Predictors of Rapid CKD Progression

Chronic kidney disease (CKD) is a major global public health problem affecting approximately 10% of the population worldwide. Diabetes mellitus and hypertension remain the leading causes of CKD, accounting for the majority of patients progressing to kidney failure. The clinical course of CKD is highly heterogeneous. While some patients maintain stable kidney function, others experience rapid deterioration leading to kidney failure within a relatively short period. Rapid progression of CKD is associated with a markedly increased risk of kidney failure, cardiovascular events, and all-cause mortality. According to KDIGO 2024 guidelines, a sustained decline in eGFR exceeding 5 mL/min/1.73 m² per year is considered rapid progression and warrants careful evaluation and optimization of renoprotective therapy. Early identification of patients at risk of rapid progression enables clinicians to intensify monitoring, initiate renoprotective therapies, and prepare patients appropriately for kidney replacement therapy. This prospective cohort study will enroll 190 adult patients with predialysis CKD from the nephrology outpatient clinic and inpatient ward at Assiut University Hospitals. Participants will undergo comprehensive clinical and laboratory assessment at baseline, including demographic data, comorbidities, eGFR (CKD-EPI equation), complete blood count, liver function tests, electrolytes, uric acid, bicarbonate, CRP, lipid profile, and thyroid function tests. Patients will be followed for 24 months to assess the incidence of rapid progression and identify independent predictors using multivariable regression analysis.