ≥6-month follow-up, 19.6% experienced CKD progression. Patients with CKD progression were significantly older in age and had a greater number of comorbidities and laboratory anomalies, and were more likely to have DN (40.5%) and CGN (40.5%) than HTN (5.5%) at baseline than patients without progression. In a multivariate analysis, factors associated with disease progression included macro- and micro-albuminuria, anaemia, hyperkalaemia, hyperphosphataemia, metabolic acidosis, CKD stage 4 and type 2 diabetes mellitus (T2DM). Conclusion: This study identified CGN, DN and HTN as the leading aetiological factors for CKD in Chinese patients. DN was a strong predictor of faster disease progression, with albuminuria (a complication of T2DM) associated with highest risk for disease progression.