Published: 2019-10-24

Clinico-biochemical profile of chronic kidney disease patients in elderly age group in a tertiary care centre

Atul V. Rajkondawar, Amit Yele


Background: Chronic kidney disease (CKD) remains one of the major health problems in India. Renal function steadily deteriorates as age advances and advancing age has been indicted to have adverse implications in the disease progression to end stage renal disease (ESRD). With the present study, clinico-biochemical profiling of chronic kidney disease patients in geriatric age group as well as comparison with non-elderly patients was undertaken.

Methods: In this cross-sectional observational study, 100 patients of CKD admitted in the tertiary care study centre were enrolled consecutively and assessed for symptoms, signs and biochemical parameters over two years. Study subjects were divided into two groups:- Group 1: Elderly patients- aged 60 years or more, and Group 2: Non-elderly patients- less than 60 years of age. Relevant comparisons were drawn statistically and tested for significance.

Results: Pallor and pedal edema were observed to be the commonest clinical features across groups. Elderly group shows higher prevalence of severe anaemia (mean hemoglobin- 7.4 gm%). Higher prevalence of clinical and biochemical derangement was found in patients with relatively lower GFR. Elderly age group also had more prevalence of electrolyte abnormalities compared with non-elderly population, with statistically significant difference observed for hyponatremia (p value- 0.023), hypoproteinemia (p value- 0.0078) and blood urea level (p value- 0.0054).

Conclusions: Understanding beforehand the biochemical abnormalities associated with old age in CKD patients helps in appropriate modifications in patient management.


Chronic kidney disease, Clinico-biochemical profile, End stage renal disease, Old age, Glomerular filtration rate

Full Text:



World Health Organization: Preventing Chronic Disease: A Vital Investment. Geneva, WHO. 2005; Sep 28. Available at: https:// www. chp/ chronic_disease_report/ en/. Accessed on 03 October 2019.

Grassmann A, Gioberge S, Moeller S, Brown G. ESRD patients in 2004: global overview of patient numbers, treatment modalities and associated trends. Nephrol Dialys Transplant. 2005;20(12):2587-93.

Hamer RA, El Nahas AM. The burden of chronic kidney disease. BMJ 2006; 332:563–564.

Lutz W, Sanderson W, Scherbov S. The coming acceleration of global population ageing. Nature. 2008;451(7179):716.

Eckardt KU, Berns JS, Rocco MV, Kasiske BL. Definition and classification of CKD: the debate should be about patient prognosis-a position statement from KDOQI and KDIGO. Am J Kidney Dis. 2009;53(6):915-20.

Rajapurkar MM, John GT, Kirpalani AL, Abraham G, Agarwal SK, Almeida AF, et al. What do we know about chronic kidney disease in India: first report of the Indian CKD registry. BMC Nephrol. 2012;13(1):10.

Cockcroft DW, Gault MH. Prediction of Creatinine Clearance from Serum Creatinine. Nephron. 1976;(16):31-41.

School werth AC, Engelgau MM, Rufo KH, Vinicor F, Hostetter TH, Chianchiano D, et al. Chronic Kidney Disease: A Public Health Problem That Needs a Public Health Action Plan. Prevent Chron Dis. 2006;3(2).

Chugh KS, Jha V. Differences in the care of ESRD patients worldwide: required resources and future outlook. Kidney Int Supp.1995;50:7-13.

Modi GK, Jha V. The incidence of end-stage renal disease in India: a population-based study. Kidney Intern. 2006;70(12):2131-3.

Prasad R, HA KM, Surathkal M. Clinical and biochemical spectrum of chronic kidney disease in tertiary care center. J Evol Med Dent Sci. 2012;1:1214-22.

Singh AK, Farag YM, Mittal BV, Subramanian KK, Reddy SR, Acharya VN et al. Epidemiology and risk factors of chronic kidney disease in India-results from the SEEK (Screening and Early Evaluation of Kidney Disease) study. BMC Nephrol. 2013;14(1):114.

Wallia R, Greenberg A, Piraino B, Mitro R, Puschett JB. Serum electrolyte patterns in end-stage renal disease. Am J Kidney Dis. 1986;8(2):98-104.

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

Kraut JA, Kurtz I. Metabolic acidosis of CKD: diagnosis, clinical characteristics, and treatment. Am J Kidney Dis. 2005;45(6):978-93.

Rao AM, Bitla AR, Reddy EP, Sivakumar V, Rao PS. Lipid abnormalities, lipoprotein (a) and apoprotein pattern in non-dialyzed patients with chronic kidney disease. Indian J Clinic Biochem. 2010;25(1):47-50.

Chan CM. Hyperlipidaemia in chronic kidney disease. Ann Acad Med Singapore. 2005;34(1):31-5.

Weiner DE, Tighiouart H, Vlagopoulos PT, Griffith JL, Salem DN, Levey AS et al. Effects of anemia and left ventricular hypertrophy on cardiovascular disease in patients with chronic kidney disease. J Am Soc Nephrol. 2005;16(6): 1803-10.

Islam MN, Ferdous A, Zahid AZ, Alam M, Islam MN. Haematological profile of patients with chronic kidney disease in Northern Bangladesh. Dinajpur Med Col J. 2015;8(1):21-7.

Drüeke TB, Locatelli F, Clyne N, Eckardt KU, Macdougall IC, Tsakiris D et al. Normalization of hemoglobin level in patients with chronic kidney disease and anemia. New Engl J Med. 2006;355(20):2071-84.

Abderraman GM, Hamat I, Tondi ZM, Lemrabott AT, Faye M, Moustapha CM et al. Hyperuricemia in Patients with Chronic Renal Failure in the General Hospital of National Reference of N’Djamena (Chad). Open J Nephrol. 2017;24;7(1).