The prevalence of kidney disease, particularly diabetic and hypertensive kidney disease is increasing rapidly specially in the disadvantageous group of population throughout the world. A cross sectional survey was carried out at certain selected slum areas of Mirpur in Dhaka city of Bangladesh over the period from July 2003 to June 2005, and a total of participants ranging from 15 to 65 years were studied. The analysis discovered that 4.1% of the participants were diabetic, 11.6% were hypertensive, and 7.7% had proteinuria. Based on MDRD equation, 13.1% of the participants were detected as having chronic kidney disease (CKD) while with Cockcroft-Gault equation 16% had CKD. Accordingly, the difference between the two equations was not significant. Association of sociodemographic factors with CKD was not significant except age more than 40 years and marital status. The association between CKD and risk factors like proteinuria, obese and overweight, use of tobacco, diabetes mellitus, and hypertension was highly significant. Combined prevalence of DM, hypertension, and proteinuria among CKD group was also demonstrated to be significantly higher (3.8% with Cockcroft-Gault equation and 5.3% with MDRD equation) than that of normal population. The survey data revealed that CKD and its risk factors like DM and hypertension are alarmingly high in disadvantageous population and adding further pressure to the existing burden of CKD.

Background and Aims Kidneys are target organs in hypertension. Hypertensive damage results in glomerular as well as tubular dysfunction. Albuminuria is a known marker of glomerular damage. Whereas, urinary uromodulin is increasingly considered as potential biomarker of early tubular dysfunction. The aim of this study was to identify the pattern of early renal involvement based on glomerular and tubular function assessment by measuring urinary albumin and uromodulin in hypertensive patients Method In this cross-sectional study 122 hypertensive subjects with age>30 years, duration of hypertension <5years, without accelerated or malignant BP, absence of dipstick proteinuria and eGFR>60ml/min. Subjects with possibility of secondary hypertension were excluded. There were also 33 normotensive volunteers included as healthy referents. Morning spot urine for albumin-creatinine ratio (ACR mg/g), urine uromodulin-creatinine ratio (urUMODµg/g), urinary sodium-creatinine ratio (mEq/g) and potassium-creatinine ratio (mEq/g) were measured in single urine sample. Urine uromodulin was measured by ELISA method. Results The hypertensive and healthy subjects were matched for age 48±11 vs. 47±11, years (P=NS). The systolic BP was 145±15 vs. 112±12 mmHg and diastolic BP 86±9 vs. 70±8 mmHg; (p<0.001) and the mean ACR was 29±65 vs. 5.6±2.7 mg/g, (p<0.001) respectively. Around 20% hypertensives had albuminuria. Urinary potassium excretion was lower in hypertensives (51±31 vs. 69±31, mEq/g; p<0.02). The median urUMOD in hypertensive subjects was 3.38 (1.73-9.06) and in normotensives 3.85(2.28-5.69) µg/g (P=NS).Multivariate analysis showed significant inverse association between diastolic blood pressure and urinary uromodulin excretion. An urURMOD cut-off of 2.9 (25th percentile in normotensives) showed eGFR, urinary sodium & potassium excretions were significantly lower at low uromodulin cut-off and this was seen in38%subjects. Conclusion The glomerular involvement was found in 20% hypertensives as evidenced by albuminuria. In general urinary uromodulin level was not different between hypertensive and normotensive subjects. Association of low uromodulin cut-off with lower eGFR, Na+ and K+ excretion indicates simultaneous tubule glomerular involvement in 38%.

Key words: CKD (Chronic Kidney Disease); DM (Diabetes mellitus); HTN (Hypertension); BMI (Body Mass Index); C-G (Cockcroft-Gault) formula; MDRD (Modification of Diet in Renal Disease) equationDOI: 10.3329/jcmcta.v21i2.7733 Journal of Chittagong Medical College Teachers' Association 2010: 21(2):25-29

Objective: Aim of the study is to identify changes that occur in renal function in eclampsia patients and to determine the effect of impaired renal function on pregnancy outcome Materials and Methods: This cross-sectional study on the impairment of renal function in eclamptic patients was carried out in the Eclampsia ward of Dhaka Medical College Hospital from July 2009 to December 2009. Study group comprised of 50 diagnosed cases of eclampsia and 50 patients with uncomplicated pregnancy was taken as control. Results: In this study 30% of the eclamptic patients were found to have impairment of renal function. Incidence of impaired renal function was significantly increased among the patients > 25 years of age. Multigravida eclamptic patients were found to be more prone to develop impaired renal function compared to primigravida patients. Blood pressure was significantly increased and platelet count was significantly low in the impaired renal function group of eclamptic patients compared to the normal renal function group. Incidence of foetal complications was significantly higher among the patients with impaired renal function. The eclamptic patients who had proteinuria of >1 gm in 24 hours had more foetal complications than those who had protienuria of <1 gm/day.Conclusion: It has been observed that impairment of renal function is common among the patients with eclampsia. So, special attention should be paid to assess renal function in this group of patient DOI: http://dx.doi.org/10.3329/bjog.v26i1.13758 Bangladesh J Obstet Gynaecol, 2011; Vol. 26(1) : 31-36

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