International Journal of Health Research and Medico Legal Practice

Sharma Manjuri ¹, Pegu Gayatri ¹, Barman Anup Kumar ¹, Kakaty Satyakam ¹, Mahanta Pranab Jyoti ¹, Bordoloi Pallavi ¹

Affiliations
1 Dept of Nephrology, Gauhati Medical College & Hospital (GMCH), Guwahati -32, Assam, IN

Abstract

Background: CKD is an important cause of mortality, morbidity and impaired quality of life in children. Data in paediatric population is sparse from this part of the country. A better understanding about the epidemiology and preventable factors can help in better management of these children. Aims: To study the etiology and clinical profile of the children with chronic kidney disease who attended Gauhati Medical College and Hospital, Assam. Materials and methods: The demographic, clinical profile and biochemical data of the children diagnosed with CKD, admitted in our Institute from August 2013-July 2016 were analysed retrospectively. CKD was defined according to NKF-K/DOQI 2002 clinical practice guideline with GFR below 60ml/min/1.73m2 estimated by modified Schwartz formula. Records were reviewed to search for their etiology and clinical profile like height, weight, BMI, presence of anaemia or hypertension. Also outcome where available were recorded. Results: Among 101 children diagnosed as CKD, 65 (64.35%) were boys. The mean age of presentation was 14.87years of age (range 3 yrs to 18yrs). Only 4 children were less than 5 years of age. The mean GFR at presentation was 14.67ml/min/1.73m2.61% of the children were already in CKD stage 5. The causes of CKD included glomerular diseases (35.6 %,), interstitial and obstructive causes (38.61%), miscellaneous (6.9%) and undetermined (18.81%). Among glomerular causes chronic GN (15.84%) was most common, followed by FSGS (8.91%) and IgA nephropathy (4.95%). Reflux nephropathy was seen in 10.89% and obstruction in 9.9%. Most patients were anaemic with mean haemoglobin at time of admission of 6.4gm/dl. By the end of the study period 8 children had undergone transplantation, 22 children were undergoing conservative therapy, and 42 children were lost to follow up. Conclusions: Obstructive and interstitial nephritis comprises a large subgroup of CKD in children from this region. Most of the children carry poor prognosis in view of their late presentation. Majority of the children were unable to undergo any effective therapy and were lost to follow up in view of limited availability and high cost of therapy.

Keywords

Glomerular Diseases, Chronic Interstitial Nephritis.

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Mahanta Pranab Jyoti ¹, Goel Rohit ², Mahanta D. Monmoyuri ³

Affiliations
1 Department of Nephrology, IN
2 Department of Nephrology- 781032, Gauhati Medical College and Hospital, Guwahati, IN
3 Guwahati Medical College, Guwahati, IN

Abstract

Background: The protein/creatinine (P/C) ratio in urine samples has been used in the clinical management of patients with glomerular diseases. The aim of this study is to evaluate the correlation between the Spot urinary Protein/Creatinine ratio and 24 hour urinary protein in patients with glomerular disease.

Methods: It was a single centre, cross sectional study, conducted in Gauhati medical college and Hospital from July 2013 to June 2014. Patients admitted in department of nephrology due to glomerular disease were included for study. The relationship between the urine P/C ratio and the 24-hour protein excretion was assessed with the Pearson's correlation test.

Result: A total 70 patients were enrolled for the study. Among them, 27 were males. The mean age of patients was 35.47 ±10.96 years. The most common glomerular disease was Systemic Lupus Nephritis (SLE, 25 cases). There was a significant correlation between 24 hour urine protein and spot urine protein ratio (P/C) ratio (correlation coefficient = 0.93, P < 0.001).

Conclusion: This cross-sectional analysis corroborates the findings of previous studies, supporting the use of the spot urine protein ratio (P/C) ratio as an accurate test to define critical levels of proteinuria in patients with glomerular diseases.

Keywords

Glomerular Disease, Proteinuria, Spot Urine Protein/Creatinine Ratio.

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