Study of clinicoetiologic and biochemical profile of incident end stage kidney disease patients

Abstract

Introduction :Chronic kidney disease (CKD) is emerging to be an important chronic disease globally. One reason is the rapidly increasing worldwide incidence of diabetes and hypertension. Diabetic kidney disease is the commonest cause of end stage Kidney disease (ESKD) in the world.Symptoms and overt signs of kidney disease are often subtle or absent until renal failure supervenes.This study was conducted as there is scare data available in our country regarding demographic, etiological and clinical profile of CKDMaterials and Methods:In this observational prospective study conducted over a period of 1 year, we included 180 consenting incident ESKD patients (age > 18 years). Clinocoetiologic profile including the search for risk factors was done. Both biochemical and radiologic profile was studied in the included patient population. Long-term therapy preference by patients was also studied. Results:Of the 180 newly diagnosed ESKD patients enrolled over 12 months, most were males (Sex ratio male: female was 2.3:1). Mean age was 43.66 +/-14 years. Although diabetes or hypertension was present in a substantial proportion of our patients,most had no identifiable risk factor for CKD. Anemia was universal as were clinical features like anorexia, nausea or vomiting. Most of our patients continued on haemodialysis as a form of RRT 10 out of the surviving 174 patients underwent Kidney transplant. Discussion :As against diabetes being the most common cause of ESKD world over, more than half of our study population had no identifiable risk factor. Similarly most had shrunken kidneys and hence the histopathologic diagnosis couldn’t be done. CKD of unknown origin is being recognized as a significant health problem in many regions across India and kidney transplantation rates are low as seen in our study. Large scale studies are needed to identify risk factors for CKD and detection of CKD at the earliest to retard the progression of disease.