Epidemiology of chronic kidney disease in a Sri Lankan population

Abstract

CONTEXT:Chronic kidney disease (CKD) is characterized by progressive destruction of renal mass with irreversible sclerosis and loss of nephrons over a period of months to years, depending on the underlying etiology.AIM:To describe demographic patterns and identify common causes of CKD in patients admitted to ward 41 and 48B, National Hospital of Sri Lanka.SETTINGS AND DESIGN:A hospital based descriptive 3-month study was conducted at ward 41 and 48B, National Hospital of Sri Lanka. A case record form was used to record sociodemographic variables, stage of renal disease, and etiology of patients in established chronic renal failure. Sources of data included patient interviews, diagnosis cards and case records, ultrasound scan reports, and biopsy findings.RESULTS:One hundred and twenty-one patients were recruited with male to female ratio being 2.5:1 (86:35). Mean age of the population was 47.8 years (SD ± 13.7). Common causes of CKD identified in these patients included diabetic nephropathy (37, 30.6%), hypertension (16, 13.2%), glomerulonephritis (12, 9.9%), and obstructive uropathy (10, 8.3%). The cause was unknown in 25.6% of patients with chronic renal disease. Fifty percent of patients were from the Western Province. The leading cause of CKD in patients from the Western Province was diabetic nephropathy (26, 37.7%). The etiology of CKD was unknown in majority of the patients (14, 27.4%) from other provinces. The difference in incidence of diabetic nephropathy in the Western Province as to other provinces was not statistically significant (P > 0.05).CONCLUSION:Diabetes is a major contributor to CKD reflecting changing disease epidemiology in Sri Lanka.

A study of chronic kidney disease patients with no known risk factors coming to tertiary care hospital

“…They reported that CKDu (CKD of unknown etiology) had a point prevalence ranging from 2-16% among those aged >18 years. [7][8][9] and that biopsy primarily showed tubulointerstitial involvement, secondary glomerulosclerosis and glomerular ischemia.…”

Tailor-Made Induction Therapy in ‘Low Risk’ Renal Transplants; A South Asian Perspective

“…It has also been reported that CKD and genito-urinary related hospital admissions in the country have almost doubled over the past two decades. Concurrently, the in-hospital mortality from CKD has increased to 9.1 from 2.6 per 100,000 population [4]. Some of the reasons for these disappointing results include; lack of adequate state sponsored renal replacement therapy, poor patient acceptance of peritoneal dialysis, relatively low rate of deceased donor organ donation and prohibitive costs of transplant immunosuppression.…”

Cystatin C Based Evaluation of Renal Function in Hypertensive Patients in Ubth, Benin City

“…The WHO recommendation for optimal blood pressure for follow up of hypertensive patients, states that the values should be 130/90mmHg or below. Uncontrolled blood pressure is a known risk factor for the development of CKD 3 . The results of serum creatinine and cystatin C with the low estimated GFR obtained from this study revealed that many of these patients have developed chronic kidney disease.…”

“…Hypertension in blacks is a notable cause of kidney disease and usually progress to end stage renal failure due to late presentation 2 . Lack of proper medical treatment of hypertension can also result in complications like stroke, visual impairment and renal disease 3 . Chronic kidney disease is a known complication of hypertension especially when the blood pressure is uncontrolled 3 .…”

“…Lack of proper medical treatment of hypertension can also result in complications like stroke, visual impairment and renal disease 3 . Chronic kidney disease is a known complication of hypertension especially when the blood pressure is uncontrolled 3 . In blacks, hypertension runs a more aggressive course and many hypertensive patients present with hypertensive nephroslecrosis 4 .…”