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An Observational Study on Assessment of Etiological and Clinical Profile in Patient with CKD in Tertiary Care Hospital
Corresponding Author(s) : Fatima Khatoon
International Journal of Allied Medical Sciences and Clinical Research,
Vol. 13 No. 2 (2025): 2025 Volume -13 - Issue 2
Abstract
Introduction: The term chronic kidney disease (CKD) refers to a decline in renal function that occurs gradually over three months to years. A physical injury, illness, such as diabetes mellitus (DM) or high blood pressure, can all affect the kidneys. They are unable to filter blood or carry out other tasks due to kidney sickness. This is typically accompanied with proteinuria and a decline in glomerular filtration rate (GFR).
Methodology: In this cross-sectional observational research, 120 individuals with various stages of chronic renal disease were included. To gather information from patients and medical records, a legitimate and trustworthy patient-specific data collecting form was developed. Student researchers developed the profile form after it had been verified by many standard publications.
Results: In this study, among the study population 120, most of them were females followed by males. CKD was more in this from group 51 to 60. The most prevalent symptom observed in CKD patients were pallor and the consistently high risk factors in CKD patients was Diabetes mellitus. The prescribing trends in managing CKD patients was evaluated. A wide range of drug classes prescribed in CKD patients were identified. Antihyperglycemic drugs most commonly utilized followed by antihypertensive drugs, blood forming agents and nutritional supplements.
Conclusion: This result of the study indicates that CKD is a significant public health issue in India, Diabetes mellitus was the frequent cause of risk observed in the study population. Multiple observations were made of abnormal laboratory parameters were observed such as Elevated Creatinine, followed by Decreased Hemoglobin, Decreased RBC, Decreased Iron, Decreased Total protein, Elevated Uric acid. The presence of several comorbidities resulted in poly pharmacy in CKD patients. Hemodialysis has demonstrated to be life-saving therapy for patients with end-stage CKD.
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- Phillips, A.O., and Steve Riley, 'Structure and function of the kidney', in David A. Warrell, Timothy M. Cox, and John D. Firth (eds), Oxford Textbook of Medicine, 5 edn, Oxford Textbooks (Oxford, 2010; online edn, Oxford Academic, 28 Nov. 2012),
- Sicree R, Shaw J, Zimmet P. Diabetes and impaired glucose tolerance. In: Gan D, editor.Diabetes Atlas. 3rd ed. Brussels: International Diabetes Federation; 2006.
- Grassmann A, Gioberge S, Moeller S, Brown G. ESRD patients in 2004: Global overview of patient numbers, treatment modalities and associated trends. Nephrol Dial Transplant 2005;20:2587-93
- Agarwal SK. Chronic kidney disease and its prevention in India. Kidney Int Suppl 2005;98: S41-5. 412
- Coresh J, Astor BC, Greene T, Eknoyan G, Levey AS. Prevalence of chronic kidney disease and decreased kidney function in the adult US population: Third National Health and Nutrition Examination Survey. Am J Kidney Dis 2003;41:1-2.
- Sakhuja V, Jha V, Ghosh AK, Ahmed S, Saha TK. Chonic renal failure in India. Nephrol Dial Transplant 1994;9:871-2.
- Agarwal SK, Dash SC. Spectrum of renal diseases in Indian adults. J Assoc Physicians India 2000;48:594-600
- Agarwal SK, Dash SC, Irshad M, et al. Prevalence of chronic renal failure in adults in Delhi, India. Nephrol Dial Transplant 2005;20: 1638-42.
- Barsoum RS. Burden of chronic kidney disease: North Africa. Kidney Int Suppl (2011) 2013;3:164-6.
- Afshar R, Sanavi S, Salimi J. Epidemiology of chronic renal failure in Iran: A four year single-center experience. Saudi J Kidney Dis Transpl 2007;18:191-4.
- Awad SM. Chronic renal failure in Al-Anbar of Iraq. Saudi J Kidney Dis Transpl 2011;22:1280-4.
- Alam V, Prasad BN, Vidyasagar, Gupta U. Study of etiology of chronic kidney disease in a tertiary care hospital in Kolar. EJPMR 2016; 3:351-4
- Like RG. Chronic renal failure. Goldman: Cecil Textbook of Medicine. 21st ed. Philadelphia: WB Saunders Company; 1998.
- Ruggenenti P, Schieppati A, Remuzzi G; Progression, remission and regression of chronic renal diseases. Lancet 2001;375(9268):1601-1608.
- Wild S, Roglic G, Green A, Sicree R, King H; Global prevalence of diabetes: estimates for the year 2000 and projections for 2030.Diabetes Care 2004; 27(5):1047-1053.[5].
- Gupta R; Trends in hypertension epidemiology in India. J Hum Hypertens 2004; 18(2)
- Khalil RA. Sex hormones as potential modulators of vascular function in hypertension. Hypertension. 2005;46:249-54
- Rajapurkar MM. 2nd annual report, CKD registry of India, Proceedings of the 38th annual conference of Indian society of Nephrology, 13-15 Dec, 2007, Delhi.
- Dharan KS, John GT, Neelakantan N. Spectrum of severe chronic kidney disease in India: A clinicopathological study. Natl Med JIndia. 2006;19:250-2.
- Modi GK, Jha V. The incidence of end-stage renal disease in India: A population based study. Kidney Int. 2006; 70(12):2131.
- Lindeman RD, Tobin J, Shock NW. Longitudinal studies on the rate of decline in renal function with age. J Am Geriatr Soc.1985;33:278-85.
- Chaudhari ST, Sadavarte AV, Chafekar D. Clinical Profile of End Stage Renal Disease in Patients Undergoing Hemodialysis. MVPJournal of Medical Science. 2017 May 22;4(1):8.
- Sathyan S, George S, Vijayan P, Jayakumar M. Clinical and epidemiological profile of chronic kidney disease patients in a tertiarycare referral centre in South India. International Journal Of Community Medicine And Public Health. 2016 Dec 22;3(12):3487-92.
- Jha V. Current status of end-stage renal disease care in India and Pakistan. Kidney IntSuppl. 2013; 3(2)
- Garber MC, Nau DP, Erickson SR, Aikens JE, Lawrence JB. The concordance of self- report with other measures of medication adherence: A summary of the literature. Med Care. 2004;42:649–52.
- Rudd P. In search of the gold standard for compliance measurement. Arch Intern Med. 1979;139:627–8. [PubMed] [Google Scholar]
- Hirth RA, Greer SL, Albert JM, Young EW, Piette JD. Out-of-pocket spending and medication adherence among dialysis patients in twelve countries. Health Aff (Millwood) 2008;27:89–10
- Awad GA. Antipsychotic medications: Compliance and attitudes toward treatment. Curr Opin Psychiatry. 2004;17:75–80.
- Saran R, Bragg-Gresham JL, Rayner HC, Goodkin DA, Keen ML, Van Dijk PC, et al. Nonadherence in hemodialysis: Associations with mortality, hospitalization, and practice patterns in the DOPPS
- Hecking E, Bragg-Gresham JL, Rayner HC, Pisoni RL, AndreucciVE,Combe C, et al. Haemodialysis prescription, adherence and nutritional indicators in five European countries: results fromthe Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrol Dial Transplant 2004;19:100-7.
- Svarstad BL, Chewning BA, Sleath BL, Claesson C. The Brief Medication Questionnaire: a tool for screening patient adherence and barriers to adherence. Patient EducCouns 1999;37:113-24.
- Morisky DE, Ang A, Ward H. Predictive validity of a medication adherence measure for hypertension control. J ClinHypertens 2008;10:348-54.
- Burkhart PV, Sabaté E. Adherence to Long-Term Therapies: Evidence for Action. JNursScholarsh. 2003;35(3):207
- Devins GM, Hollomby DJ, Barre PE et al. Long-term knowledge retention following pre- dialysis psycho-educational intervention. Nephron 2000; 86:129–134.
- Bairwa M, Rajput M, Sachdeva S (2013) Modified Kuppuswamy's Socioeconomic Scale: Social Researcher Should Include Updated Income Criteria, 2012. Indian J Community Med 38: 185-186.
- Sathvik BS, Mangasuli S, Narahari MG, Medication knowledge of hemodialysis patients and influence of clinical pharmacist provided education on their knowledge. Indian J Pharm Sci. 2007; 69:232 -9.
- Complications of Chronic Kidney Disease: Prevention https://www.healthline.com/health/kidney-disease/complications-of-chronic-kidney- disease
References
Phillips, A.O., and Steve Riley, 'Structure and function of the kidney', in David A. Warrell, Timothy M. Cox, and John D. Firth (eds), Oxford Textbook of Medicine, 5 edn, Oxford Textbooks (Oxford, 2010; online edn, Oxford Academic, 28 Nov. 2012),
Sicree R, Shaw J, Zimmet P. Diabetes and impaired glucose tolerance. In: Gan D, editor.Diabetes Atlas. 3rd ed. Brussels: International Diabetes Federation; 2006.
Grassmann A, Gioberge S, Moeller S, Brown G. ESRD patients in 2004: Global overview of patient numbers, treatment modalities and associated trends. Nephrol Dial Transplant 2005;20:2587-93
Agarwal SK. Chronic kidney disease and its prevention in India. Kidney Int Suppl 2005;98: S41-5. 412
Coresh J, Astor BC, Greene T, Eknoyan G, Levey AS. Prevalence of chronic kidney disease and decreased kidney function in the adult US population: Third National Health and Nutrition Examination Survey. Am J Kidney Dis 2003;41:1-2.
Sakhuja V, Jha V, Ghosh AK, Ahmed S, Saha TK. Chonic renal failure in India. Nephrol Dial Transplant 1994;9:871-2.
Agarwal SK, Dash SC. Spectrum of renal diseases in Indian adults. J Assoc Physicians India 2000;48:594-600
Agarwal SK, Dash SC, Irshad M, et al. Prevalence of chronic renal failure in adults in Delhi, India. Nephrol Dial Transplant 2005;20: 1638-42.
Barsoum RS. Burden of chronic kidney disease: North Africa. Kidney Int Suppl (2011) 2013;3:164-6.
Afshar R, Sanavi S, Salimi J. Epidemiology of chronic renal failure in Iran: A four year single-center experience. Saudi J Kidney Dis Transpl 2007;18:191-4.
Awad SM. Chronic renal failure in Al-Anbar of Iraq. Saudi J Kidney Dis Transpl 2011;22:1280-4.
Alam V, Prasad BN, Vidyasagar, Gupta U. Study of etiology of chronic kidney disease in a tertiary care hospital in Kolar. EJPMR 2016; 3:351-4
Like RG. Chronic renal failure. Goldman: Cecil Textbook of Medicine. 21st ed. Philadelphia: WB Saunders Company; 1998.
Ruggenenti P, Schieppati A, Remuzzi G; Progression, remission and regression of chronic renal diseases. Lancet 2001;375(9268):1601-1608.
Wild S, Roglic G, Green A, Sicree R, King H; Global prevalence of diabetes: estimates for the year 2000 and projections for 2030.Diabetes Care 2004; 27(5):1047-1053.[5].
Gupta R; Trends in hypertension epidemiology in India. J Hum Hypertens 2004; 18(2)
Khalil RA. Sex hormones as potential modulators of vascular function in hypertension. Hypertension. 2005;46:249-54
Rajapurkar MM. 2nd annual report, CKD registry of India, Proceedings of the 38th annual conference of Indian society of Nephrology, 13-15 Dec, 2007, Delhi.
Dharan KS, John GT, Neelakantan N. Spectrum of severe chronic kidney disease in India: A clinicopathological study. Natl Med JIndia. 2006;19:250-2.
Modi GK, Jha V. The incidence of end-stage renal disease in India: A population based study. Kidney Int. 2006; 70(12):2131.
Lindeman RD, Tobin J, Shock NW. Longitudinal studies on the rate of decline in renal function with age. J Am Geriatr Soc.1985;33:278-85.
Chaudhari ST, Sadavarte AV, Chafekar D. Clinical Profile of End Stage Renal Disease in Patients Undergoing Hemodialysis. MVPJournal of Medical Science. 2017 May 22;4(1):8.
Sathyan S, George S, Vijayan P, Jayakumar M. Clinical and epidemiological profile of chronic kidney disease patients in a tertiarycare referral centre in South India. International Journal Of Community Medicine And Public Health. 2016 Dec 22;3(12):3487-92.
Jha V. Current status of end-stage renal disease care in India and Pakistan. Kidney IntSuppl. 2013; 3(2)
Garber MC, Nau DP, Erickson SR, Aikens JE, Lawrence JB. The concordance of self- report with other measures of medication adherence: A summary of the literature. Med Care. 2004;42:649–52.
Rudd P. In search of the gold standard for compliance measurement. Arch Intern Med. 1979;139:627–8. [PubMed] [Google Scholar]
Hirth RA, Greer SL, Albert JM, Young EW, Piette JD. Out-of-pocket spending and medication adherence among dialysis patients in twelve countries. Health Aff (Millwood) 2008;27:89–10
Awad GA. Antipsychotic medications: Compliance and attitudes toward treatment. Curr Opin Psychiatry. 2004;17:75–80.
Saran R, Bragg-Gresham JL, Rayner HC, Goodkin DA, Keen ML, Van Dijk PC, et al. Nonadherence in hemodialysis: Associations with mortality, hospitalization, and practice patterns in the DOPPS
Hecking E, Bragg-Gresham JL, Rayner HC, Pisoni RL, AndreucciVE,Combe C, et al. Haemodialysis prescription, adherence and nutritional indicators in five European countries: results fromthe Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrol Dial Transplant 2004;19:100-7.
Svarstad BL, Chewning BA, Sleath BL, Claesson C. The Brief Medication Questionnaire: a tool for screening patient adherence and barriers to adherence. Patient EducCouns 1999;37:113-24.
Morisky DE, Ang A, Ward H. Predictive validity of a medication adherence measure for hypertension control. J ClinHypertens 2008;10:348-54.
Burkhart PV, Sabaté E. Adherence to Long-Term Therapies: Evidence for Action. JNursScholarsh. 2003;35(3):207
Devins GM, Hollomby DJ, Barre PE et al. Long-term knowledge retention following pre- dialysis psycho-educational intervention. Nephron 2000; 86:129–134.
Bairwa M, Rajput M, Sachdeva S (2013) Modified Kuppuswamy's Socioeconomic Scale: Social Researcher Should Include Updated Income Criteria, 2012. Indian J Community Med 38: 185-186.
Sathvik BS, Mangasuli S, Narahari MG, Medication knowledge of hemodialysis patients and influence of clinical pharmacist provided education on their knowledge. Indian J Pharm Sci. 2007; 69:232 -9.
Complications of Chronic Kidney Disease: Prevention https://www.healthline.com/health/kidney-disease/complications-of-chronic-kidney- disease