The rate of progression of chronic kidney disease based on etiology

Abstract

Background. Chronic kidney disease (CKD) progression varies by etiology: diabetic nephropathy, hypertensive nephrosclerosis, glomerulonephritis and polycystic kidney disease. Proteinuria and hypertension accelerate renal decline and ESRD risk. Early etiologic diagnosis and risk stratification guide personalized therapy. Objective(s). The aim of this study is to compare progression rates of chronic kidney disease across etiologies and to identify clinical risk factors that influence decline in renal function. Materials and methods. A systematic review of studies published between 2015 and 2025 in PubMed, Scopus, and Web of Science was conducted. English-language clinical and prospective cohort studies reporting CKD progression rates by etiology were included. Two independent reviewers performed study selection and extracted data on eGFR decline and associated risk factors. Results. The systematic review of the literature revealed important differences in the rate of progression of chronic kidney disease, depending on its underlying etiology. Diabetic nephropathy and polycystic kidney disease were linked to the most rapid decline in eGFR, followed by glomerulonephritis. Hypertensive nephrosclerosis progressed more slowly. Proteinuria, high blood pressure, older age, male sex, and cardiovascular comorbidities were frequently associated with disease worsening. Studies emphasize that early etiological diagnosis and specific treatment strategies can help delay progression to end-stage renal disease. Conclusion(s). Identifying the etiology of CKD early is essential for predicting its rate of progression and guiding appropriate therapy. Etiology-based interventions can reduce complications, delay the onset of end-stage renal disease, and improve long-term clinical and functional outcomes.