DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20161993

To study the clinical profile of chronic kidney disease and associated comorbidities in geriatric patients

Ashvani Pathak, Lalit Jain, Praveen Jaiswal

Abstract


Background: Chronic kidney disease (CKD) has become a major issue in our nation. CKD does not have a specific target, but individuals with diseases such as diabetes mellitus, cardiovascular disease, and obesity are all at increased risk. The chronic kidney disease (CKD) is associated with many features like hyperkalemia, hypocalcemia, hyponatremia, anaemia, hypoalbuminemia, high blood pressure etc. So if we detect all these features early, we can extend the quality life of CKD patients. Aim and objectives of the study were early detection of CKD in elderly people at Initial stage to prevent progression of disease, to study the clinical and biochemical profile and co-morbidities in elderly people with CKD.

Methods: This Hospital based descriptive study was done in the Department Of Medicine, NSCB Medical college, Jabalpur from October 2014 to October 2015 including 100 patients of 60+ years of age.

Results: In present study the etiology of chronic kidney disease was diabetes in 45.0%, hypertension in 38.0%, obstructive uropathy in 8.0% and undetermined etiology was 9.0%. Cardiovascular disease was present in 28% cases, stroke in 22% cases. Most common clinical features was dyspnoea [63.0% (p<0.001)] pedal oedema (31%), high blood pressure [54.0% (p<0.001)], pallor [49.0% (p<0.001)], and pedal oedema (31.0%).The abnormality in the laboratory profile was dyslipidemia  in 73%  hypoalbuminemia  in 31.0% (p<0.05),  albuminuria in 73.0% (p<0.001), hypocalcemia in 54.0% (p<0.001),  hyponatremia  in 23.0%,  hyperkalemia  in 14%, anemia in 60.0% (p<0.05). LVH on echocardiography is present in 34.0% (p<0.05) cases.

Conclusions: The major causes of CKD in descending order were, type 2 diabetes mellitus, hypertension, and obstructive uropathy. All these features needs prompt detection and correction at earlier stages of CKD to delay progression and reduce associated morbidity and exacerbating factors and to prevent early mortality.

 


Keywords


CKD, Geriatric patients

Full Text:

PDF

References


Chakrabarti S, Sarkar A. Pattern and Trend of Population Ageing in India, The Indian Journal of Spatial Science. 2011;2(2):1-11.

Juan F. Macias Nunez, Oreopoulos DG. The Aging Kidney in Health and Disease; Springer International Edition. 2008;65.

United Nations, The sex and age distribution of population. 1990.

Mani M.K Prevention of chronic renal failure at the community level. Kidney International. 2003;63:586-9.

Agarwal SK, Dash SC, Mohammad I, Sreebhuasn R, Singh R, Pandy RM. Prevalence of chronic renal failure in adults in Delhi, India. Nephrology Dial Transplantation. 2005;21:232-3.

Agarwal SK. Chronic kidney disease and its prevention in India. Kidney International. 2005;68(98):S41-5.

National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002;39:S18.

Prasad R. Murthy K. Clinical and biochemical spectrum of chronic kidney disease in tertiary care center”- journal of evolution of medical and dental science. 2012;1(6)1214-22.

Dash SC, Agarwal SK. Incidence of chronic kidney disease in India. Neprhol dial transplant 2006;21:232-3.

Lysaght MJ. Maintenance dialysis population dynamics: Current trends and long-term implications. J Am Soc Nephrol. 2002;13:S37-40.

Xue JL, Ma JZ, Louis TA, Collins AJ. Forecast of the number of patients with the end stage renal disease in United States. Am J Kidney Dis. 2001;12:2753-8.

McGonigle RJ, Wallin JD, Shadduck RK, Fisher JW. Erythropoietin deficiency and inhibition of erythropoiesis in renal insufficiency Kidney. Int. 1984;25:437-44.

Einhorn LM, Zhan M, Hsu VD, Walker LD, Moen MF, Seliger SL, et al. The frequency of hyperkalemia and its significance in chronic kidney disease. Arch Intern Med. 2009;169(12):1156-62.

Waikar SS, Mount DB, Curhan GC. Mortality after Hospitalization with Mild, Moderate, and Severe Hyponatremia Am J Med. 2009;122(9):857-65.

Coen G, Manni M, Addari O, Ballanti P, Pasquali M, Bonucci E. Metabolic acidosis and osteodystrophic bone disease in predialysis chronic renal failure. Miner Eectrolyte Metabo. 1995;21:375-82.

Kopple JD, Greene T, Chumlea WC, Hollinger D, Manoni BJ, Merill D, et al. Relationship between nutritional status and the albumin levels: results from MDRD study. Kidney Int. 2000;57:1688-703.

Yano Y, Fujimoto S, Sato Y, Konta T, Iseki K, Moriyama T, et at. Association between prehypertension and chronic kidney disease in, the Japanese general population. Kidney Int. 2012;81(3):293-9.

Attman PO, Alaupovic P, Tavella M, Knight-Gibson C. Abnormal lipid and apolipoprotein composition of major lipoprotien density clases in patients with chronic renal failue. Nephrol dial transplant. 1996;11:63-9.

Kawagishi T, Nishizawa Y, Konishi T, Kawasaki K, Emoto M, Shoji T, et al. High resolution B-mode ultrasonography in evaluation of atherosclerosis in uremia. Kidney Int. 1995;48:820-6.

Preston E, Ellis MR, Kulinskaya E, Davies AH, Brown EA. Association between carotid artery intima-media thickness and cardiovascular risk factors in CKD. Am J Kidney Dis. 2005;46:856-62.