An Analysis of Demography and Clinical Spectrum of Chronic Kidney Disease: A Tertiary Hospital-based Study

ABSTRACT

Background: Chronic kidney disease (CKD) is a condition characterized by a gradual loss of kidney function over a periodof time. Patients with CKD stages 1–3 (glomerular filtration rate [GFR] >30 mL/min/1.73 m²) are frequently asymptomatic;absence of symptoms associated with a reduction in GFR; without clinically evident disturbances in water or electrolytebalance or endocrine/metabolic derangements. In general, these disturbances become clinically manifest with CKD stages4–5 (GFR < 30 mL/min/1. 73 m²).Aim of the Study The aim of the study was to analyze the symptoms, signs, and laboratory investigations of patients with CKD.Materials and Methods: Atotal of 178 consecutive patients of CKD were included in the study. The presenting clinical symptomsand signs were observed and analyzed. Related laboratory investigations were undertaken and analyzed for the benefit ofidentifying and correlating with the clinical spectrum of the disease.Observations Results: A total of 178 consecutive patients of CKD admitted in five medical units of a tertiary teaching hospital ofNorth Kerala state were included in the study. There were 106/72 males (59.55%) and 29/72 females (40.44%). The male to femalegender ratio was 11.47. Patients belonged to the age group between 18 and 78 years with a mean age of 51.35 ± 2.75 years.87/178 (48.87%) patients belonged to the age group of 39–58 years. Gastrointestinal tract related symptoms such as anorexiawere seen in 76/178 (42.69%), nausea in 52/178 (29.21%), and vomiting in 57/178 (32.02%) patients. Pallor due to anemia wasobserved in 91/178 (51.12%) patients and hypertension (HTN) (blood pressure >140/90 mmHg) was present in 54/178 (30.33%)patients. Edema was observed in 65/178 (36.51%) patients, left ventricular hypertrophy in 45/72 (25.28%) patients.Conclusions: Glomerulonephritis, HTN, and diabetes mellitus were the most common risk factors in causing CKD. The mostcommon clinical presentations were anemia, fatigue, anorexia, nausea, vomiting, dyspnea, hiccups, itching, HTN, and edema.As the clinical spectrum of CKD is diverse, further studies are needed to recognize the various presentations of this disease atan early stage in the local population. Early diagnosis and management of these conditions may prevent or delay the progressto end-stage renal disease.