Work

Predictors of rapid eGFR decline in early to moderate chronic kidney disease (stages G1–G4): insights from a real-world Thai cohort incorporating KDIGO 2024 guidelines

Year: 2025

Type: article

Abstract: Many studies have identified risk factors for kidney failure; however, few have incorporated guideline-based recommendations or evaluated risk across all stages of CKD. This study aimed to identify factors associated with rapid eGFR decline in CKD stages G1–G4 using real-world clinical data. This retrospective cohort study included 2,157 patients with CKD stages 1–4 between January 2018 and December 2022. Rapid eGFR decline was defined as an average eGFR reduction of ≥5 mL/min/1.73 m2/year. Clinical variables including age, sex, BMI, diabetes mellitus (DM), hypertension, albuminuria, hemoglobin, systolic blood pressure (SBP), and use of RAASi, GLP-1RA, SGLT2i, and statins were assessed. Multivariable logistic regression was performed to identify independent predictors. Among 2,157 patients, 527 (24.4%) were classified as having rapid eGFR decline. Factors independently associated with rapid decline included SBP ≥120 mmHg (OR 1.84, p = 0.001), hemoglobin <10 g/dL (OR 1.78, p = 0.002), DM (OR 1.80, p < 0.001), and moderately increased albuminuria (OR 1.88, p = 0.002); severely increased albuminuria (OR 1.63, p = 0.02). In contrast, being in moderate to severe CKD stages (G3–G4) was associated with a lower risk of rapid progression (G3: OR 0.62, p = 0.010; G4: OR 0.59, p = 0.02). Statin use was also associated with a reduced risk of rapid eGFR decline (OR 0.77, p = 0.04). In conclusion, this study identified SBP control, anemia, DM, albuminuria and stage of CKD as key factors associated with rapid CKD progression. Achieving SBP <120 mmHg demonstrated renal benefits. Interestingly, statin use was also associated with a reduced risk of rapid eGFR decline.

Source: Renal Failure

DOI: 10.1080/0886022x.2025.2593732

Authors: Suthiya Anumas, Poomsit Rattanapanop, Pattharawin Pattharanitima

Institution: Thammasat University

Language: English

Topic: Chronic Kidney Disease and Diabetes

Subfield: Nephrology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,306