ABSTRACT
Background: Chronic Kidney Disease (CKD) is characterized by irreversible sclerosis and loss of nephrons. The renal mass progressively declines over a prolonged period, depending on the underlying etiology. In CKD the most common feature is hypovitaminosis D which alter the vascular smooth muscle cell proliferation and reprogram the osteoblastic changes, finally leading to increase arterial wall thickness.Methods: A cross sectional study carried out over a 2-year period in Department Nephrology and General Medicine OPD, MIMS, Vizianagaram, Andhra Pradesh, India. 120 in which 60 are normal healthy individuals and 60 are CKD patients with stage 3 to 5. In all the participants serum creatinine, blood urea, serum triglycerides serum total cholesterol, HDL cholesterol estimated and serum 25 OH vitamin D are estimated.Results: The diagnostic criteria for CKD like blood urea, serum creatinine and eGFR were significantly higher in CKD when compared to control. In the present study, systolic and diastolic blood pressure was significantly increased in CKD compared with control. The Carotid Intima Media Thickness (CIMT) both left and right side were significant higher in CKD when compared with control. There is a significantly decreased levels of serum vitamin D in CKD (14.53 ng/mL±6.88) when compared with control (28.87 ng/mL±6.28).Conclusions: Present study finding suggested that there is a raised value of CIMT in CKD patients. High triglycerides, cholesterol and decreased HDL and declined vitamin D low hemoglobin, decreased eGFR, increased systolic blood pressure, raised CIMT value were found to be significantly increased in CKD patients.
ABSTRACT
Objectives:Renal impairment in Patients with chronic liver disease is a common phenomenon and is a functional impairment. It seems difficult for the assessment of renal function abnormalities by normal parameters. We aimed to determine the usefulness of creatinine clearance by timed urine collection and Cockcroft Gault formula and Serum creatinine as parameters in assessing renal function in this cohort of patients and also to find if etiology of chronic liver disease has a bearing on renal dysfunction. Material and methods:Renal parameters of 200 patients with chronic liver disease were studied to assess the reliability of the each parameter. Results: In the present study, Only 22% of alcoholics have clearance more than 60ml/min. 58% patients were found to have creatinine clearance more than 60ml/min by Cockcroft Gault formula while only 36% Patients have that by timed urine collection where the difference was found to be statistically significant (Pvalue<0.01). Cockcroft Gault formula overestimates probably due to disparity in weight due to fluid retention. Conclusion:ThemostreliableParameterin our clinicalsetup isCreatinine clearance by timed urine collection.Presence ofAscites,lowserumalbumin levels andAlcoholic etiologyhadmorepredispositiontorenalimpairment,however, a largerstudywithmorenumber ofpatients canthrowmore ligh