Omar, Fatin Farhanah Haji
(2016)
Renal survival and its prognostic factors in chronic kidney disease patients in Hospital Universiti Sains Malaysia, Kelantan.
Masters thesis, Universiti Sains Malaysia.
Abstract
Introduction: End Stage of Renal Disease (ESRD) in Chronic Kidney Disease (CKD)
patients represents a heavy burden for patients, families, and health care systems.
Objectives: The objectives of this study were to determine the renal survival time of
CKD patients at Hospital USM and to identify the prognostic factors that influence the
renal survival of patients. Methodology: A retrospective cohort study was conducted
involving 247 CKD patients at Hospital USM, Kelantan from January 2005 until
December 2015. All patients who fulfilled the criteria were included in the study. The
medical record were reviewed and the renal survival time based on the time of the first
date of diagnosis with CKD until the the first date of diagnosis with ESRD or received
dialysis. The Kaplan-Meier and Cox proportional hazard regression analyses were
used in the statistical analysis. Results: Overall renal survival time of CKD patients
was 26 months. The significant prognostic factors that influence the renal survival of
CKD patients were GFR (adjusted hazard ratio (HR)=0.96, 95% confidence interval
(CI): 0.98,0.99; p value <0.001), smoking status (adjusted HR=2.19, 95% CI: 1.53,
3.13; p value=0.042), comorbid hyperlipidemia (adjusted HR=1.87, 95% CI: 1.34,2.60;
p value =0.005), analgesics (adjusted HR=1.87, 95% CI: 1.21,2.88; p value =0.015),
functional GI disorder (adjusted HR=1.42, 95% CI:1.07,2.01; p value =0.016), lipid
lowering agents (adjusted HR=1.41, 95% CI: 1.02,1.97; p value=0.039), corticosteroid
(adjusted HR=2.10, 95% CI: 1.25,3.55; p value =0.005), urea (adjusted HR=1.03, 95%
CI: 1.01,1.05; p value <0.001), and creatinine (adjusted HR=0.99, 95% CI: 0.98,1.00; p
value =0.005). Conclusion: The medium renal survival time of CKD patients in this study very fast within 26 month. The prognostic factors of renal survival identified were
GFR level, smoking status, comorbid hyperlipidemia, analgesics, lipid lowering agents,
functional GI disorder, corticosteroid drugs, urea and creatinine are significant to renal
survival among CKD patients in Hospital USM. Thus, the clinician can change the
clinical management by focus on the factors and slow the progression to ESRD.
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