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Introduction: The prevalence of chronic kidney disease (CKD) in Mexico is considerably growing; therefore, it is important to define factors associated with the progression of the disease to establish public health policies. This study aimed to evaluate factors associated with CKD progression in patients of nephrology consultation in a third-level hospital.
Prospective cohort study. Patients attending nephrology consultations at least twice during January 2019 and August 2023 were included. We used Cox regression analysis to identify factors associated with the progression of CKD.
We included 2004 patients with CKD, but only 347 had a second visit, the median between visits was 3 (0-43) months. Between visits we found an increment in CKD-G5 (30 vs 36%, p<0.001), and no difference in the rest of the stages. Comparing the prevalence of hyperuricemia, hyperlipidemia, and hypoalbuminemia no differences were found, on the contrary, we found a reduction in their prevalence. The prevalence of hemoglobin (Hb) <11g/L showed an increment between the two visits (32% vs 36%, p=0.003). We identified anemia (HR 1.66, IC 1.26-2.18, p<0.001) and diabetes mellitus (HR 1.65, IC 1.26-2.1, p<0.001) during visit 1, as risk factors of CKD progression at the second visit. The rest of the variables did not show a significant association with CKD progression.
In this study, we found diabetes as one of the main risk factors associated with CKD progression, in concordance with most of the publications. Even though anemia is a recognized progression risk factor, it has not received enough importance, but in our population, it is especially relevant.