Clinical and Laboratory Profile of Diabetic-Hypertension, Kidney Disease Syndrome - A Hospital Based Study in South India

Abstract

BACKGROUND Diabetes mellitus and hypertension remain one of the most common causes of chronic kidney disease. Diabetes hypertension, kidney disease syndrome is a new term introduced in medical terminology. The present study was conducted to examine clinical & laboratory profile of diabetes hypertension kidney disease syndrome – “DHKD syndrome” over a period of one year. METHODS A hospital-based observational cross-sectional study was done in the Department of General Medicine and Nephrology, outpatient department (OPD), among 120 patients with diabetes & hypertension in combination with kidney disease, with duration of diabetes > 2 years and duration of hypertension > 2 years after obtaining ethical clearance. The patients were then scored based on modified diet in renal disease (MDRD) formula and chronic kidney disease epidemiology collaboration equation (CKD EPI) formula to calculate the estimated glomerular function rate & placed into various stages of CKD. RESULTS A total of 120 subjects were included in the final analysis. The mean age was 63.64 ± 10.80. In study population of no albuminuria group, 50 % had glomerular filtration rate (GFR) of 30 - 44 (grade 3 CKD) and 50 % had GFR of < / = 15 (grade 5), among microalbuminuria group, 4.45 % had GFR of 60 - 89 (grade 2) and 1 had GFR of 45 - 59 (grade 3a), 13.64 % had GFR 30 - 44 (grade 3b), 40.91 % had GFR 15 - 29 (grade 4), 36.36 % had GFR < = 15 (grade 5), among macroalbuminuria group, 4.6 % had GFR 45 - 59 (grade 3a), 9.2 % had GFR 30 - 44 (grade 3b), 13.79 % had GFR 15 - 29 (grade 4) and 72.41 % had GFR < = 15 (grade 5). Majority had macro albuminuria. The proportion of the difference between systolic blood pressure (SBP) and macroalbuminuria was statistically significant. (P-value < 0.05) as well as proportion of the difference between insulin usage with macroalbuminuria was statistically significant. (P-value < 0.05). CONCLUSIONS Our study delivers sufficient evidence endorsing high relationship between diabetes, hypertension, and kidney disease. KEYWORDS Diabetic Nephropathy, Macroalbuminuria, Hypertension, DHKD Syndrome