Clinical and epidemiological profile of chronic kidney disease patients in a tertiary care referral centre in South India

Abstract

Background: The clinical course of CKD (chronic kidney disease) is typically a progressive loss of nephron function ultimately leading to end stage renal disease (ESRD) requiring some form of renal replacement therapy. As this puts a significant burden on global resources, planning for prevention of CKD by early identification of kidney damage by identifying and screening high-risk individuals is the most practical solution. Aim: To study the clinico-epidemiological profile of newly diagnosed cases of CKD.

Methods: This study was conducted between January 2008 and June 2008 at a Government tertiary referral institution in South India. All newly diagnosed cases of CKD based on the National Kidney foundation definition  were included in this study.

Results: Of the total 333 patients included in the study, 217 (65%) were males and 116 (35%) were females. Majority (275, 82.59%) of the patients were between 21-60 years of age. Chronic glomerulonephritis was by far the most common etiological diagnosis (51%) followed by diabetic nephropathy (22%) and hypertensive nephrosclerosis (7%) . About 24% had diabetes mellitus while 84% of the patients had hypertension. Dyspnea (75.68%), symptoms suggestive of volume overload in 242 (72.7%) and Oliguria (69%) were the chief presenting complaint. An overwhelming majority of the patients in the study presented in stage 5 CKD (264, 79.2%). 167 (50.15%) patients were found to have some form of cardiovascular disease. Cigarette smoking was prevalent in 32.7%, alcohol consumption in 6.91%, NSAID use in 5.1% and herbominerals in 4.5% .The mean hemoglobin in the study was 8.42 g/dl. Mean phosphate level in the study was 5.94 mg/dl. There was significant statistical correlation between hemoglobin level and stage of CKD and also between serum phosphate level and stage of CKD.

Conclusions: Early detection of CKD by screening of high risk individuals will go a long way in retarding the progression of ESRD. This will help in bringing down the huge burden due to mismatch between demand and availability of resources for renal replacement therapy in developing countries like India, especially for patients belonging to lower socioeconomic group.