Prognostic Factors of Renal Survival among Chronic Kidney Disease Patients in Tertiary Care Centre in Kelantan, Malaysia

Chronic kidney disease (CKD) has the potential to evolve towards end-stage renal disease (ESRD) rather than being a functionally static process. The study aimed to identify the prognostic factors of renal survival in CKD patients. This study was a retrospective cohort study, which involved the medical record review of CKD patients between January 2005 and December 2015 in one of the tertiary referral hospitals in Malaysia. All CKD patients were included, whereas patients who were transferred out to other hospitals and had incomplete data were excluded from the study. Cox proportional hazards regression was implemented to assess the prognostic factors for renal survival among CKD patients. The significant prognostic factors that influence renal survival were smoking status (adjusted hazard ratio (HR): 2.19; 95% confidence interval (CI): 1.53, 3.13; p<0.001), hyperlipidaemia (adjusted HR:1.87; 95% CI: 1.34, 2.60; p<0.001), use of analgesics (adjusted HR: 1.87; 95% CI: 1.21, 2.8; p=0.005), use of functional GI disorder drugs (adjusted HR: 1.42; 95% CI: 1.07, 2.01; p=0.016), use of lipid lowering agents (adjusted HR: 1.41, 95% CI: 1.02, 1.97; p=0.039), use of corticosteroid (adjusted HR: 2.10; 95% CI: 1.25, 3.55: p=0.005), level of glomerular filtration rate (GFR) (adjusted HR: 0.96; 95% CI: 0.98, 0.99; p=0.001), level of urea (adjusted HR: 1.03; 95% CI: 1.01, 1.05: p<0.001) and level of creatinine (adjusted HR: 0.98; 95% CI: 0.97, 0.99; p<0.001). Patients who were smokers, had hyperlipidaemia, took medications, include analgesics, functional GI disorder drugs, lipid-lowering agents and corticosteroids as well as level of urea had more hazard for worse renal survival, while level of GFR and creatinine had lower hazards for worse renal survival.