Baseline characteristics of patients with chronic kidney disease stage 3 and stage 4 in Spain: The MERENA observational cohort study

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Show simple item record Martínez-Castelao, Alberto M. Górriz, José Luis Portolés, José María De Álvaro, Fernando Cases, Aleix I. Lũo, José Navarro-González, Juan F. Montes, Rafael De La Cruz-Troca, Juan José Natarajan, Aparna Batlle, Daniel C.
dc.contributor.other UAM. Departamento de Medicina Preventiva y Salud Pública y Microbiología es_ES 2015-01-08T16:04:59Z 2015-01-08T16:04:59Z 2011-10-07
dc.identifier.citation BMC Nephrology 12 (2011): 53 en_US
dc.identifier.issn 1471-2369 es_ES
dc.description.abstract To obtain information on cardiovascular morbidity, hypertension control, anemia and mineral metabolism based on the analysis of the baseline characteristics of a large cohort of Spanish patients enrolled in an ongoing prospective, observational, multicenter study of patients with stages 3 and 4 chronic kidney diseases (CKD). Methods: Multicenter study from Spanish government hospital-based Nephrology outpatient clinics involving 1129 patients with CKD stages 3 (n = 434) and 4 (n = 695) defined by GFR calculated by the MDRD formula. Additional analysis was performed with GFR calculated using the CKD-EPI and Cockcroft-Gault formula. Results: In the cohort as a whole, median age 70.9 years, morbidity from all cardiovascular disease (CVD) was very high (39.1%). In CKD stage 4, CVD prevalence was higher than in stage 3 (42.2 vs 35.6% p < 0.024). Subdividing stage 3 in 3a and 3b and after adjusting for age, CVD increased with declining GFR with the hierarchy (stage 3a < stage 3b < stage 4) when calculated by CKD-EPI (31.8, 35.4, 42.1%, p 0.039) and Cockcroft-Gault formula (30.9, 35.6, 43.4%, p 0.010) and MDRD formula (32.5, 36.2, 42.2%,) but with the latter, it did not reach statistical significance (p 0.882). Hypertension was almost universal among those with stages 3 and 4 CKD (91.2% and 94.1%, respectively) despite the use of more than 3 anti-hypertensive agents including widespread use of RAS blockers. Proteinuria (> 300 mg/day) was present in more than 60% of patients and there was no significant differences between stages 3 and 4 CKD (1.2 ± 1.8 and 1.3 ± 1.8 g/day, respectively). A majority of the patients had hemoglobin levels greater than 11 g/dL (91.1 and 85.5% in stages 3 and 4 CKD respectively p < 0.001) while the use of erythropoiesisstimulating agents (ESA) was limited to 16 and 34.1% in stages 3 and 4 CKD respectively. Intact parathyroid hormone (i-PTH) was elevated in stage 3 and stage 4 CKD patients (121 ± 99 and 166 ± 125 pg/mL p 0.001) despite good control of calcium-phosphorus levels. Conclusion: This study provides an overview of key clinical parameters in patients with CKD Stages 3 and 4 where delivery or care was largely by nephrologists working in a network of hospital-based clinics of the Spanish National Healthcare System en_US
dc.format.extent 11 pag. en
dc.format.mimetype application/pdf en
dc.language.iso eng en
dc.publisher BioMed Central en_US
dc.relation.ispartof BMC Nephrology en_US
dc.rights © 2011 Martínez-Castelao et al; licensee BioMed Central Ltd. en_US
dc.subject.other Cardiovascular morbidity en_US
dc.subject.other Hypertension control en_US
dc.subject.other Spain en_US
dc.title Baseline characteristics of patients with chronic kidney disease stage 3 and stage 4 in Spain: The MERENA observational cohort study en_US
dc.type article en
dc.subject.eciencia Medicina es_ES
dc.relation.publisherversion es_ES
dc.identifier.doi 10.1186/1471-2369-12-53 es_ES
dc.identifier.publicationfirstpage 53 es_ES
dc.identifier.publicationlastpage 53 es_ES
dc.identifier.publicationvolume 12 es_ES
dc.type.version info:eu-repo/semantics/publishedVersion en Reconocimiento es_ES
dc.rights.accessRights openAccess en
dc.authorUAM Portoles Pérez, José María (262442)
dc.authorUAM De Álvaro Moreno, Fernando (261178)

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