KUMJ | VOL. 24 | NO. 3 | ISSUE 96 | JULY-SEPTEMBER, 2026
Determinants of Rapid Renal Function Decline in Elderly Patients with Stage 3-4 Chronic Kidney Disease: A retrospective study from Northeastern Thailand
Thiantongin P, Kankarn W
Abstract: Background
Rapid kidney function decline in elderly patients with chronic kidney disease (CKD)
often leads to end-stage renal disease (ESRD) and a higher healthcare burden.
Evidence on its determinants in Thai populations, especially in Northeastern
Thailand, is limited.
Objective
To examine factors associated with rapid estimated glomerular filtration rate (eGFR)
decline in elderly patients with stage 3-4 chronic kidney disease.
Method
A retrospective study was conducted using electronic medical records of 232 patients
aged 60-75 years with stage 3-4 chronic kidney disease who received care at four
healthcare facilities between October 2022 and September 2023. Demographic,
clinical, and laboratory data were collected. Rapid eGFR decline was defined as a
reduction of ≥ 5 mL/min/1.73 m2 per year. Determinants were assessed using
multivariable logistic regression.
Result
Among 232 patients (66.4% female; mean age 67.8 ± 4.9 years; mean estimated
glomerular filtration rate 43.4 mL/min/1.73 m2), 65.1% experienced rapid estimated
glomerular filtration rate decline. Independent predictors included older age
(adjusted odds ratio [aOR] 1.06, 95% CI 1.01–1.12, p = 0.04), income (aOR 0.99, 95%
CI 0.99-1.00, p = 0.03), and higher systolic blood pressure (aOR 1.06, 95% CI 1.00-
1.12, p = 0.02).
Conclusion
Rapid estimated glomerular filtration rate decline is common among elderly stage
3-4 chronic kidney disease patients in Northeastern Thailand. Advanced age,
income, and high systolic blood pressure are key determinants of rapid kidney
function decline. Early detection and strict blood pressure control, supported by
multidisciplinary care, may slow chronic kidney disease progression and reduce endstage
renal disease risk.
Keyword : Chronic kidney disease, Elderly patients, Rapid estimated glomerular filtration rate decline, Risk factors, Thailand
