DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20171837

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

Arti Muley, Mitali Rathod, Kunjan Shah, Nikhil Patel, Aakash Patel, Palak Bhuta

Abstract


Background: Chronic kidney disease (CKD) has become a major cause of morbidity and. in some parts of the world CKD incidence has increased regardless of hypertension, diabetes mellitus or metabolic syndrome. This study was done to identify the unknown factors which can be contributing to the increased incidence of CKD.

Methods: It was a case control study. There were 61 cases and 50 controls. A detailed history regarding residence, occupation, addiction, drug intake, family history, diet and environmental factors was taken. The data was analysed to identify a common factor amongst the CKD patients who did not have history of any known risk factors of CKD.

Results: Age of onset of CKD in 48% of cases was <40 years. Much higher percentage of cases gave family history of CKD (10%), history of consumption of NSAIDs (20%) and smoking for >5 years (30%) as compared to controls. Much more cases as compared to controls gave history of mixed diet (46% vs 26%). Much higher proportion of cases had history of heat exposure, excessive heating and sugarcane exposure (72%, 70% and 48% respectively) as compared to controls.

Conclusions: This study supports the association of sugarcane exposure, heat exposure and excessive sweating with CKD and reports a changing trend of renal involvement starting at an earlier age. It highlights need of study with sufficient sample size and greater emphasis on family history, smoking, extent of heat exposure and sugarcane exposure to help identifying area of further research and guide policy making.


Keywords


Case control study, Chronic kidney disease, Heat exposure, Sugarcane exposure

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References


Wijkström J, Leiva R, Elinder CG, Leiva S, Trujillo Z, Trujillo L, et al. Clinical and pathological characterization of Mesoamerican nephropathy: a new kidney disease in Central America. Am J Kidney Dis. 2013;62(5):908-18.

Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2095-128.

Couser WG, Remuzzi G, Mendis S, Tonelli M. The contribution of chronic kidney disease to the global burden of major non-communicable diseases. Kidney Int. 2011;80(12):1258-70.

Jha V, García G, Iseki K, Li Z, Naicker S, Plattner B, et al. Chronic kidney disease: global dimension and perspectives. Lancet. 2013;382(9888):260-72.

Wesseling C, Crowe J, Hogstdet C, Jakobsson K, Lucas R, Wegman DH, et al. Resolving the enigma of the mesoamerican nephropathy: a research workshop summary. Am J Kidney Dis. 2014;63(3):396-404.

Correa-Rotter R, Wesseling C, Johnson RJ. CKD of unknown origin in Central America: the case for a Mesoamerican nephropathy. Am J Kidney Dis. 2014;63(3):506-20.

Jayatilake N, Mendis S, Maheepala P, Mehta FR; CKDu National Research Project Team. Chronic kidney disease of uncertain aetiology: prevalence and causative factors in a developing country. BMC Nephrol. 2013;14:180.

Gooneratne IK, Ranaweera AK, Liyanarachchi NP, Gunawardane N, Lanerolle RD. Epidemiology of chronic kidney disease in a Sri Lankan population. Int J Diabetes Dev Ctries. 2008;28(2):60-4.

Chandrajith R, Nanayakkara S, Itai K, Aturaliya TN, Dissanayake CB, Abeysekera T, et al. Chronic kidney diseases of uncertain etiology (CKDue) in SriLanka:geographic distribution and environmental implications. Environ Geochem Health. 2011;33(3):267-78.

Wanigasuriya KP, Peiris-John RJ, Wickremasinghe R. Chronic kidney disease of unknown aetiology in Sri Lanka: is cadmium a likely cause? BMC Nephrol. 2011;12:32.

Guh JY, Chen HC, Tsai JF, Chuang LY. Herbal therapy is associated with the risk of CKD in adults not using analgesics in Taiwan. Am J Kidney Dis. 2007;49(5):626-33.

Yang L, Su T, Li XM, Wang X, Cai SQ, Meng LQ, et al. Aristolochic acid nephropathy: variation in presentation and prognosis. Nephrol Dial Transplant. 2012;(1):292-8.

Stefanovic V, Cukuranovic R, Miljkovic S, Marinkovic D, Toncheva D. Fifty years of Balkan endemic nephropathy: challenges of study using epidemiological method. Ren Fail. 2009;31(5):409-18.

Davies DF, Shock NW. Age changes in glomerular filtration rate, effective renal plasma flow, and tubular excretory capacity in adult males. J Clin Invest. 1950;29:496-507.

Garg AX, Papaioannou A, Ferko N, Campbell G, Clarke JA, Ray JG: Estimating the prevalence of renal insufficiency in seniors requiring long-term care. Kidney Int 2004;65:649-53.

Hemmelgarn BR, Zhang J, Manns BJ, Tonelli M, Larsen E, Ghali WA, Southern DA, McLaughlin K, Mortis G, Culleton BF: progression of kidney dysfunction in the community-dwelling elderly. Kidney Int 2006;69:2155-61.

Manjunath G, Tighiouart H, Coresh J, Macleod B, Salem DN, Griffith JL, Levey AS, Sarnak MJ: Level of kidney function as a risk factor for cardiovascular outcomes in the elderly. Kidney Int 2003;63:1121-29.

Wasen E, Isoaho R, Mattila K, Vahlberg T, Kivela SL, Irjala K: Estimation of glomerular filtration rate in the elderly: a comparison of creatinine-based formulae with serum cystatin C. J Intern Med. 2004;256:70-78.

McClellan W, Warnock DG, McClure L, Campbell RC, Newsome BB, Howard V, Cushman M, Howard G: Racial differences in the prevalence of chronic kidney disease among participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Cohort Study. J Am Soc Nephrol 2006;17:1710-15.