Progression of renal disease in the pre-dialysis stage

Background. The aim of this study was to quantify the decrease in the creatinine clearance during the year prior to the initiation of hemodialysis and to identify factors linked to the progression of kidney disease. Methods. From January 1998 to December 1999, 76 patients with kidney disease presented to the Department of Nephrology, Juan Canalejo Hospital, A Coruna, Spain. Of those, 52 were begun on hemodialysis and were included in this study. The progression of the disease was measured by changes in creatinine clearance. A multiple regression analysis was performed using the decrease in clearance as the dependent variable. Results. There was a mean drop of 4.4 +/- 6.1 ml/min in creatinine clearance over the course of the year. After developing a multiple linear regression model to fit the variables that correlated significantly with the decrease in creatinine clearance in the univariate analysis, we found that the only variable modifying the decrease in creatinine clearance (after adjustments were made for baseline values) was the LDL value (p = 0.035). When the mean values for the year prior to dialysis were fit into the model, none of the parameters were found to have a significant effect on the decrease in creatinine clearance; the variable coming closest to statistical significance was proteinuria. Conclusion. This study demonstrates a relation between dyslipidemia and the progression of kidney disease.