dc.contributor.author |
Martínez Castelao, Alberto |
dc.contributor.author |
Górriz, José L. |
dc.contributor.author |
Portolés, José M. |
dc.contributor.author |
Alvaro, Fernando de |
dc.contributor.author |
Cases Amenós, A. (Aleix) |
dc.contributor.author |
Luño, José |
dc.contributor.author |
Navarro González, Juan F. |
dc.contributor.author |
Montes, Rafael |
dc.contributor.author |
Cruz Troca, Juan J. de la |
dc.contributor.author |
Natarajan, Aparna |
dc.contributor.author |
Batlle, Daniel |
dc.date |
2018-11-16T13:26:03Z |
dc.date |
2018-11-16T13:26:03Z |
dc.date |
2011-10-05 |
dc.date |
2018-11-16T13:26:03Z |
dc.identifier.citation |
1471-2369 |
dc.identifier.citation |
638842 |
dc.identifier.uri |
http://hdl.handle.net/2445/126189 |
dc.format |
application/pdf |
dc.language.iso |
eng |
dc.publisher |
BioMed Central |
dc.relation |
Reproducció del document publicat a: https://doi.org/10.1186/1471-2369-12-53 |
dc.relation |
BMC Nephrology, 2011, vol. 12, p. 53 |
dc.relation |
https://doi.org/10.1186/1471-2369-12-53 |
dc.rights |
cc-by (c) Martínez Castelao, Alberto et al., 2011 |
dc.rights |
info:eu-repo/semantics/openAccess |
dc.rights |
http://creativecommons.org/licenses/by/3.0/es |
dc.subject |
Malalties del ronyó |
dc.subject |
Nefrologia |
dc.subject |
Espanya |
dc.subject |
Malalties cròniques |
dc.subject |
Formulació clínica |
dc.subject |
Kidney diseases |
dc.subject |
Nephrology |
dc.subject |
Spain |
dc.subject |
Chronic diseases |
dc.subject |
Case formulation |
dc.title |
Baseline Characteristics of Patients with Chronic Kidney Disease Stage 3 and Stage 4 in Spain: the MERENA Observational Cohort Study |
dc.type |
info:eu-repo/semantics/article |
dc.type |
info:eu-repo/semantics/publishedVersion |
dc.description.abstract |
Background: 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 erythropoiesis-stimulating 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. |