Résumé
Background: Iron deficiency anemia (IDA) is the most common type of anemia. But the incidence of iron deficiency anemia in chronic kidney disease (CKD) has not been well established in Kaveri Delta Region, Tamilnadu, India. Hence, the present study has been undertaken to evaluate the prevalence of iron deficiency anemia in chronic kidney disease patients of Kaveri Delta Region, Tamilnadu, India. Materials and Methods: The present study enrolled 221 chronic kidney disease patients from a private nephrology outpatient clinic, Tiruchirappalli. All biochemical tests were done including serum ferritin. Patients were categorized into two groups based on ferritin levels. Group 1 (N: 87) considered as case and the group 2 (N: 134) patients considered as control. These two groups were compared each other respective with gender and age groups with all parameters. Results: Out of these patients, 87 belonged to iron deficiency anemia patients. Group 1 patients (Total Number of Patients: 87 Male: 29 Female: 58) showing significantly lower serum ferritin levels (15.04±12.48) than group 2 patients (88.98±47.39) (P<0.0001). Within group 1, females had lower ferritin levels (12.98±8.84) than males (17.11±10.78) in the age group of 31-40 years (P <0.0001). Conclusion: The prevalence of iron deficiency anemia among chronic kidney disease in Kaveri Delta Region was found to be 39%.
Résumé
Secondary hyperparathyroidism is common in patients with chronic kidney disease (CKD). Currently, cinacalcet has evidently improved the management of secondary hyperparathyroidism in patients on hemodialysis. Though, to the best of our knowledge, there are no studies addressing the dose regimen of cinacalcet in CKD stage II to IV. Hence we decided to study and evaluate the efficacy of cinacalcet in the treatment of secondary hyperparathyroidism in two different dose schedules. A total of 174 patients (M: 138, F: 36), ages ranging from 23 to 87 years with CKD stage II –IV not on dialysis and intact PTH (iPTH) >150 pg/dl were enrolled in this study. The study population was divided into two groups. Group I: daily 30 mg cinacalcet hydrochloride and Group II: weekly twice 30 mg cinacalcet hydrochloride. Both groups received cinacalcet hydrochloride 30 mg with the main meal. In group I, 42 patients (48 %) stopped the drug within one month due to various side effects. During the follow up, the levels of iPTH decreased significantly in both the groups within a period of four weeks & persisted till the end of the study. No significant side effects requiring stoppage of the drug were noted in the group II study population. In conclusion, cinacalcet hydrochloride 30 mg twice weekly is a safe regimen in suppressing high PTH levels in CKD patients.
Résumé
There is no literature available on the performance of cystatin C in Chronic Kidney Disease [CKD] patients of Indian population based on age group. Hence, this study is aimed to compare the diagnostic performance of serum cystatin C and creatinine with measured glomerular filtration rate [GFR] and estimated GFR [eGFR] in subjects of Indian origin. The study was carried out at Tiruchirappalli, South India during the period of September 2010 to march 2011. One hundred and six CKD patients [82 males, 24 females] were enrolled and categorized into three groups based on age. The eGFR was calculated using Cockcroft-Gault [CG] and Modification of Diet in Renal Disease [MDRD] formulae. Serum cystatin C was measured with a particle-enhanced nephelometric immunoassay [PENIA] method. GFR was measured using 99mTC - diethylene triamine penta aceticacid [DTPA] renal scan method. Serum cystatin C showed significant correlation with measured GFR in all the three groups [r=-0.9735, r=-0.8975 and r=-0.7994 respectively] than serum creatinine [r=-0.7380, r=- 0.6852 and r=-0.5127 respectively]. Serum cystatin C showed a high correlation with measured GFR in young and older patients with CKD than creatinine. Thus, cystatin C is a good alternative marker to creatinine in CKD patients