Factors associated with stage 5 chronic kidney disease in patients from a health service provider in Valle del Cauca

Abstract

Introduction: Chronic kidney disease (CKD) is a condition characterized by structural or functional abnormalities of the kidney that persist for more than three months and may progress to advanced stages, leading to significant health consequences.

Objective: The aim of this study was to determine the factors associated with stage 5 chronic kidney disease (CKD-5) in patients affiliated with a health insurance provider (EPS) in Valle del Cauca, Colombia, between 2018 and 2020.

Methods: A retrospective observational study was conducted, analyzing patients diagnosed with arterial hypertension, type 2 diabetes mellitus, obesity, dyslipidemia, and CKD, registered in the institutional database (n = 57,643) during the study period. Patients who already had stage 5 CKD (CKD-5), were undergoing prior dialysis, had incomplete information, or exhibited significant changes during follow-up were excluded. Sociodemographic and clinical variables were evaluated. Associations with progression to CKD-5 were assessed using binary logistic regression.

Results: A total of 74.5% of patients entered follow-up in CKD stages 2 and 3 during the 2018–2020 period. The most frequent comorbidities were arterial hypertension, overweight, and obesity. The incidence of CKD-5 was six new cases per 1,000 patients. A higher frequency was observed among individuals aged 30–44 years, males, those not belonging to an ethnic minority or vulnerable population, and residents primarily of the municipalities of Cali, Buenaventura, Palmira, Tuluá, and Buga.

Conclusions: Early detection and appropriate follow-up of patients with risk factors are essential to prevent disease progression. Conditions such as arterial hypertension, diabetes mellitus, obesity, and poor treatment adherence were associated with an increased risk of progression to stage 5 CKD.