scholarly journals Prevalence of Chronic Kidney Disease and Its Determinants in Rural Pondicherry, India-A Community Based Cross-Sectional Study

2019 ◽  
Vol 12 (1) ◽  
pp. 14-22 ◽  
Author(s):  
Ravi Kumar P ◽  
Amol Dongre ◽  
R. Muruganandham ◽  
Pradeep Deshmukh ◽  
D. Rajagovindan

Introduction: The burden of CKD is on the rise globally and in India. There are scarce population based studies based in rural industrialized settings in India and elsewhere. Objective: To find out the prevalence and determinants of Chronic Kidney Disease (CKD) among adults in rural Pondicherry, India Methods: It was a community-based cross-sectional study in 13 villages of a Primary Health Centre in rural Pondicherry. A representative sample of 422 adults more than or equal to 50 years of both genders was selected by population proportional to size methods. All the participants were screened by SCORED questionnaire to get the potential cases of CKD. We did serum creatinine, urine examination, blood pressure and anthropometric measurement for the potential cases. CKD was diagnosed by estimation of glomerular filtration rate and presence of protienuria. The data was analyzed using Statistical Package for Social Science version 24. The study was approved by the Institutional Ethics Committee of SMCMCH, Pondicherry. Results: The prevalence of CKD was found to be 24.2% in the study sample of respondents 50 years or more. Most (73.5%) of the CKD cases were at stage 2, Stage 3a had 15% and stage 3b had 2% of the cases. The determinants of CKD were (60-69 years, PR: 2.36,CI:1.36-4.07), poor nutrition(underweight, overweight and obesity)poor nutritional status (underweight:PR: 2.26,CI:1.05-4.89), (overweight:PR: 2.19,CI:1.06-4.52), (obese:PR: 2.13 CI: 1.13-4.01) and presence of at least one chronic co-morbidity(PR:5.85,CI:1.38-24.78). Majority of the patients in the CKD group had minimal proteinuria 87.25%. And 42.15% of the CKD group had no k.w:5 or k.w:6. Conclusion and Recommendation: Considering the higher prevalence of CKD in the study area, targeted screening of adult population should be undertaken as means of early detection, diagnosis, treatment and follow up of at-risk individuals to prevent further progression of CKD. Further research is required to look at the aetiology of CKD.

Biomedicines ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. 19
Author(s):  
Ashani Lecamwasam ◽  
Tiffanie M. Nelson ◽  
Leni Rivera ◽  
Elif I. Ekinci ◽  
Richard Saffery ◽  
...  

(1) Background: Individuals with diabetes and chronic kidney disease display gut dysbiosis when compared to healthy controls. However, it is unknown whether there is a change in dysbiosis across the stages of diabetic chronic kidney disease. We investigated a cross-sectional study of patients with early and late diabetes associated chronic kidney disease to identify possible microbial differences between these two groups and across each of the stages of diabetic chronic kidney disease. (2) Methods: This cross-sectional study recruited 95 adults. DNA extracted from collected stool samples were used for 16S rRNA sequencing to identify the bacterial community in the gut. (3) Results: The phylum Firmicutes was the most abundant and its mean relative abundance was similar in the early and late chronic kidney disease group, 45.99 ± 0.58% and 49.39 ± 0.55%, respectively. The mean relative abundance for family Bacteroidaceae, was also similar in the early and late group, 29.15 ± 2.02% and 29.16 ± 1.70%, respectively. The lower abundance of Prevotellaceae remained similar across both the early 3.87 ± 1.66% and late 3.36 ± 0.98% diabetic chronic kidney disease groups. (4) Conclusions: The data arising from our cohort of individuals with diabetes associated chronic kidney disease show a predominance of phyla Firmicutes and Bacteroidetes. The families Ruminococcaceae and Bacteroidaceae represent the highest abundance, while the beneficial Prevotellaceae family were reduced in abundance. The most interesting observation is that the relative abundance of these gut microbes does not change across the early and late stages of diabetic chronic kidney disease, suggesting that this is an early event in the development of diabetes associated chronic kidney disease. We hypothesise that the dysbiotic microbiome acquired during the early stages of diabetic chronic kidney disease remains relatively stable and is only one of many risk factors that influence progressive kidney dysfunction.


Medicina ◽  
2020 ◽  
Vol 57 (1) ◽  
pp. 15
Author(s):  
Altynay Balmukhanova ◽  
Kairat Kabulbayev ◽  
Harika Alpay ◽  
Assiya Kanatbayeva ◽  
Aigul Balmukhanova

Background and objectives: Chronic kidney disease (CKD) in children is a complex medical and social issue around the world. One of the serious complications is mineral-bone disorder (CKD-MBD) which might determine the prognosis of patients and their quality of life. Fibroblast growth factor 23 (FGF-23) is a phosphaturic hormone which is involved in the pathogenesis of CKD-MBD. The purpose of the study was to determine what comes first in children with CKD: FGF-23 or phosphate. Materials and Methods: This cross-sectional study included 73 children aged 2–18 years with CKD stages 1–5. We measured FGF-23 and other bone markers in blood samples and studied their associations. Results: Early elevations of FGF-23 were identified in children with CKD stage 2 compared with stage 1 (1.6 (1.5–1.8) pmol/L versus 0.65 (0.22–1.08), p = 0.029). There were significant differences between the advanced stages of the disease. FGF-23 correlated with PTH (r = 0.807, p = 0.000) and phosphate (r = 0.473, p = 0.000). Our study revealed that the elevated level of FGF-23 went ahead hyperphosphatemia and elevated PTH. Thus, more than 50% of children with CKD stage 2 had the elevating level of serum FGF-23, and that index became increasing with the disease progression and it achieved 100% at the dialysis stage. The serum phosphate increased more slowly and only 70.6% of children with CKD stage 5 had the increased values. The PTH increase was more dynamic. Conclusions: FGF-23 is an essential biomarker, elevates long before other markers of bone metabolism (phosphate), and might represent a clinical course of disease.


2021 ◽  
Author(s):  
Farzam Tajalli ◽  
Seyed‐Mohamad‐Sadegh Mirahmadi ◽  
Samaneh Mozafarpoor ◽  
Azadeh Goodarzi ◽  
Mitra Nasiri Partovi ◽  
...  

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