Chronic Kidney Diseases, Chronic Renal Insufficiency, CKD, Kidney Failure, Kidney Failure, Chronic
Conditions
Keywords
Chronic Kidney Disease, CKD, Predictors; Predialysis; eGFR
Brief summary
This prospective observational cohort study aims to identify independent predictors of rapid chronic kidney disease (CKD) progression and determine its incidence among predialysis CKD patients. A total of 190 adult patients will be enrolled from the nephrology outpatient clinic and inpatient ward at Assiut University Hospitals and followed for 24 months. Rapid progression is defined as a sustained decline in eGFR \> 5 mL/min/1.73 m² per year according to KDIGO 2024 criteria. Clinical and laboratory parameters will be assessed at baseline and during follow-up to identify predictive factors
Detailed description
Chronic kidney disease (CKD) is a major global public health problem affecting approximately 10% of the population worldwide. Diabetes mellitus and hypertension remain the leading causes of CKD, accounting for the majority of patients progressing to kidney failure. The clinical course of CKD is highly heterogeneous. While some patients maintain stable kidney function, others experience rapid deterioration leading to kidney failure within a relatively short period. Rapid progression of CKD is associated with a markedly increased risk of kidney failure, cardiovascular events, and all-cause mortality. According to KDIGO 2024 guidelines, a sustained decline in eGFR exceeding 5 mL/min/1.73 m² per year is considered rapid progression and warrants careful evaluation and optimization of renoprotective therapy. Early identification of patients at risk of rapid progression enables clinicians to intensify monitoring, initiate renoprotective therapies, and prepare patients appropriately for kidney replacement therapy. This prospective cohort study will enroll 190 adult patients with predialysis CKD from the nephrology outpatient clinic and inpatient ward at Assiut University Hospitals. Participants will undergo comprehensive clinical and laboratory assessment at baseline, including demographic data, comorbidities, eGFR (CKD-EPI equation), complete blood count, liver function tests, electrolytes, uric acid, bicarbonate, CRP, lipid profile, and thyroid function tests. Patients will be followed for 24 months to assess the incidence of rapid progression and identify independent predictors using multivariable regression analysis.
Interventions
None listed
Sponsors
Assiut University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Inclusion criteria
* Age 18 years or older * Diagnosis of CKD according to KDIGO 2024 criteria * Predialysis status (not on maintenance dialysis) * Ability to provide written informed consent * Availability for 24-month follow-up
Exclusion criteria
* Acute kidney injury * Current maintenance dialysis * Previous kidney transplantation * Active malignancy * Pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of rapid CKD progression | 24 months | Proportion of participants who experience rapid CKD progression, defined as a sustained decline in eGFR greater than 5 mL/min/1.73 m² per year. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Independent predictors of rapid CKD progression | 24 months | Clinical and laboratory variables independently associated with rapid CKD progression using multivariate logistic regression analysis. |
| Change in estimated glomerular filtration rate (eGFR) | Baseline, 12 months, and 24 months | Absolute change in eGFR (mL/min/1.73 m²) from baseline to follow-up visits. |
| Change in albuminuria | Baseline, 12 months, and 24 months | Change in urine albumin-to-creatinine ratio from baseline to follow-up visits. |
Contacts
CONTACTNoura D Fahmi, Resident
STUDY_CHAIREffat A tony, prof
Internal Medicine Department, Assiut University Hospitals
Outcome results
None listed