Factors affecting progression in advanced chronic renal failure

In a series of 174 patients with advanced chronic renal failure due to well defined primary nephropathies, we retrospectively studied factors influencing the rate of progression of renal failure. Using multivariate analysis of variance, we examined the role of gender, type of nephropathy, body mass...

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Bibliographic Details
Published inClinical nephrology Vol. 39; no. 6; p. 312
Main Authors Hannedouche, T, Chauveau, P, Kalou, F, Albouze, G, Lacour, B, Jungers, P
Format Journal Article
LanguageEnglish
Published Germany 01.06.1993
Subjects
Adult
Age Factors
Analysis of Variance
Antihypertensive Agents - therapeutic use
Dietary Proteins - administration & dosage
Female
Humans
Hypertension, Renal - epidemiology
Kidney Failure, Chronic - epidemiology
Kidney Failure, Chronic - etiology
Male
Middle Aged
Multivariate Analysis
Renal Dialysis
Retrospective Studies
Risk Factors
Sex Factors
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Summary:In a series of 174 patients with advanced chronic renal failure due to well defined primary nephropathies, we retrospectively studied factors influencing the rate of progression of renal failure. Using multivariate analysis of variance, we examined the role of gender, type of nephropathy, body mass index, age, protein intake quantified from 24-hour urine urea excretion, blood pressure and need for antihypertensive treatment (including a group of patients treated with ACE inhibitors) on the rate of decline of creatinine clearance (Ccr). We found a prominent and independent influence of sex and type of nephropathy, and to a lesser extent of mean arterial pressure and protein intake. Overall, these covariates were significantly correlated with the slope of decline in creatinine clearance (n = 174; r = 0.61; r2 = 0.37; p < 0.001) indicating that nearly 40% of the total variation in the slope could be predicted by these covariates. The influence of blood pressure was more readily apparent in males, and in patients with the opposite extreme values, i.e., chronic tubulointerstitial nephritis (CIN) and hypertensive angionephrosclerosis (ANS). The effect of protein intake was marginal and limited to patients with CIN and chronic glomerulonephritis (CGN). Effect of gender was important with a progression nearly two times faster in males than in females, and was mostly apparent in polycystic kidney disease (PKD) and in CGN. Type of nephropathy was also determinant. The rate of progression was steeper in Alport's syndrome than in CGN and ANS, and in the latter than in PKD and CIN (slope: CIN = PKD < CGN = ANS < Alport).
ISSN:0301-0430