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Chronic Kidney Disease (CKD) is a progressive, long-term condition characterized by a gradual and irreversible deterioration of renal function. In its early stages, it is a slow and silent process, leading to a decrease in the estimated glomerular filtration rate (eGFR), a measure of kidney function. Therefore, the objective was to monitor the risk profiles for requiring renal replacement therapy according to the Kidney Failure Risk Equation (KFRE) in patients with Chronic Kidney Disease enrolled in a nephroprotection program in La Guajira (CO) between the years 2021 and 2023.
An analytical study was conducted, where variables were described descriptively in terms of central tendency measures. Quantitative variables were described, and either the Student's t-test or the Wilcoxon test was used, depending on the normality of the variable. On the other hand, the Kruskal-Wallis test was used to assess kidney function according to ASCVD risk categories (Low, Moderate, High). Likewise, the relationship between albuminuria and ASCVD risk score was explored through Spearman correlation. To relate KFRE risk categories (Low, Moderate, High) and ASCVD risk categories (Low, Moderate, High), a correspondence analysis was performed. The Fisher exact test or Chi-square test was applied to analyze categorical variables. The statistical software used was R-CRAN version 4.3.2.
This study included 847 patients from the Nephroprotection program. It was observed that the majority of patients were female, with an average age of 65 years. Hypertension (HTA) was the most common comorbidity, followed by obesity and dyslipidemia. In terms of CKD stages, stage G2 was the most common. When clinical and biochemical parameters were analyzed by gender, significant differences were observed, with higher rates of obesity and dyslipidemia in female patients. Differences were also observed in hemoglobin levels and lipid profile, with females having significantly higher levels of cholesterol and LDL, while males had higher levels of HDL and hemoglobin. When evaluating renal risk with the KFRE formula, it was found that male patients had a significantly higher risk at 2 and 5 years compared to female patients. However, there were no significant differences in KFRE risk categories between sexes. Additionally, cardiovascular risk was analyzed using the ASCVD formula from ACC/AHA, and it was found that female patients had a higher prevalence in cardiovascular risk categories, and a weak positive correlation was observed between albuminuria levels and cardiovascular risk. Finally, the relationship between KFRE renal risk and ASCVD cardiovascular risk was explored, revealing a weak positive correlation between these two risks.
These findings highlight the importance of considering gender differences and risk factor relationships in the care of patients with chronic kidney disease and their cardiovascular risk.