만성신장질환의 동반질환이 말기신부전으로의 진행에 미치는 영향: 국민건강보험공단 표본코호트 자료 기반

Abstract

Objectives: Due to the aging of population and increase of chronic diseases worldwide, the prevalence of chronic kidney disease (CKD) is on the rise. The increase of CKD is connected to the development of end-stage renal diseases (ESRD) and the occurrence of death caused by ESRD. This study explored the risk factors affecting the progression of CKD patients to ESRD using the sample cohort database built by the Korean National Health Insurance Service. Methods: This study targeted 2,354 new patients to whom the CKD occurred between 2003 and 2012. The development of ESRD of the CKD patients was checked through the number of cases per 1,000 person years. Significance was confirmed through the t-test and Wilcoxon signed-rank test. For the factors affecting the occurrence of ESRD by risk factor of comorbidities, the Cox proportional hazard regression analysis was carried out. Results: The average routing period of the subjects of this study was 2.98 ± 2.69 years. 105.69 cases of ESRD among CKD patients took place per 1,000 person years during the observation period. The proportional hazard of CKD patients’ ESRD became higher as the subjects’ age became younger (50-59, HR = 0.76; 60-69, 0.64; 70-79, HR = 0.63), and the proportional hazard was higher from the subjects having proteinuria (Yes, HR = 2.16), high hypertension (Yes, HR = 1.38), diabetes mellitus (Yes, HR = 1.23), and anemia (Yes, HR = 1.77) (All p< 0.05). Conclusions: Risk factors for the progression of CKD to ESRD were low age group (less than 60), underweight (less than 23), diabetes, hypertension, and anemia patients. To control the occurrence of ESRD that increases social and economic burdens, along with death risk, it is necessary to establish individualized treatment plans depending on the characteristics and risks of patients based on each type of comorbidity.