Predictors of chronic kidney disease progression in residents of the Far North

Zhmurov V.A., Vanuito E.Ya., Zhmurov D.V., Petrov I.M., Petrova Yu.A., Zhmurova E.A., Ermakova A.A., Ermakova P.A.

Tyumen Medical University, Tyumen, Russia

Objective. Evaluation of the rate of progression of chronic kidney disease (CKD) and identification offactors influencing disease progression in residents of the Far North.
Materials and methods. The study analyzed clinical and laboratory data from 243 CKD patients from the outpatient department of the Noyabrsk Central District Hospital, Yamalo-Nenets Autonomous Okrug, Tyumen Region. Clinical, laboratory, and instrumental parameters were examined. Glomerular filtration rate (GFR) was calculated using the CKD-EPI formula.
Results. The highest rates of CKD progression after 18 months of follow-up were observed in patients aged 45–59 years, in patients with type 2 diabetes mellitus (DM2), in patients with more advanced stages of the disease (C3b–C4), and in patients with poor treatment adherence. Independent predictors of progressive disease progression included creatinine levels greater than 125.4 μmol/L, uric acid levels greater than 0.43 μmol/L, and decreased hemoglobin levels (a 10 g/L decrease increases the likelihood of progression by 17.5%). Signs of accelerated disease progression included age over 74 years, microalbuminuria greater than 287 mg/day, and pulmonary artery systolic pressure greater than 44 mmHg.
Conclusion. The identified signs of progressive and rapidly progressive CKD can be used in the clinical examination of patients living in the Far North.

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About the Authors

Vladimir A. Zhmurov – Dr.Sci. (Med.), Professor, Head of the Department of Propaedeutics of Internal Disease, Tyumen State Medical University.
Address: 8 Magnitogorskaya St., Tyumen, 625049
Evgeny Ya. Vanuito – Postgraduate Student, Department of Propaedeutics of Internal Disease, Tyumen State Medical University.
Address: 8 Magnitogorskaya St., Tyumen, 625049
Denis V. Zhmurov – Cand.Sci. (Med.), Associate Professor, Department of Propaedeutics of Internal Disease, Tyumen State Medical University.
Address: 8 Magnitogorskaya St., Tyumen, 625049: email: zhmdenis@yandex.ru
Ivan M. Petrov – Dr.Sci. (Med.), Associate Professor, Head of the Medical Informatics Department, Tyumen State Medical University.
Address: 8 Magnitogorskaya St., Tyumen, 625049
Yulianna A. Petrova – Cand.Sci. (Med.), Associate Professor, Department of Propaedeutics of Internal Disease, Tyumen State Medical University..
Address: 8 Magnitogorskaya St., Tyumen, 625049
Ekaterina A. Zhmurova – Teaching Assistant, Department of Internal Medicine, Outpatient Therapy, and Family Medicine, Tyumen State Medical University. Address: 8 Magnitogorskaya St., Tyumen, 625049
Anna A. Ermakova – Teaching Assistant, Department of Propaedeutics of Internal Disease, Tyumen State Medical University. Address: 8 Magnitogorskaya St., Tyumen, 625049
Polina A. Ermakova – Assistant Professor, Department of Propaedeutics of Internal Disease, Tyumen State Medical University. Address: 8 Magnitogorskaya St., Tyumen, 625049

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