Progression of Kidney Failure in Patients with Non-diabetic Chronic Kidney Disease under Combination Therapy in Japan
Journal of Rural Medicine
: Details about the progression of chronic kidney disease (CKD) have yet to be clarified in Asia. We investigated the progression rate of CKD in Japanese patients treated with combination therapy. Methods : This study was conducted with patients with non-diabetic CKD. Their dietary protein intake (DPI) was 0.6 to 0.9 g/kg/day. Angiotensin -converting-enzyme inhibitors or angiotension-IIreceptor blockades were regularly prescribed. The rate of loss of kidney function was defined as the decline
... creatinine clearance (CCr) per month. Factors correlating with the rate of loss of kidney function and CCr were analyzed by regression analysis, and CCr prediction formulae were then developed by multiple logistic regression analysis. Results : Thirty-eight patients were enrolled in this study (male 19, female 19) and observed for 71.0 months. Their average age was 57.7 years old. The average CCr and the rate of loss of kidney function were 38.2 ml/min/1.73 m 2 and 0.410 ml/ min/1.73 m 2 /month, respectively. The loss of kidney function was accelerated by urinary proteine excretion and hypoalbuminemia. Values for the CCr prediction formulae were calculated using serum creatinine concentration, weight, and age, and the formulae showed that the rate of loss of kidney function in younger males was faster than that in the elderly or females. The differences among the formulae in the loss of kidney function were greatest in the younger males. Conclusions : We found that the loss of kidney function varies according to patients' age and background. To slow the progression of CKD, future strategies should take the different characteristics of each age group into account.