Clinical Characteristics of Patients with Ckd Crash Landing and Initiating Dialysis…… Is it Time for Mandatory Screening Programme for Detection of CKD?

• Published in: Journal of the Association of Physicians of India Vol. 70; no. 4; pp. 11 - 12
• Main Authors: Meena, Ravi Kumar, Gupta, Vartul, Malhotra, Vinay, Agrawal, Dhananjay, Beniwal, Pankaj, Sharma, Sanjeev
• Format: Journal Article
• Language: English
• Published: India 01-04-2022
• Subjects: Cross-Sectional Studies; Echocardiography; Female; Humans; Hypertrophy, Left Ventricular - etiology; Male; Mandatory Testing; Renal Dialysis; Renal Insufficiency, Chronic - complications; Renal Insufficiency, Chronic - diagnosis; Renal Insufficiency, Chronic - therapy
• ISSN: 0004-5772

The present study was undertaken to study clinical, biochemical and echocardiographic characteristics of patients with Chronic Kidney Disease crash- landing and initiating hemodialysis at first presentation in our centre.
Ours was a cross-sectional study of one hundred and seventy patients with chronic kidney disease starting hemodialysis. Detailed history and examination were done. Apart from routine biochemical tests and CKD-MBD profile, all patient underwent ultrasonography, urine examination and echocardiography. Efforts were made to delineate etiology in each patient.
Out of 170 patients 64% were males, 36% were females. Mean age at presentation in our study was 41.27 (±16.47) yrs. Chronic glomerulonephritis was the most common etiology accounting for 54% of cases followed by Diabetes (20%). Mean eGFR at presentation was <5 ml/min/1.73 m². Hypocalcemia was present in 87.1%, hyperphosphatemia in 84.2% and elevated PTH levels in 98% with mean PTH levels being 588.07±309.58 ng/ml. LVH on echocardiogram was present in 58.4 % of patient with diastolic dysfunction being reported in 31 % of patients. DCM was present in 28% of patients and 21% of patients had frank left ventricular failure at presentation.
Chronic Kidney Disease patients referred late have clinical and lab characteristics which are worse as compared to routine CKD patients .This calls for a mandatory CKD screening programme for increasing awareness and early identification of CKD patients.