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

• Published in: NEPHROLOGY Vol. 25; no. 9; pp. 714 - 722
• Main Authors: Sui, Zhun, Wang, Jiemin, Cabrera, Claudia, Wei, Jia, Wang, Mi, Zuo, Li
• Format: Journal Article Publication
• Language: English
• Published: Melbourne John Wiley & Sons Australia, Ltd 01.09.2020; Wiley Subscription Services, Inc
• Subjects: Acidosis; Aged; China - epidemiology; chronic kidney diseases; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - epidemiology; diabetic nephropathies; Diabetic Nephropathies - complications; Diabetic Nephropathies - diagnosis; Diabetic Nephropathies - epidemiology; Disease Progression; Electronic medical records; Etiology; Female; Glomerulonephritis; Humans; Hypertension, Renal - complications; Hypertension, Renal - epidemiology; hypertensive nephropathy; Kidney diseases; Male; Metabolic acidosis; Middle Aged; Multivariate analysis; Nephritis - complications; Nephritis - epidemiology; Nephropathy; Original; Patients; Renal Insufficiency, Chronic - diagnosis; Renal Insufficiency, Chronic - epidemiology; Renal Insufficiency, Chronic - etiology; Retrospective Studies; Risk Assessment - methods; Risk Assessment - statistics & numerical data; Risk Factors; China; chronic kidney diseases; hypertensive nephropathy; disease progression; diabetic nephropathies; glomerulonephritis
• ISSN: 1320-5358; 1440-1797; 1440-1797
• DOI: 10.1111/nep.13714

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. SUMMARY AT A GLANCE This study identified diabetic nephropathy was a strong predictor of faster disease progression, and confirmed albuminuria to be associated with highest risk for disease progression.