International Journal of Health Research and Medico Legal Practice

Sharma Manjuri ¹, K. R. Baruah Swaroop ², Teron Mithu ², Das Himanab Jyoti ³

Affiliations
1 Dept of Nephrology, Gauhati Medical College and Hospital, Guwahati, Assam, IN
2 Gauhati Medical College and Hospital, IN
3 Dept Of Nephrology, Gauhati Medical College and Hospital, IN

Abstract

Background: Lipid abnormalities in chronic kidney disease (CKD) are significant, because atherosclerotic heart disease is the foremost cause of morbidity and mortality in patients with end stage renal disease. The growing recognition that dyslipidemia is a major risk factor for coronary heart disease has prompted interest in the identification and management of abnormalities in plasma lipids and lipoproteins.

Method: It was hospital based observational study conducted from January 2014 to January 2015 in Department of Medicine and Nephrology, Gauhati Medical College, where 50 patients of chronic kidney disease were included and evaluated for dyslipidemia.

Results: Most common presenting symptoms were swelling of legs (80%), followed by anorexia, nausea, vomiting (72%), puffiness of face ( 64%), decrease urine output (60%). 100% patients presented with anemia, 80 % with edema and 76% with hypertension. 24 (48%) patients had normal ECG, 13 (26%) patients had left ventricular hypertrophy ( LVH). 13 patients (26%) had hyperkalemia. Mean total cholesterol (TC) was 189±43.3mg/dl, triglyceride 174±60.7, high density lipoprotein (HDL) 36.51 ±5.1, very low density lipoprotein (VLDL) 34.88±12.15, low density lipoprotein (LDL) 116.49±38.34 and HDL/ TC ratio 0.2002±0.0478.

Conclusion: Dyslipidemias are the important predictive indices for the risk of developing coronary artery disease in chronic kidney disease patients, and so early evaluation and treatment of dyslipidemia may improve the cardiovascular outcome.

Keywords

Chronic Kidney Disease, Dyslipidemia.

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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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