1
|
Singh A, Verma M, Das M, Parija PP, Nayak S, Jha V. Prevalence and associated factors of impaired kidney functions among children and adolescents in India: insights from the Comprehensive National Nutrition Survey (CNNS) 2016-18. BMC Pediatr 2024; 24:429. [PMID: 38965471 PMCID: PMC11223285 DOI: 10.1186/s12887-024-04903-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 06/21/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is a significant public health problem. The burden of CKD in children and adolescents in India is not well described. We used data from the recent Comprehensive National Nutrition Survey (CNNS) to estimate the prevalence of impaired kidney function (IKF) and its determinants in children and adolescents between the ages of 5 and 19. METHODS CNNS 2016-18 adopted a multi-stage sampling design using probability proportional to size sampling procedure after geographical stratification of urban and rural areas. Serum creatinine was tested once in 24,690 children and adolescents aged 5-19 years. The estimated glomerular filtration rate (eGFR) was derived using the revised Schwartz equation. The eGFR value below 60 ml/min/1.73 m2 is defined as IKF. Bivariate analysis was done to depict the weighted prevalence, and multivariable logistic regression examined the predictors of IKF. RESULTS The mean eGFR in the study population was 113.3 + 41.4 mL/min/1.73 m2. The overall prevalence of IKF was 4.9%. The prevalence in the 5-9, 10-14, and 15-19 year age groups was 5.6%, 3.4% and 5.2%, respectively. Regression analysis showed age, rural residence, non-reserved social caste, less educated mothers, Islam religion, children with severe stunting or being overweight/obese, and residence in Southern India to be predictors of IKF. CONCLUSIONS The prevalence of IKF among children and adolescents in India is high compared to available global estimates. In the absence of repeated eGFR-based estimates, these nationally representative estimates are intriguing and call for further assessment of socio-demographic disparities, genetics, and risk behaviours to have better clinical insights and public health preparedness.
Collapse
Affiliation(s)
- Angad Singh
- International Institute for Population Sciences, Mumbai, India
| | - Madhur Verma
- Community and Family Medicine, All India Institute of Medical Sciences Bathinda, Punjab, India.
| | - Milan Das
- International Institute for Population Sciences, Mumbai, India
| | - Pragyan Paramita Parija
- Community and Family Medicine, All India Institute of Medical Sciences Vijaypur, Jammu, India
| | - Saurabh Nayak
- Nephrology, All India Institute of Medical Sciences Bathinda, Punjab, India
| | - Vivekanand Jha
- The George Institute for Global Health India, UNSW, New Delhi, India
- Manipal Academy of Higher Education, Manipal, India
- Faculty of Medicine, Imperial College London, London, UK
- Faculty of Medicine, University of New South Wales, Sydney, Australia
| |
Collapse
|
2
|
Samitinjay A, Vaishnavi K, Gongireddy R, Kulakarni SC, Panuganti R, Vishwanatham C, Manikanta AK, Biswas R. Understanding clinical complexity in organ and organizational systems: Challenges local and global. J Eval Clin Pract 2024; 30:316-329. [PMID: 37335625 DOI: 10.1111/jep.13886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 04/04/2023] [Accepted: 05/19/2023] [Indexed: 06/21/2023]
Abstract
INTRODUCTION Complexity in healthcare systems has been arbitrarily defined as tasks or systems ranging from complicated to intractable, with a general view of these not being 'simple'. Complexity in healthcare systems in first-world countries has been well elucidated, however, data from third-world countries is still scant. MATERIALS AND METHODS: We present four cases each from three different organ systems-chronic kidney disease, alcohol use disorder, and heart failure-in the backdrop of our healthcare organization. We present our analysis of the complexities faced clinically and, in our local healthcare system which led to these events. RESULTS Analysis of these cases showed that patients with chronic kidney disease had vertebral-spinal pathologies due to poor infection control measures during haemodialysis. All these patients were young with a long history of secondary hypertension. In patients with alcohol use disorder, a common theme of how government regulations and peer pressure promote alcohol use is analysed. In the four patients with unexplained heart failure, vascular health is viewed as a fractal dimension and the various factors affecting vascular health are elaborated. CONCLUSION Complexities exist clinically in making a diagnosis, and organizationally, in the variables and nodes dictating patient outcomes. Clinical complexities cannot be simplified but have to be navigated in an optimized way to improve clinical outcomes.
Collapse
Affiliation(s)
- Aditya Samitinjay
- Department of General Medicine, Kamineni Institute of Medical Sciences, Narketpally, India
| | - Karnati Vaishnavi
- Department of General Medicine, Government Medical College, Sangareddy, India
| | | | - Sai Charan Kulakarni
- Department of General Medicine, Kamineni Institute of Medical Sciences, Narketpally, India
| | - Raveen Panuganti
- Department of General Medicine, Kamineni Institute of Medical Sciences, Narketpally, India
| | - Chandana Vishwanatham
- Department of General Medicine, Kamineni Institute of Medical Sciences, Narketpally, India
| | | | - Rakesh Biswas
- Department of General Medicine, Kamineni Institute of Medical Sciences, Narketpally, India
| |
Collapse
|
3
|
Badrachalam R, Mani V, Kumar R, Shafiulla A. Vitamin D receptor (BsmI) gene polymorphism and allele frequency among chronic kidney disease patients in south Indian population. Bioinformation 2023; 19:380-384. [PMID: 37822821 PMCID: PMC10563556 DOI: 10.6026/97320630019380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 04/30/2023] [Accepted: 04/30/2023] [Indexed: 10/13/2023] Open
Abstract
The vitamin D receptor (VDR) axis plays an important role in multiple physiological renal functions. BsmI gene is one among the VDR gene plays a vital role in maintaining this VDR axis and any polymorphism in VDR gene will cause dysfunction of renal tissues. The main objective of the study is to study the link between BsmI VDR gene polymorphism and Chronic Kidney Disease (CKD). This was a case-control study, which includes 100 cases and 100 controls. BsmI gene analysis was done by polymerase chain reaction - restriction fragment length polymorphism (PCR-RFLP). Among 100 CKD study participants, BB (wild-type) genotype of BsmI gene was present in 7 patients (7%), Bb (heterozygous) genotype was present in 23 patients (23%) and bb (mutant) genotype was present in 70 patients (70%). And among 100 controls, 92 subjects were found to have BB genotype and 8 subjects were found to have Bb genotype and none of subjects were found to have bb genotypes. CKD patients with Bb and bb genotypes were found to have significantly elevated serum urea, creatinine and decreased Glomerular Filtration Rate (GFR) when compared to the BB genotype of BsmI gene. 'b' allele of BsmI gene, Bb and bb genotypes of BsmI gene plays a greater role in Guanine/Adenine single nucleotide polymorphism of BsmI gene in CKD.
Collapse
Affiliation(s)
- Ramya Badrachalam
- Department of Biochemistry, Sri Manakula Vinayagar Medical College and Hospital, Puducherry - 605107, Tamil Nadu, India
| | - Vadivel Mani
- Department of Biochemistry, Konaseema Institute of Medical sciences and research foundation, Amalapuram, East Godavari Dt-533201, Andhra Pradesh, India
| | - Ravi Kumar
- Department of Biochemistry, Sri Manakula Vinayagar Medical College and Hospital, Puducherry - 605107, Tamil Nadu, India
| | - Asmathulla Shafiulla
- Department of Biochemistry, All India Institute of Medical Sciences, Madurai- 625006, Tamilnadu, India
| |
Collapse
|
4
|
Abraham G, Almeida A, Gaurav K, Khan MY, Patted UR, Kumaresan M. Reno protective role of amlodipine in patients with hypertensive chronic kidney disease. World J Nephrol 2022; 11:86-95. [PMID: 35733653 PMCID: PMC9160710 DOI: 10.5527/wjn.v11.i3.86] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/23/2021] [Accepted: 04/04/2022] [Indexed: 02/06/2023] Open
Abstract
Chronic kidney disease (CKD) and hypertension (HTN) are closely associated with an overlapping and intermingled cause and effect relationship. Decline in renal functions are usually associated with a rise in blood pressure (BP), and prolonged elevations in BP hasten the progression of kidney function decline. Regulation of HTN by normalizing the BP in an individual, thereby slowing the progression of kidney disease and reducing the risk of cardiovascular disease, can be effectively achieved by the anti-hypertensive use of calcium channel blockers (CCBs). Use of dihydropyridine CCBs such as amlodipine (ALM) in patients with CKD is an attractive option not only for controlling BP but also for safely improving patient outcomes. Vast clinical experiences with its use as monotherapy and/or in combination with other anti-hypertensives in varied conditions have demonstrated its superior qualities in effectively managing HTN in patients with CKD with minimal adverse effects. In comparison to other counterparts, ALM displays robust reduction in risk of cardiovascular endpoints, particularly stroke, and in patients with renal impairment. ALM with its longer half-life displays effective BP control over 24-h, thereby reducing the progression of end-stage-renal disease. In conclusion, compared to other classes of CCBs, ALM is an attractive choice for effectively managing HTN in CKD patients and improving the overall quality of life.
Collapse
Affiliation(s)
- Georgi Abraham
- Department of Nephrology, MGM Healthcare, Nelson Manickam Road, Aminjikarai, Chennai 6300028, India
| | - A Almeida
- PD Hinduja Hospital and Medical Research Center, Almeida, A (reprint author), PD Hinduja, Hinduja Clin, Dept Med, Nephrol Sect, 2209 Veer Savarkar Marg, Bombay 400016, Maharashtra, Mumbai 400016, India
| | - Kumar Gaurav
- Medical Affairs, Dr. Reddys Labs, Hyderabad 500016, Telangana, India
| | | | - Usha Rani Patted
- Medical Affairs, Dr. Reddys Labs, Hyderabad 500016, Telangana, India
| | | |
Collapse
|
5
|
Jolly AM, Thomas J. Chronic kidney disease of unknown etiology in India: a comparative study with Mesoamerican and Sri Lankan nephropathy. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:15303-15317. [PMID: 34984612 DOI: 10.1007/s11356-021-16548-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 09/11/2021] [Indexed: 06/14/2023]
Abstract
Chronic kidney disease of unknown etiology [CKDu] is a condition characterized by decline in kidney function and is not associated with diabetic nephropathy or hypertensive nephropathy. In this review, we have done a detailed literature analysis on CKDu in India, and then had a comparison with that of Mesoamerica and Sri Lanka. In India, CKDu became the second most common type of CKD after diabetic nephropathy. Silica was seen in the groundwater of both India and Sri Lanka, whereas in Mesoamerica silica exposure through particulate matter was seen among CKDu communities. DDE is a common agrochemical seen in both India and Sri Lanka. The risk factors vary from region to region and it is important to categorize CKDu population based on the risk factors to avoid misinterpretation of the condition as non-CKDu category and to evade further complications. More studies have to be conducted to reveal the detailed pathophysiological mechanisms and its relation with irrational exploitation of environmental resources.
Collapse
Affiliation(s)
- Aleeta Maria Jolly
- Department of Pharmacology, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, Ponekkara, Kerala, India
| | - Jaya Thomas
- Department of Pharmacology, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, Ponekkara, Kerala, India.
| |
Collapse
|
6
|
Elias MA, Van Damme W, Wouters E. Accessibility and quality of haemodialysis services in an urban setting in South India: a qualitative multiperspective study. BMJ Open 2022; 12:e052525. [PMID: 35131824 PMCID: PMC8823140 DOI: 10.1136/bmjopen-2021-052525] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To explore the accessibility and quality of existing haemodialysis services in an urban setting. SETTING The study was conducted in Bangalore city, India. PARTICIPANTS A total of 28 stakeholders including 2 nephrologists, 7 duty doctors, 13 dialysis technicians and 6 patients on long-term haemodialysis were selected from 20 dialysis centres in Bangalore city. DESIGN AND METHODS Qualitative study using in-depth interviews. A thematic analysis was done using the Availability, Accessibility, Acceptability and Quality Framework of WHO and the Bruce's Quality of Care Framework. RESULTS The study found several gaps with regard to the access and quality of existing services for patients with end-stage kidney disease (ESKD). The charges for dialysis sessions across settings displayed a wide variance. Patients often started dialysis services in private and later shifted to government and non-governmental organisations-run centres and reduced the number of weekly dialysis sessions due to financial constraints. Most standalone dialysis centres did not have the facilities to manage any emergencies. Most centres did not admit patients with hepatitis or HIV. The quality of care in dialysis centres seemed to be variable and most centres were managed solely by dialysis technicians. There were no psychosocial interventions available to the patients irrespective of the settings. Cost-cutting practices such as employing underqualified technicians, reusing dialysis equipment and using substandard water for dialysis were common. CONCLUSION The study highlights the need for more financial and personnel investments in ESKD care in India to ensure optimal care for the growing patient population. The study points towards the need for comprehensive management practices, including diet counselling and psychosocial support. While there are comprehensive guidelines on the establishment and management of dialysis services, more policy attention needs to be on effective implementation of these, to ensure better accessibility and quality of existing services.
Collapse
Affiliation(s)
- Maya Annie Elias
- Department of Sociology, University of Antwerp, Antwerp, Belgium
| | - Wim Van Damme
- Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Edwin Wouters
- Department of Sociology, University of Antwerp, Antwerp, Belgium
| |
Collapse
|
7
|
Kumar V, Yadav AK, Sethi J, Ghosh A, Sahay M, Prasad N, Varughese S, Parameswaran S, Gopalakrishnan N, Kaur P, Modi GK, Kamboj K, Kundu M, Sood V, Inamdar N, Jaryal A, Vikrant S, Nayak S, Singh S, Gang S, Baid-Agrawal S, Jha V. The Indian Chronic Kidney Disease (ICKD) study: baseline characteristics. Clin Kidney J 2022; 15:60-69. [PMID: 35035937 PMCID: PMC8757418 DOI: 10.1093/ckj/sfab149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 08/10/2021] [Indexed: 11/12/2022] Open
Abstract
Background Chronic kidney disease (CKD) is an important cause of morbidity and mortality worldwide. There is a lack of information on epidemiology and progression of CKD in low–middle income countries. The Indian Chronic Kidney Disease (ICKD) study aims to identify factors that associate with CKD progression, and development of kidney failure and cardiovascular disease (CVD) in Indian patients with CKD. Methods ICKD study is prospective, multicentric cohort study enrolling patients with estimated glomerular filtration rate (eGFR) 15–60 mL/min/1.73 m2, or >60 mL/min/1.73 m2 with proteinuria. Clinical details and biological samples are collected at annual visits. We analysed the baseline characteristics including socio-demographic details, risk factors, disease characteristics and laboratory measurements. In addition, we compared characteristics between urban and rural participants. Results A total of 4056 patients have been enrolled up to 31 March 2020. The mean ± SD age was 50.3 ± 11.8 years, 67.2% were males, two-thirds of patients lived in rural areas and the median eGFR was 40 mL/min/1.73 m2. About 87% were hypertensive, 37% had diabetes, 22% had CVD, 6.7% had past history of acute kidney injury and 23% reported prior use of alternative drugs. Diabetic kidney disease, chronic interstitial nephritis (CIN) and CKD-cause unknown (CKDu) were the leading causes. Rural participants had more occupational exposure and tobacco use but lower educational status and income. CIN and unknown categories were leading causes in rural participants. Conclusions The ICKD study is the only large cohort study of patients with mild-to-moderate CKD in a lower middle income country. Baseline characteristics of study population reveal differences as compared with other cohorts from high-income countries.
Collapse
Affiliation(s)
- Vivek Kumar
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ashok Kumar Yadav
- Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Jasmine Sethi
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Arpita Ghosh
- George Institute for Global Health India, New Delhi, India
| | - Manisha Sahay
- Department of Nephrology, Osmania Medical College, Osmania General Hospital, Hyderabad, India
| | - Narayan Prasad
- Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Science, Lucknow, India
| | | | - Sreejith Parameswaran
- Department of Nephrology, Jawaharlal Institute of Postgraduate Medical Education & Research, Pondicherry, India
| | | | - Prabhjot Kaur
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Gopesh K Modi
- Samarpan Kidney Institute and Research Center, Bhopal, India
| | - Kajal Kamboj
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Monica Kundu
- George Institute for Global Health India, New Delhi, India
| | - Vivek Sood
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Neeraj Inamdar
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ajay Jaryal
- Department of Nephrology, Indira Gandhi Medical College, Shimla, India
| | - Sanjay Vikrant
- Department of Nephrology, Indira Gandhi Medical College, Shimla, India
| | - Saurabh Nayak
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shivendra Singh
- Department of Nephrology, Institute of Medical Science, Banaras Hindu University, Varanasi, India
| | - Sishir Gang
- Department of Nephrology, Muljibhai Patel Urological Hospital, Nadiad, India
| | - Seema Baid-Agrawal
- Department of Nephrology and Transplant Center, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
| | - Vivekanand Jha
- George Institute for Global Health India, New Delhi, India
| |
Collapse
|
8
|
Anupama YJ, Conjeevaram A, Vincent L, Sastry N, Siddini V, Revanasiddappa M, Srinivasa S, Thimmegeowda A, Kulkarni M, Patil V. Clinico-epidemiological profile of dialysis services in Karnataka, India – A multicentric exploratory study. Indian J Nephrol 2022; 32:223-232. [PMID: 35814317 PMCID: PMC9267092 DOI: 10.4103/ijn.ijn_94_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/18/2021] [Accepted: 08/03/2021] [Indexed: 11/04/2022] Open
Abstract
Introduction: Material and Methods: Results: Conclusions:
Collapse
|
9
|
Shrestha N, Gautam S, Mishra SR, Virani SS, Dhungana RR. Burden of chronic kidney disease in the general population and high-risk groups in South Asia: A systematic review and meta-analysis. PLoS One 2021; 16:e0258494. [PMID: 34648578 PMCID: PMC8516300 DOI: 10.1371/journal.pone.0258494] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 09/28/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is an emerging public health issue globally. The prevalence estimates on CKD in South Asia are however limited. This study aimed to examine the prevalence of CKD among the general and high-risk population in South Asia. METHODS We conducted a systematic review and meta-analysis of population-level prevalence studies in South Asia (Afghanistan, Bangladesh, Bhutan, Maldives, Nepal, India, Pakistan, and Sri Lanka). Three databases namely PubMed, Scopus and Web of Science were systematically searched for published reports of kidney disease in South Asia up to 28 October 2020. A random-effect model for computing the pooled prevalence was used. RESULTS Of the 8749 identified studies, a total of 24 studies were included in the review. The pooled prevalence of CKD among the general population was 14% (95% CI 11-18%), and 15% (95% CI 11-20%) among adult males and 13% (95% CI 10-17%) in adult females. The prevalence of CKD was 27% (95% CI 20-35%) in adults with hypertension, 31% (95% CI 22-41%) in adults with diabetes and 14% (95% CI 10-19%) in adults who were overweight/obese. We found substantial heterogeneity across the included studies in the pooled estimates for CKD prevalence in both general and high-risk populations. The prevalence of CKD of unknown origin in the endemic population was 8% (95% CI 3-16%). CONCLUSION Our study reaffirms the previous reports that CKD represents a serious public health challenge in South Asia, with the disease prevalent among 1 in 7 adults in South Asian countries.
Collapse
Affiliation(s)
| | | | | | - Salim S. Virani
- Section of Cardiovascular Research, Baylor College of Medicine and Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, United States of America
| | | |
Collapse
|
10
|
Newtonraj A, Tovia S, Girija G, Manikandan M, Vincent A. Chronic Kidney Disease among Diabetes and Hypertensive Patients in a Remote Rural Area of South India: A Population-based Cross-sectional Study. Indian J Nephrol 2021; 31:420-422. [PMID: 34584366 PMCID: PMC8443100 DOI: 10.4103/ijn.ijn_260_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 08/14/2020] [Accepted: 08/29/2020] [Indexed: 11/24/2022] Open
Affiliation(s)
- Ariarathinam Newtonraj
- Department of Community Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India
| | - Stephen Tovia
- Department of Community Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India
| | - Ganesan Girija
- Department of Community Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India
| | - Mani Manikandan
- Department of Community Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India
| | - Antony Vincent
- Department of Community Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India
| |
Collapse
|
11
|
Palo SK, Swain S, Chowdhury S, Pati S. Epidemiology & attributing factors for chronic kidney disease: Finding from a case-control study in Odisha, India. Indian J Med Res 2021; 154:90-98. [PMID: 34782534 PMCID: PMC8715704 DOI: 10.4103/ijmr.ijmr_2148_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Indexed: 11/04/2022] Open
Abstract
Background & objectives Chronic kidney disease (CKD) is one of the leading causes of mortality in developing countries, however, evidence from some geographical areas of India is scantly available on its risk factors. Other than diabetes and hypertension, several personal and environmental factors are also associated with CKD. Methods A population-based case-control study was conducted over a period of 12 months in two high CKD reporting districts of Odisha, India. A total of 236 participants, 1:2 age- and sex-matched cases (83):controls (153), were included. Various factors were modelled with univariate and multivariable conditional logistic regression and analyzed using the Bayesian method in STATA SE v.12. Results Among the study cases, about 81 per cent were male and about 25 per cent were aged <40 yr. CKD-associated risk factors were hypertension for more than five years [adjusted odds ratio (aOR)=4.24; 95% credible interval: 1.23-10.05], scheduled tribe/caste (aOR=2.81; 1.09-5.95), use of tube well/bore well water for drinking (aOR=1.21; 1.02-1.43), consumption of locally made alcohol (aOR=1.09; 1.02-1.17) and eating red meat and vegetarian diet with (aOR=1.24; 1.12-1.39) and (aOR=1.09; 1.04-1.14), respectively. Interpretation & conclusions The presence of CKD among younger age groups and association of multiple factors including personal and environmental suggest for more research to establish the cause and effect relation of these factors.
Collapse
Affiliation(s)
- Subrata Kumar Palo
- ICMR-Regional Medical Research Center (RMRC), Bhubaneswar, Odisha, India
| | - Subhasisha Swain
- Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK
| | | | - Sanghamitra Pati
- ICMR-Regional Medical Research Center (RMRC), Bhubaneswar, Odisha, India
| |
Collapse
|
12
|
Govindarajan Venguidesvarane A, Jasmine A, Varadarajan S, Shriraam V, Muthuthandavan AR, Durai V, Thiruvengadam G, Mahadevan S. Prevalence of Vascular Complications Among Type 2 Diabetic Patients in a Rural Health Center in South India. J Prim Care Community Health 2020; 11:2150132720959962. [PMID: 33111620 PMCID: PMC7786422 DOI: 10.1177/2150132720959962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Introduction: Vascular complications are the major cause of morbidity in patients with diabetes mellitus. Screening for these complications is crucial in early detection and tertiary prevention. Hence, this study aimed at finding the prevalence of micro and macrovascular complications and their associated factors in type 2 diabetes mellitus patients in a rural health center by using simple and easily available tools. Methodology: This hospital based cross sectional study was conducted in Rural Health and Training Centre (RHTC) of Sri Ramachandra medical college from Jan 2017 to Aug 2017. All type 2 diabetes patients registered at RHTC were included in the study. By the use of questionnaire, clinical examination and laboratory investigations, the prevalence of macro and microvascular complications and associated factors were ascertained. Multiple logistic regression was used to identify factors associated with vascular complications of diabetes. Results: The study included 390 type 2 diabetes patients. The overall prevalence of macrovascular and microvascular complications in our study population was 29.7% and 52.1%, respectively. Among the macrovascular complications, both coronary artery disease (CAD) and peripheral vascular disease (PVD) had a prevalence rate of 15.1%. Among the microvascular complications, peripheral neuropathy (44.9%) had the highest prevalence followed by nephropathy (12.1%) and diabetic foot (7.2%). Multiple logistic regression analyses showed high HbA1c level, lower education, high postprandial blood sugar, hypertension, abdominal obesity were significantly associated with increased risk of vascular complications of diabetes. Conclusion: This study demonstrated the increased prevalence of vascular complications in Type 2 diabetes patients in rural India. Regular screening to identify those patients at risk could prevent further progression of complications.
Collapse
Affiliation(s)
| | - Aliya Jasmine
- Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Samya Varadarajan
- Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Vanishree Shriraam
- Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | | | - Vanitha Durai
- Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | | | - Shriraam Mahadevan
- Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| |
Collapse
|
13
|
Ravi R, Abraham G, Ravi R, Mathews M, Partasarathy R. Early detection of renal disease among truck drivers through organized screening. J Family Med Prim Care 2020; 9:4880-4884. [PMID: 33209816 PMCID: PMC7652140 DOI: 10.4103/jfmpc.jfmpc_903_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/19/2020] [Accepted: 07/27/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Trucking industry is the backbone of trade and economy and in India, truck drivers are occupationally faced with various challenges. Several risk factors including stress and abnormal lifestyle predisposes this group to non-communicable disease and chronic kidney disease (CKD) is one of the major threats. This study was carried out to evaluate the prevalence and risk factors of chronic kidney disease. METHODS The present cross-sectional study was carried out as a population-based screening programme among 3,200 truck drivers in Tamil Nadu for a period of 1 year in 2018. A structured proforma was used to obtain information regarding the diabetic and hypertensive status. Body mass index was calculated and blood pressure was measured using standard equipments. Urine dipstick method was used to detect the presence of albumin and glucose in the urine. RESULTS The mean age of the participants was 40.3 years. Overweight and obesity was seen in 49.9% of the participants, while elevated blood pressure was observed in 41.1%. About 12.4% of the participants were known hypertensives on medications. Albuminuria was present in 19.7% of the participants. Albuminuria was significantly associated with elevated blood pressure, high body mass index and elevated random blood sugars (P < 0.0001). In 83.7% of the participants, random blood sugar was elevated beyond 200 mg/dl. CONCLUSION The screening programme can be enhanced when coupled with an awareness campaign, with due focus on culturally relevant information delivered by trained health educators in the native language, so as to bring about adequate education through effective communication.
Collapse
Affiliation(s)
- Rama Ravi
- Department of Public Health, Tamilnad Kidney Research Tanker Foundation, Chennai, Tamil Nadu, India
| | - Georgi Abraham
- Department of Public Health, Tamilnad Kidney Research Tanker Foundation, Chennai, Tamil Nadu, India
| | - Rajalakshmi Ravi
- Department of Public Health, Tamilnad Kidney Research Tanker Foundation, Chennai, Tamil Nadu, India
| | - Milly Mathews
- Department of Nephrology, Madras Medical Mission, Hospital, Chennai, Tamil Nadu, India
| | | |
Collapse
|
14
|
Rai PK, Rai P, Bhat RG, Bedi S. Chronic Kidney Disease among Middle-Aged and Elderly Population: A cross-sectional screening in a Hospital Camp in Varanasi, India. SAUDI JOURNAL OF KIDNEY DISEASES AND TRANSPLANTATION 2020; 30:795-802. [PMID: 31464235 DOI: 10.4103/1319-2442.265454] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Chronic kidney disease (CKD) is no longer considered just a health burden, but a major health priority owing to its high treatment costs and poor outcome. The lack of community-based screening programs has led to the detection of CKD patients at advanced stages. This study aims to estimate the prevalence of CKD and patterns of known risk factors among the general population (middle-aged and elderly) attending a screening camp in a community-based setting. The study participants constituted a part of the general population of Varanasi (aged ≥45 years) who volunteered in a screening camp that was organized as part of the World Kidney Day Initiative at Opal Hospital. Information on age, sex, height, weight, smoking and drug history, history of diabetes, hypertension, and family history of kidney disease was extensively interrogated, while laboratory investigations such as urinalysis and serum creatinine levels were recorded. More than three-fifths of the participants were middle-aged adults (i.e., 45-64 years) and the remaining 34.8% were elderly population, i.e., ≥65 years. The overall prevalence of CKD in the 198 studied participants was 29.3%. Higher number of participants (40.6%) of elderly population had CKD (P = 0.011). The serum creatinine, albuminuria, and estimated glomerular filtration rate levels were strongly associated with CKD (P <0.05). Our study suggests that elderly individuals are at risk with higher serum creatinine levels and would benefit from early detection of CKD to prevent disease progression and associated morbidity and mortality.
Collapse
Affiliation(s)
- Pradeep Kumar Rai
- Department of Nephrology, Opal Hospital, Varanasi, Uttar Pradesh, India
| | - Punam Rai
- Department of Clinical Physiology, Opal Hospital, Varanasi, Uttar Pradesh, India
| | - Rasika Ganpathi Bhat
- Department of Medical Genetics, College of Nursing, Bombay Hospital and Research Center, Mumbai, Maharashtra, India
| | - Sonam Bedi
- Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| |
Collapse
|
15
|
Mohanty NK, Sahoo KC, Pati S, Sahu AK, Mohanty R. Prevalence of Chronic Kidney Disease in Cuttack District of Odisha, India. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020456. [PMID: 31936746 PMCID: PMC7014305 DOI: 10.3390/ijerph17020456] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 10/29/2019] [Accepted: 11/25/2019] [Indexed: 12/17/2022]
Abstract
Chronic kidney disease is one of the major health challenges in India. Cuttack district of the Odisha state of India is regarded as a hotspot for chronic kidney disease (CKD). However, there is limited information on true prevalence. This study estimates the prevalence of CKD in the Narsinghpur block of Cuttack district, Odisha. A cross-sectional study was conducted among population members aged 20-60 years. Using a multi-stage cluster sampling. 24 villages were randomly selected for mass screening for CKD. Blood samples were collected and glomerulus filtration rates were calculated. It was found that among the 2978 people screened, 14.3% were diagnosed with CKD and 10.8% were diagnosed with CKD without either diabetes or hypertension. In one-third of the sampled villages, about 20% population was diagnosed with CKD. The prevalence was higher among males (57%), in the population below 50 years of age (54%), lower socioeconomic groups (70%), and agricultural occupational groups (48%). Groundwater tube wells (49%) and wells (41%) were the main drinking water sources for CKD patients. This study highlights the need for detection of unknown etiologies of CKD and public health interventions for the prevention of CKD in India.
Collapse
Affiliation(s)
- Nisith Kumar Mohanty
- Utkal Kidney Foundation, Apollo Hospitals, Bhubaneswar 751005, Odisha, India; (N.K.M.); (A.K.S.)
| | - Krushna Chandra Sahoo
- Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar 751023, Odisha, India;
- Correspondence: ; Tel.: +91-83-2892-0344
| | - Sanghamitra Pati
- Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar 751023, Odisha, India;
| | - Asish K. Sahu
- Utkal Kidney Foundation, Apollo Hospitals, Bhubaneswar 751005, Odisha, India; (N.K.M.); (A.K.S.)
| | - Reena Mohanty
- Capital Hospital, Bhubaneswar 751001, Odisha, India;
| |
Collapse
|
16
|
Anupama YJ, Kiran SK, Hegde SN. Heavy Metals and Pesticides in Chronic Kidney Disease - Results from a Matched Case-Control Study from a Rural Population in Shivamogga District in South India. Indian J Nephrol 2019; 29:402-409. [PMID: 31798222 PMCID: PMC6883862 DOI: 10.4103/ijn.ijn_325_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION There is a high prevalence of chronic kidney disease (CKD) in the rural agrarian population of South India and it often appears unrelated to major known causes such as diabetes or glomerulonephritis. METHODS In a matched case-control study conducted in a rural population in Shivamogga district in South India, the association of heavy metals - lead (Pb), arsenic (As), cadmium (Cd) - and pesticides in CKD was studied. Blood and spot urine samples were tested quantitatively for heavy metals and qualitatively for pesticides. RESULTS In all, 69 matched pairs (40 female, 58%) were recruited. The mean estimated glomerular filtration rate (mL/min/1.73 m2) was 60.1 (14.2) in cases and 83.4 (13.4) in controls. Elevated blood lead level >5 μg/dL was seen in 15 cases and 25 controls, respectively [P = 0.035, matched odds ratio (MOR) 0.5, 95% confidence interval (CI) 0.22-1.05]. Urinary Pb was elevated in 16 cases and 13 controls, respectively (P = 0.28, MOR 1.25, 95% CI 0.58-2.73). There was no significant association with As and Cd, while pesticide residues were undetectable in cases as well as controls. These results did not change even after excluding CKD cases with diabetes, stage 2 hypertension, and significant proteinuria. CONCLUSIONS There was no statistical significant association between any of the studied heavy metals and CKD, although there was a significant burden of heavy metals in the studied subjects.
Collapse
Affiliation(s)
- Y. J. Anupama
- Department of Nephrology, Nanjappa Hospital, Shivamogga, Karnataka, India
| | - S. K. Kiran
- Taluka Medical Officer, Thirthahalli, Karnataka, India
| | - Shrikanth N. Hegde
- Department of Medicine, Anushri Medical and Diabetes Care Center, Shivamogga, Karnataka, India
| |
Collapse
|
17
|
Newtonraj A, Selvaraj K, Purty AJ, Nanda SK, Arokiaraj MC, Vincent A, Manikandan M. Feasibility and outcome of community-based screening for cardiovascular disease risk factors in a remote rural area of South India: The Chunampet rural-Cardiovascular health assessment and management program. Indian J Endocrinol Metab 2019; 23:628-634. [PMID: 32042699 PMCID: PMC6987782 DOI: 10.4103/ijem.ijem_528_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND As committed by India in Global Action Plan, Sustainable Development Goals and National Health Policy 2017, India has the responsibility to provide accessible, affordable noncommunicable disease care to the people. Our study aimed to find out the burden of cardiovascular risk factors among hypertension and diabetic patients, through a community-based screening, in a remote rural area of South India. METHODS A special program named "Chunampet Rural-Cardiovascular Health Assessment and Management Program" (CR-CHAMP) was launched in August and September 2017 in a Rural Health Training Center (RHTC), functioning under a private medical college in South India. In this program, participants with hypertension (HT) and diabetes (DM) were line listed from 10 remote villages, and then history, initial biochemical, hormonal, and hematological screenings were done to assess the cardiovascular diseases (CVDs) risk factors among these patients, following which special consultation was offered in RHTC. RESULTS Out of 415 eligible patients with HT and DM, 389 were approached; among them, 328 were willing to participate and were screened initially; among them, 235 were attended special consultation. Higher CVD risk was found in 21%. Prevalence of chronic kidney disease was 14%, deranged lipid profile was more than 50%, metabolic syndrome was 49%, anemia was 68%, abnormal waist-hip ratio was 56%, abdominal obesity was 59%, and overweight and obesity using body mass index (BMI) was 59%. Females' participation was more in our community-based screening procedure (66%) than male participation (34%). CONCLUSION CR-CHAMP demonstrated feasibility and value of implementing a screening program for high-risk individuals with HT and DM for CVD risk through existing primary care in a remote rural area of South India. This will help the National Program and policymakers to plan for interventions in the remote rural area in future.
Collapse
Affiliation(s)
- Ariarathinam Newtonraj
- Department of Community Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India
| | - Kalaiselvi Selvaraj
- Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
| | - Anil J. Purty
- Department of Community Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India
| | - Sunil K. Nanda
- Department of Biochemistry, Pondicherry Institute of Medical Sciences, Puducherry, India
| | - Mark C. Arokiaraj
- Department of Cardiology, Pondicherry Institute of Medical Sciences, Puducherry, India
| | - Antony Vincent
- Department of Community Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India
| | - Mani Manikandan
- Department of Community Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India
| |
Collapse
|
18
|
Jacob SR, Raveendran R, Kannan S. Causes, comorbidities and current status of chronic kidney disease: A community perspective from North Kerala. J Family Med Prim Care 2019; 8:2859-2863. [PMID: 31681656 PMCID: PMC6820375 DOI: 10.4103/jfmpc.jfmpc_478_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 06/19/2019] [Accepted: 08/01/2019] [Indexed: 11/04/2022] Open
Abstract
Context Chronic kidney disease is an upcoming public health problem characterized by premature mortality and expensive treatment in low resource settings where diabetes is highly prevalent. Aim To find out the causes and comorbidities and to explore the community support systems for treatments availed. Settings and Design Community based cross sectional design. Materials and Methods Interview of known chronic kidney disease patients above 18 years registered under palliative clinics. Statistical Analysis Used Mean, SD, proportions, and 95% Confidence interval, chi square test at significance level P = 0.05. Results Majority of patients were males, below 60 years. Mean duration was 5.26 years and mean age at onset was 48.6 years and 62% were in advanced stages of disease. The commonest cause was diabetic nephropathy (44.6%) followed by hypertensive nephropathy (33.3%). The comorbidities included hypertension (61.4%), diabetes (47.3%), cardiovascular disease (30.6%), Chronic obstructive pulmonary disease (10%) malignancies (2.6%), and retinopathy (28%). Considering treatment status 60.6% were on dialysis 13.3% had undergone transplantation, mostly from private institutions with help of public donations and both at significant underutilization by women. Though 44.6% were protected by social security schemes, the median monthly cost of disease management amounted to Rs. 10,500 which was unaffordable for the majority who were below the poverty line. Conclusions There is an impending need for strengthening management, high-risk screening among diabetic and hypertensive patients and provision for specialist care to delay the onset of end-stage renal disease. The social security support system should be improvised for our setting to facilitate dialysis and transplantation to minimize out of the pocket expenditure.
Collapse
Affiliation(s)
- Sabitha Rose Jacob
- Department of Community Medicine, Govt Medical College Manjeri, Kerala, India
| | - Rini Raveendran
- Department of Community Medicine, Govt Medical College Thrissur, Kerala, India
| | - Suthanthira Kannan
- Department of Community Medicine, ESIC Medical College Hyderabad, Telangana, India
| |
Collapse
|
19
|
Asserraji M, Bouzerda A, Soukrate S, Maoujoud O, Belarbi M, Zemraoui N, Bendriss L, Khatouri A. Usefulness of ambulatory blood pressure monitoring in chronic kidney disease: The moroccan experience. SAUDI JOURNAL OF KIDNEY DISEASES AND TRANSPLANTATION 2019; 30:913-918. [PMID: 31464249 DOI: 10.4103/1319-2442.265468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Among patients with chronic kidney disease (CKD), hypertension (HTN) is very common and widely recognized to accelerate the progression of CKD and increase the risk for cardiovascular events. Accumulated data indicate that ambulatory blood pressure monitoring (ABPM) is better in detecting HTN than office blood pressure (BP) measurement. The goal of this study is to describe the ABPM characteristics in a group of CKD and hypertensive patients. A transversal study was conducted over a period of six months, to evaluate the ABPM patterns among a group of hypertensive patients with CKD (Group 1) and compared the data with a control group (Group 2). ABPM was performed with measurement rate every 15 min during daytime and 30 min at night. Nondipping BP patterns were defined as the absence of fall in nocturnal systolic and diastolic BP >10% of daytime values. Masked HTN was defined as controlled office BP (<140/90 mm Hg) with an elevated overall average BP by 24-h ABPM (>125/75 mm Hg), and white-coat HTN was defined as association of elevated BP readings (>140/90 mm Hg) in a clinical setting and normal 24-h average BP levels (<130/80 mm Hg). Fifty patients were included in each group. HTN was much longer in duration among hypertensive patients with CKD and frequently associated with obesity, dyslipidemia, and diabetes (64% vs. 39.60%). Positive proteinuria was present in 82% of CKD patients with HTN. CKD patients with HTN received more antihypertensive drugs than Group 2 patients. HTN was much more uncontrolled among CKD patients (60% vs. 24%), more serious with higher daytime and nighttime SBP, and loss of physiologic dipping during nighttime BP measurement (80%). Out-of-office BP monitoring by ABPM may improve the assessment and the successful management of HTN in patients with CKD. Standardized definitions for the diagnosis of masked and white-coat HTN would facilitate research.
Collapse
Affiliation(s)
- Mohammed Asserraji
- Department of Nephrology, Avicenne Military Hospital and Marrakech School of Medicine, Cadi Ayyad University, Marrakech, Morocco
| | | | - Safia Soukrate
- Department of Cardiology, Avicenne Armed Forces Hospital, Marrakesh, Morocco
| | - Omar Maoujoud
- Department of Nephrology, Avicenne Military Hospital and Marrakech School of Medicine, Cadi Ayyad University, Marrakech, Morocco
| | - Merouane Belarbi
- Department of Nephrology, Avicenne Military Hospital and Marrakech School of Medicine, Cadi Ayyad University, Marrakech, Morocco
| | - Nadir Zemraoui
- Department of Nephrology, Avicenne Military Hospital and Marrakech School of Medicine, Cadi Ayyad University, Marrakech, Morocco
| | - Leila Bendriss
- Department of Cardiology, Avicenne Armed Forces Hospital, Marrakesh, Morocco
| | - Ali Khatouri
- Department of Cardiology, Avicenne Armed Forces Hospital, Marrakesh, Morocco
| |
Collapse
|
20
|
Tatapudi RR, Rentala S, Gullipalli P, Komarraju AL, Singh AK, Tatapudi VS, Goru KB, Bhimarasetty DM, Narni H. High Prevalence of CKD of Unknown Etiology in Uddanam, India. Kidney Int Rep 2019; 4:380-389. [PMID: 30899865 PMCID: PMC6409405 DOI: 10.1016/j.ekir.2018.10.006] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Revised: 09/14/2018] [Accepted: 10/08/2018] [Indexed: 01/27/2023] Open
Abstract
INTRODUCTION There were concerns raised regarding a high prevalence of chronic kidney disease (CKD) in Uddanam, a fertile subtropical low-altitude territory in the southern Indian state of Andhra Pradesh. The present study was undertaken to ascertain the prevalence of CKD, disease characteristics, and risk factor profile in this area. METHODS We selected 2210 subjects (age >18 years) using multistage sampling. After obtaining demographic and anthropometric data, urinary protein-creatinine ratio, serum creatinine, and blood glucose were measured in all the subjects. Glomerular filtration rate was estimated (eGFR) using the Modification of Diet in Renal Disease equation. RESULTS Mean age of the subjects was 43.2 ± 14.2 years (range: 18-98), 44.3% were men and 55.7% were women. Mean eGFR of subjects was 94.3 ± 33.4. Low eGFR (<60 ml/min per 1.73 m2) was seen in 307 (13.98%) patients with a mean eGFR of 34.8 ± 16.6. The prevalence of subjects having low eGFR and with proteinuria (CKD) was 18.23%. Major risk factors, such as diabetes, long-standing hypertension, and significant proteinuria, were absent in 73% of patients with CKD, implying that a significant proportion of the population is afflicted with the entity "CKD of unknown etiology (CKDu)." CONCLUSION The prevalence of CKD and CKDu in Uddanam is much higher than other earlier studies in either rural or urban communities in India. We suggest that there is a dire need to review health policies and allocate resources for prevention and treatment of CKD in the Uddanam region.
Collapse
Affiliation(s)
- Ravi Raju Tatapudi
- GITAM Institute of Medical Sciences and Research, GITAM deemed to be University, Gandhi Nagar, Visakhapatnam, India
| | - Satyanarayana Rentala
- Department of Biotechnology, GITAM Institute of Technology, GITAM deemed to be University, Gandhi Nagar, Visakhapatnam, India
| | - Prasad Gullipalli
- Department of Nephrology, Andhra Medical College, Visakhapatnam, India
| | - Aruna Lakshmi Komarraju
- GITAM Institute of Science, GITAM deemed to be University, Gandhi Nagar, Visakhapatnam, India
| | - Ajay K. Singh
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Vasishta S. Tatapudi
- Department of Medicine, NYU Langone Transplant Institute, NYU Langone Health, New York, New York, USA
| | - Krishna Babu Goru
- Department of Social and Preventive Medicine, Rangaraya Medical College, Kakinada, Andhra Pradesh, India
| | | | - Hanumanth Narni
- Department of Community Medicine, Gayatri Vidya Parishad Institute of Health Care and Medical Technology, Visakhapatnam, India
| |
Collapse
|
21
|
Hasan M, Sutradhar I, Gupta RD, Sarker M. Prevalence of chronic kidney disease in South Asia: a systematic review. BMC Nephrol 2018; 19:291. [PMID: 30352554 PMCID: PMC6199753 DOI: 10.1186/s12882-018-1072-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 10/05/2018] [Indexed: 11/26/2022] Open
Abstract
Background Chronic kidney disease (CKD) is becoming a major public health problem around the world. But the prevalence has not been reported in South Asian region as a whole. This study aimed to systematically review the existing data from population based studies in this region to bridge this gap. Methods Articles published and reported prevalence of CKD according to K/DOQI practice guideline in eight South Asian countries between December 1955 and April 2017 were searched, screened and evaluated from seven electronic databases using the PRISMA checklist. CKD was defined as creatinine clearance (CrCl) or GFR less than 60 ml/min/1.73 m2. Results Sixteen population-based studies were found from four South Asian countries (India, Bangladesh, Pakistan and Nepal) that used eGFR to measure CKD. No study was available from Sri Lanka, Maldives, Bhutan and Afghanistan. Number of participants ranged from 301 in Pakistan to 12,271 in India. Majority of the studies focused solely on urban population. Different studies used different equations for measuring eGFR. The prevalence of CKD ranged from 10.6% in Nepal to 23.3% in Pakistan using MDRD equation. This prevalence was higher among older age group people. Equal number of studies reported high prevalence among male and female each. Conclusions This systematic review reported high prevalence of CKD in South Asian countries. The findings of this study will help pertinent stakeholders to prepare suitable policy and effective public health intervention in order to reduce the burden of this deadly disease in the most densely populated share of the globe. Electronic supplementary material The online version of this article (10.1186/s12882-018-1072-5) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Mehedi Hasan
- Centre for Non-Communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, BRAC University, 5th Floor (Level-6), icddrb Building, 68 Shahid Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.
| | - Ipsita Sutradhar
- Centre for Non-Communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, BRAC University, 5th Floor (Level-6), icddrb Building, 68 Shahid Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Rajat Das Gupta
- Centre for Non-Communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, BRAC University, 5th Floor (Level-6), icddrb Building, 68 Shahid Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Malabika Sarker
- Centre for Science of Implementation and Scale-Up, Centre for Non-Communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh.,Adjunct Research Faculty, Institute of Public Health, Heidelberg University, Heidelberg, Germany
| |
Collapse
|
22
|
Anbarasu K, Verma VK, Beevi SS, Reddy VS. Environmental impact on the onset of hypertension-induced end-stage renal disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2018; 28:511-521. [PMID: 29989454 DOI: 10.1080/09603123.2018.1491954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 06/19/2018] [Indexed: 06/08/2023]
Abstract
This study intends to assess the impact of environmental factors on the onset of hypertension-induced end-stage renal disease (ESRD) and to compare the level of oxidative stress with nonhypertensive diabetic ESRD. ESRD patients were evaluated along with healthy controls through questionnaire for demographic, nutritional and lifestyle variables. Oxidants were measured along with antioxidants. Multiple linear regression (MLR) models were applied to analyze association of studied variables with oxidants and antioxidants. Most of the hypertensive nephrosclerotic patients were residing in locality that was either closer to industrial belt or polluting water bodies, belonging to low socioeconomic status that invariably affected their lifestyle and nutritional status. Hypertensive ESRD patients showed more pronounced oxidative stress than diabetic ESRD. Several of the studied variables were significantly associated with oxidants and antioxidants. Demographic, nutritional and lifestyle variables appeared to have suggestive effect on the onset of hypertensive nephrosclerosis.
Collapse
Affiliation(s)
- Kavitha Anbarasu
- a Department of Regenerative Medicine , KIMS Foundation & Research Center , Secunderabad , India
| | - Vinod Kumar Verma
- a Department of Regenerative Medicine , KIMS Foundation & Research Center , Secunderabad , India
| | - Syed Sultan Beevi
- a Department of Regenerative Medicine , KIMS Foundation & Research Center , Secunderabad , India
| | - Velagala Satti Reddy
- b Department of Nephrology , Krishna Institute of Medical Sciences , Secunderabad , India
| |
Collapse
|
23
|
Mihardja L, Delima D, Massie RGA, Karyana M, Nugroho P, Yunir E. Prevalence of kidney dysfunction in diabetes mellitus and associated risk factors among productive age Indonesian. J Diabetes Metab Disord 2018; 17:53-61. [PMID: 29984211 PMCID: PMC6013541 DOI: 10.1007/s40200-018-0338-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 02/12/2018] [Indexed: 12/16/2022]
Abstract
Background The prevalence of diabetes mellitus is increasing in Indonesia due to population growth, urbanization, and lifestyle. Diabetes mellitus (DM) is the leading cause of chronic kidney disease that escalates mortality rate, but not all DM develop into chronic kidney disease. Aims To estimate the prevalence of kidney dysfunction (KD) in DM and the associated dominant risk factors among productive age Indonesian based on the National Health Survey (Riskesdas) 2013. Methods The statistical data consisted of 15,791 females and 10,349 males, aged 20 to 54, who lived in rural and urban areas. The data was obtained from National Institute of Health Research and Development (NIHRD), Ministry of Health. Data were collected from 33 provinces using cross sectional method. The variables data analyzed were sociodemographic, lifestyle, anthropometric, blood pressure, blood lipid, blood glucose, and creatinine. Kidney dysfunction was defined according to Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Multivariable logistic regression was used to analyze the dominant associated risk factors. Results The prevalence of KD in DM was 4% (CI 95% 3.1-5.1) and only 0.6% had been diagnosed. Many associated risk factors could affect DM leading to KD such as age, sex, rural, economic status, sugary food/drinks, salty food, coffee, hypertension, hypercholesterolemia, low HDL, high LDL, and hypertriglyceridemia. The dominant associated risk factors were age, sex, economic status, sugary food/drinks, and low HDL. Conclusion The prevalence of KD in DM among productive age Indonesian was 4% and only 0.6% had been diagnosed. Early detection of identification of KD in DM is needed in order to slow progression and complications. The dominant associated risk factors of KD in DM were age, sex, economic status, sugary food/drinks, and low HDL. Controlling of risk factors in DM should be done in order to prevent diabetic kidney disease.
Collapse
Affiliation(s)
- Laurentia Mihardja
- 1National Institute of Health Research and Development, Ministry of Health, Percetakan Negara no 29, Jakarta, Indonesia
| | - Delima Delima
- 1National Institute of Health Research and Development, Ministry of Health, Percetakan Negara no 29, Jakarta, Indonesia
| | - Roy G A Massie
- 1National Institute of Health Research and Development, Ministry of Health, Percetakan Negara no 29, Jakarta, Indonesia
| | - Muhammad Karyana
- 1National Institute of Health Research and Development, Ministry of Health, Percetakan Negara no 29, Jakarta, Indonesia
| | - Pringgodigdo Nugroho
- 2Department of Internal Medicine, Medical Faculty, University of Indonesia, Jakarta, Indonesia
| | - Em Yunir
- 2Department of Internal Medicine, Medical Faculty, University of Indonesia, Jakarta, Indonesia
| |
Collapse
|
24
|
Kodgirwar PS, Jajoo SU, Jajoo UN, Taksande BA, Gupta SS. Nonalbuminuric chronic kidney disease: A dominant presentation in noncommunicable disease population of rural central India. J Family Med Prim Care 2018; 7:442-446. [PMID: 30090791 PMCID: PMC6060909 DOI: 10.4103/jfmpc.jfmpc_87_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background: India has largest number of people with diabetes mellitus (DM), and hypertension (HTN) is expected to double in next 25 years, which are common causes of chronic kidney disease (CKD). The focus for prevention of end-stage renal disease has shifted to detection of the iceberg of DM and HTN and its adequate control. Prevalence studies of CKD in India rural community are lacking. Methodology: We did community-based cross-sectional study with 3 monthly diagnostic camps in adults ≥20 years (n = 6278), from 13 villages for early detection of CKD in rural population around Sevagram in a group of noncommunicable disease (NCD) with DM, HTN, ischemic heart diseases (IHD), and stroke in year 2015–2016. Results: Study achieved 87% (5440/6278) coverage for albuminuria screening. Prevalence of CKD in NCD population was 19.6% (220/1121) where 86% (181/220) were nonalbuminuric CKD. Prevalence of persistent albuminuria in the study population was 0.8% (45/5440); in NCD population (DM, HTN, IHD, and stroke), it was 2.8% (31/1121). Prevalence of CKD was 19% in HTN and 18.9% in diabetes. The prevalence of nonalbuminuric versus albuminuric CKD was 17.1% versus 1.9% (9 times) in hypertensive individuals and 11.3% versus 7.5% (1.5 times) in individuals with DM. Conclusion: Predominance of nonalbuminuric CKD in NCD participants raises suspicion of CKD with undetermined risk factors. Further studies are needed to find the prevalence of nonalbuminuric CKD in overall population and to find out if exposure of pesticides, chemical fertilizers over long duration play an important role in agrarian rural community.
Collapse
Affiliation(s)
| | - Sumedh Ulhas Jajoo
- Department of Medicine, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India
| | - Ulhas Narayan Jajoo
- Department of Medicine, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India
| | - Bharti Amar Taksande
- Department of Medicine, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India
| | - Subodh S Gupta
- Department of Community Medicine, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India
| |
Collapse
|
25
|
Khalil AA, Abed MA, Ahmad M, Mansour AH. Under-diagnosed chronic kidney disease in Jordanian adults: prevalence and correlates. J Ren Care 2017; 44:12-18. [PMID: 28884500 DOI: 10.1111/jorc.12214] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Jordan has no relevant database or registry by which chronic kidney disease (CKD) would be early identified. The purpose of the present study is to uncover the prevalence of CKD in a national sample of Jordanian patients at high risk and examine the association of CKD with demographic and clinical factors. METHODS This is a cross-sectional, correlational study that involved 540 outpatients at high risk for CKD. Demographic and clinical data were obtained in the period from September 2013 to March 2014. Prevalence of CKD was defined based on the National Kidney Foundation Kidney Disease Outcomes Quality Initiative Classification of CKD using estimated glomerular filtration rate. Associations of CKD and demographic and clinical factors were examined using bivariate analysis. RESULTS The majority of the sample were females (64%), their mean age (±SD) was 55.0 ± 12.5 years, their mean eGFR (±SD) was 116.0 ± 47.5. One third of patients had eGFR of 23.5%, 5.4%, 0.7% and 0.7% which corresponds with mild, moderate, severe and very severe reduction in eGFR, respectively. Ageing, being male, unemployment, packs/years of smoking, co-morbidities [hypertension (HTN), diabetes mellitus (DM) and cardiovascular disease] and low high density lipoprotein (HDL) correlated positively with development of CKD. CONCLUSION This study demonstrates a high rate of under-diagnosed CKD among Jordanians. Several demographic and clinical factors are linked with the development of CKD. Policymakers and healthcare providers need to establish an evidence-based practice project to prevent and screen for CKD in Jordan.
Collapse
Affiliation(s)
- Amani A Khalil
- School of Nursing, The University of Jordan, Amman, Jordan
| | - Mona A Abed
- Faculty of Nursing, Hashemite University, Zarqa, Jordan
| | - Muayyad Ahmad
- School of Nursing, The University of Jordan, Amman, Jordan
| | | |
Collapse
|
26
|
Ahlawat R, Tiwari P, D'Cruz S. Direct Cost for Treating Chronic Kidney Disease at an Outpatient Setting of a Tertiary Hospital: Evidence from a Cross-Sectional Study. Value Health Reg Issues 2017. [PMID: 28648314 DOI: 10.1016/j.vhri.2016.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Chronic kidney disease (CKD) has a high morbidity and mortality in developing countries. And this burden is also increasing rapidly in India. Unaffordability due to high cost of medication and hemodialysis remains one of the major barriers in the successful treatment of CKD. OBJECTIVES To determine the direct cost involved in treating CKD at an outpatient department of a public tertiary care hospital. METHODS This cross-sectional study was carried out at a public tertiary care hospital. Patients diagnosed with CKD by a physician were included in the study after obtaining a written informed consent. All the relevant data were collected on a predesigned case record form. RESULTS The results are based on data obtained from 150 patients. The average age of the patients was 55.7 ± 10.1 years. The average number of drugs per prescription was found to be 6.5 ± 1.7. The annual average costs of treatment for patients on medication only and for patients on hemodialysis plus medication were Rs 25,836 (US $386) and Rs 2,13,144 (US $3181), respectively (Rs = Indian rupee). Treatment cost was found to be statistically significantly higher in patients on hemodialysis, treatment support by employer, patients with a smoking habit, patients with comorbidities, and patients with end-stage renal disease. Calcium tablets, vitamin D sachets, iron supplements, torsemide, and amlodipine were the top five medications prescribed. CONCLUSIONS Reimbursement, patient's dialysis status, habits, and comorbidities were found to have a significant effect on the direct cost of treatment.
Collapse
Affiliation(s)
- Rajiv Ahlawat
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER), Mohali, Punjab, India
| | - Pramil Tiwari
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER), Mohali, Punjab, India.
| | - Sanjay D'Cruz
- Department of General Medicine, Government Medical College and Hospital, Chandigarh, India
| |
Collapse
|
27
|
Rao PS, Wright Nunes JA, Gillespie BW, Perlman RL, Ravichandran R. Education and screening for chronic kidney disease in Indian youth: pilot program results. Int J Nephrol Renovasc Dis 2017; 10:85-90. [PMID: 28490898 PMCID: PMC5414574 DOI: 10.2147/ijnrd.s128417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND There is a paucity of information on kidney education and screening programs in Indian youth. METHODS Participants (n=2,158) from Chennai colleges were educated about the kidneys and chronic kidney disease (CKD) and screened in a pilot program from April to May 2013. This entailed: 1) a presentation and educational video and 2) an on-site assessment of weight, blood pressure, and demographic information. Urinalysis (UA) kits were distributed and returned in ≤48 hours. We examined participant characteristics and their association with dipstick proteinuria using logistic regression. RESULTS The mean (standard deviation [SD]) age was 18.9 (1.6) years, and 1,451 (68%) were men. Mean (SD) body mass index (BMI) was 21.9 (4.3) kg/m2; 745 (36%) had a BMI consistent with being overweight or obese. Mean (SD) systolic blood pressure (SBP) was 118.7 (13.1) mm Hg, and 94 (5%) of the participants had SBP ≥140. Mean (SD) diastolic blood pressure (DBP) was 70.9 (11.4) mm Hg, with 119 participants (6%) having ≥90 mm Hg. A total of 136 participants had glycosuria (UA≥1+) and 120 (6%) had proteinuria (UA≥1+). In unadjusted analyses, sex (odds ratio [OR]=1.64 [confidence interval, CI 1.06-2.55]; p=0.026 men vs. women) and age (OR=1.13 per year [CI 1.01-1.26]; p=0.032) were significantly associated with proteinuria. In the analysis adjusted for age, sex, SBP, DBP, glycosuria, and BMI, age remained independently associated with higher odds for proteinuria (OR=1.14 per year [1.02-1.29]; p=0.026). Males showed a trend of higher risk compared with women (OR=1.57 [CI 1.00-2.50]; p=0.051). CONCLUSION This education and screening pilot program in a population of college students offers unique opportunities for identification, education, and early intervention for CKD.
Collapse
Affiliation(s)
- Panduranga S Rao
- Division of Nephrology, Department of Internal Medicine, University of Michigan Health System
| | - Julie A Wright Nunes
- Division of Nephrology, Department of Internal Medicine, University of Michigan Health System
| | - Brenda W Gillespie
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Rachel L Perlman
- Division of Nephrology, Department of Internal Medicine, University of Michigan Health System
| | - Rajan Ravichandran
- Department of Nephrology, Madras Institute of Nephrology, Madras Institute of Orthopedics and Trauma Hospitals, Chennai, India
| |
Collapse
|
28
|
Pandey RK, Arya TVS, Kumar A, Yadav A. Effects of 6 months yoga program on renal functions and quality of life in patients suffering from chronic kidney disease. Int J Yoga 2017; 10:3-8. [PMID: 28149061 PMCID: PMC5225742 DOI: 10.4103/0973-6131.186158] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Aim: To study the effect of 6 months yoga program in patients suffering from chronic kidney disease (CKD). Materials and Methods: Fifty-four patients with CKD were studied and divided into two groups (yoga group and control group) to see the effect of yoga in CKD. Patients in the yoga group were offered yoga therapy along with other conventional treatment modalities, while the control group was only on conventional treatment. Subjects in yoga group were trained to perform specific yogic asanas for at least 5 days a week for 40–60 min a day. Regular monitoring of blood pressure, renal function, requirement of a number of dialysis, and quality of life (QOL) indicators were done. Fifty patients (yoga – 25; control-25) completed 6 months follow-up. Results: In yoga group, a significant reduction of systolic and diastolic blood pressure, significant reduction in blood urea and serum creatinine levels, and significant improvement in physical and psychological domain of the World Health Organization QOL (as assessed by BREF QOL scores) were seen after 6 months. In control group, rise of blood pressure, deterioration of renal function, and QOL were observed. Poststudy comparison between the two groups showed a statistically significant reduction of blood pressure, nonsignificant reduction in blood urea and serum creatinine, and significant improvement in physical and psychological domain of QOL in yoga group as compared to control group. For subjects in yoga group, the need for dialysis was less when compared to control group although this difference was statistically insignificant. Except for inability of some patients to perform certain yogic asanas no adverse effect was found in the study. Conclusion: Six months yoga program is safe and effective as an adjuvant therapy in improving renal functions and QOL of CKD patients.
Collapse
Affiliation(s)
- Rajendra Kumar Pandey
- Department of Internal Medicine, Lala Lajpat Rai Medical College, Meerut, Uttar Pradesh, India
| | - Tung Vir Singh Arya
- Department of Internal Medicine, Lala Lajpat Rai Medical College, Meerut, Uttar Pradesh, India
| | - Amit Kumar
- Department of Internal Medicine, Lala Lajpat Rai Medical College, Meerut, Uttar Pradesh, India
| | - Ashish Yadav
- Department of International Health, Global Disease Epidemiology and Control, John Hopkins Bloomberg School of Public Health, Baltimore, USA
| |
Collapse
|
29
|
Renal dysfunction in primary hyperparathyroidism; effect of Parathyroidectomy: A retrospective Cohort Study. Int J Surg 2016; 36:383-387. [DOI: 10.1016/j.ijsu.2016.11.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 11/02/2016] [Indexed: 01/16/2023]
|
30
|
Anupama YJ, Hegde SN, Uma G, Patil M. Hypertension is an important risk determinant for chronic kidney disease: results from a cross-sectional, observational study from a rural population in South India. J Hum Hypertens 2016; 31:327-332. [PMID: 27882930 DOI: 10.1038/jhh.2016.81] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 09/23/2016] [Accepted: 10/06/2016] [Indexed: 12/19/2022]
Abstract
Hypertension (HTN) is an important cause for chronic kidney disease (CKD). There is a paucity of studies exploring the association of HTN with CKD from rural India. The objective of the study was to determine the prevalence and the determinants for HTN in a rural population in South India, focusing on the association with CKD. In a cross-sectional study on 2984 adults in three villages, demographic and anthropometric data were collected. Blood pressure was recorded on all individuals and prevalence was estimated. Proteinuria, microalbuminuria (MA) and estimated glomerular filtration rate (eGFR) were determined in a subgroup of 1331 subjects and the relation with HTN was analysed. Prevalence of HTN was 30.4% (95% CI 28.75-32.05%). In all, 78.08% had stage 1 HTN while 22% had stage 2 HTN. In total, 27.4% (249/908) subjects were aware of their hypertensive status. Of them, only 14.4% had adequate control of blood pressure. Age>50 years, diabetes, body mass index >25 and eGFR<60 ml min-1 were independent significant predictors of HTN (P<0.05). HTN was found to be an important risk factor for CKD even after adjusting for age, diabetes and cardiovascular risk factors (OR 2.22, 95% CI 1.46-3.36, P<0.001). The high prevalence of HTN, very low level of awareness and control, and the significant association with kidney disease indicate a need for stronger public health initiative with better penetration for awareness and screening for HTN and CKD in India's villages.
Collapse
Affiliation(s)
- Y J Anupama
- Department of Nephrology, Nanjappa Hospital, Shivamogga, Karnataka, India
| | - S N Hegde
- Anushri Medical Center, Shivamogga, Karnataka, India
| | - G Uma
- Department of Nursing, Nanjappa Institute of Nursing Sciences, College of Nursing, Shivamogga, Karnataka, India
| | - M Patil
- Department of Nursing, Nanjappa Institute of Nursing Sciences, College of Nursing, Shivamogga, Karnataka, India
| |
Collapse
|
31
|
Pandya D, Nagrajappa AK, Ravi KS. Assessment and Correlation of Urea and Creatinine Levels in Saliva and Serum of Patients with Chronic Kidney Disease, Diabetes and Hypertension- A Research Study. J Clin Diagn Res 2016; 10:ZC58-ZC62. [PMID: 27891460 DOI: 10.7860/jcdr/2016/20294.8651] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 07/05/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Serum urea and creatinine are most widely accepted parameters to assess Chronic Kidney Disease (CKD)status as well as to assess renal status in susceptible diabetic and hypertensive subjects. AIM To assess and correlate the serum and salivary urea and creatinine levels of CKD, diabetes mellitus and hypertensive subjects. MATERIALS AND METHODS This cross-sectional study was done on 120 subjects involving 30 CKD, 30 diabetic, 30 hypertensive subjects and 30 healthy controls. After collection of saliva and blood samples, urea was analyzed by enzymatic calorimetric method and creatinine by Jaffe's method. Kruskal Wallis test and Mann Whitney U test were used for comparison between different groups and correlations between serum and salivary parameters were evaluated by applying Spearman's correlation test. The p-value <0.05 was considered statistically significant. RESULTS The median serum and salivary urea and creatinine levels were highest in CKD group followed by diabetic, hypertensive groups and controls. The correlation coefficient for serum urea and salivary urea was 0.977 and for serum creatinine and salivary creatinine was 0.976, with p-value <0.001. CONCLUSION This study showed that there is a significant positive relationship between salivary and serum urea and creatinine. Thus, salivary urea and creatinine levels can be used non-invasively to detect serum urea and creatinine levels respectively in renal disease and diabetic and hypertensive nephropathic cases.
Collapse
Affiliation(s)
- Divya Pandya
- Postgraduate Student, Department of Oral Medicine and Radiology, Hitkarini Dental College and Hospital , Jabalpur, Madhya Pradesh, India
| | - Anil Kumar Nagrajappa
- Professor and HOD, Department of Oral Medicine and Radiology, Hitkarini Dental College and Hospital , Jabalpur, Madhya Pradesh, India
| | - K S Ravi
- Assistant Professor, Department of Preventive and Pediatric Dentisty, King Khalid University , Saudi Arabia
| |
Collapse
|
32
|
Hill NR, Fatoba ST, Oke JL, Hirst JA, O’Callaghan CA, Lasserson DS, Hobbs FDR. Global Prevalence of Chronic Kidney Disease - A Systematic Review and Meta-Analysis. PLoS One 2016; 11:e0158765. [PMID: 27383068 PMCID: PMC4934905 DOI: 10.1371/journal.pone.0158765] [Citation(s) in RCA: 2033] [Impact Index Per Article: 254.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 06/21/2016] [Indexed: 12/11/2022] Open
Abstract
Chronic kidney disease (CKD) is a global health burden with a high economic cost to health systems and is an independent risk factor for cardiovascular disease (CVD). All stages of CKD are associated with increased risks of cardiovascular morbidity, premature mortality, and/or decreased quality of life. CKD is usually asymptomatic until later stages and accurate prevalence data are lacking. Thus we sought to determine the prevalence of CKD globally, by stage, geographical location, gender and age. A systematic review and meta-analysis of observational studies estimating CKD prevalence in general populations was conducted through literature searches in 8 databases. We assessed pooled data using a random effects model. Of 5,842 potential articles, 100 studies of diverse quality were included, comprising 6,908,440 patients. Global mean(95%CI) CKD prevalence of 5 stages 13·4%(11·7-15·1%), and stages 3-5 was 10·6%(9·2-12·2%). Weighting by study quality did not affect prevalence estimates. CKD prevalence by stage was Stage-1 (eGFR>90+ACR>30): 3·5% (2·8-4·2%); Stage-2 (eGFR 60-89+ACR>30): 3·9% (2·7-5·3%); Stage-3 (eGFR 30-59): 7·6% (6·4-8·9%); Stage-4 = (eGFR 29-15): 0·4% (0·3-0·5%); and Stage-5 (eGFR<15): 0·1% (0·1-0·1%). CKD has a high global prevalence with a consistent estimated global CKD prevalence of between 11 to 13% with the majority stage 3. Future research should evaluate intervention strategies deliverable at scale to delay the progression of CKD and improve CVD outcomes.
Collapse
Affiliation(s)
- Nathan R. Hill
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Samuel T. Fatoba
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Jason L. Oke
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Jennifer A. Hirst
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | | | - Daniel S. Lasserson
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - F. D. Richard Hobbs
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
33
|
Thawornchaisit P, de Looze F, Reid CM, Seubsman SA, Tran TT, Sleigh A. Health-Risk Factors and the Prevalence of Chronic Kidney Disease: Cross-Sectional Findings from a National Cohort of 87,143 Thai Open University Students. Glob J Health Sci 2015; 7:59-72. [PMID: 26156905 PMCID: PMC4803887 DOI: 10.5539/gjhs.v7n5p59] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Accepted: 12/04/2014] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is becoming a major health challenge worldwide as its aetiology has transferred from predominantly infectious disease to emerging chronic diseases, especially diabetes and hypertension. A rapid health-risk transition driven by economic development is transforming Thailand which is now becoming an ageing country where chronic diseases are a major health burden. METHODS This study used the 2005 baseline cross-sectional dataset of 87,143 Thai Cohort Study members to investigate risk factors associated with CKD. Using multivariate logistic regression, we looked into the relationship between CKD and demographic and socioeconomic factors, personal health status and various health-related behaviours. RESULTS The prevalence of CKD in men was lower than that in women (2.5% vs 2.7%). In both sexes, CKD is associated with ageing, cigarette smoking and drinking alcohol, having diabetes, high lipids and hypertension. In men, CKD was associated with living in rural areas, having a low income, a higher BMI, short sleeping and having Western fast food. In women, marriage is associated with a higher risk of CKD. CONCLUSIONS CKD is strongly associated with ageing, underlying diseases, smoking and drinking. Hypertension, elevated lipids, or diabetes are all risk factors that could be prevented or detected and treated. The Ministry of Public Health should encourage Thai people to consume healthy food, maintain a normal weight, stop smoking and drink alcohol in moderation, all of which will help prevent CKD.
Collapse
Affiliation(s)
| | | | | | | | - Thanh Tam Tran
- National Centre for Epidemiology and Population Health, ANU College of Medicine, Biology and Environment, The Australian National University.
| | | |
Collapse
|
34
|
Bhowmik D, Agrawal A, Panda S. Assessing the prevalence of chronic kidney disease in the community: Estimating glomerular filtration rate is the Achilles heel. Indian J Nephrol 2014; 24:411-2. [PMID: 25484546 PMCID: PMC4244732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- D. Bhowmik
- Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India,Address for correspondence: Dr. D. Bhowmik, Department of Nephrology, All India Institute of Medical Sciences, New Delhi - 110 029, India. E-mail:
| | - A. Agrawal
- Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India
| | - S. Panda
- Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|