Pharmacoeconomic evaluation of chronic kidney disease patients: a study on cost of illness

2020 ◽  
Vol 8 (2) ◽  
pp. 82-88
Author(s):  
Sarada Sheethal Y ◽  
Ch Esther ◽  
Syed Sabiha Sultana ◽  
Mounika M ◽  
Dileep Kumar T ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Direct Cost ◽  
Kidney Diseases ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Care Hospital ◽  
Important Public Health Problem ◽  
Major Barrier ◽  
Life Style Changes

Chronic kidney diseases (CKD) is an important public health problem due to its high prevalence , morbidity and mortality. It is associated with high expenditure among indian patients. Higher stages of CKD have higher economic burden especially on the lower middle class. Hemodialysis, patients habits like alcohol consumption and smoking, treatment support by employer and patients with co morbid conditions and ESRD was found to effect the direct cost of the treatment.. Although CKD is generally Progressive and irreversible patients are advised regarding nutrition, life style changes and compliance with treatment might slow progression, enabling patients to live longer without complication and need for renal replacement therapy. Major barrier in the successful treatment of CKD is high cost of hemodialysis and medication which is difficult for the patient to afford. The main objective is to analyse the direct cost involved in treating Chronic Kidney disease patients in tertiary care hospital. Reimbursement, patients dialysis , social habits and comorbid conditions were found to have a significant effect on the direct cost of treatment.

Clinico - Radiological and pulmonary function profile of treated pulmonary Tuberculosis patients

2020 ◽  
Vol 6 (2) ◽  
pp. 17-22
Author(s):  
Vishal N Kushare ◽  
Suvarna A Wagh
Keyword(s):  
Pulmonary Tuberculosis ◽  
Socioeconomic Development ◽  
Communicable Disease ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Control Program ◽  
Care Hospital ◽  
Important Public Health Problem ◽  
Major Barrier ◽  
Tuberculosis Patients

Tuberculosis causes most number of deaths due to infections worldwide. Around 9.0 million new cases and 1.5 million deaths registered worldwide of which 360,000 were HIV positive. One fourth of the global TB encumbrance occurs in India, making it the most important public health problem facing this country. It is estimated that out of 9.0 million cases worldwide, 2.3 million cases were reported in India. TB control program of India is on track as far as reduction in the disease burden. There is 42% lessening in humanity since 1990 and 51% lessening in TB pervasiveness as associated to 1990. Further, TB pervasiveness has concentrated from 40 lakhs to 28 lakhs annually from 1990. A total of 9,28,190 smear positive TB cases were diagnosed and 14,10,880 were registered for treatment under RNTCP. It has become a major barrier to our socioeconomic development. Tuberculosis (TB) still remains as the most common communicable disease. It is estimated that 21% of the global TB burden occurs in India. Two in every five Indians are infected with tuberculosis and two persons die every minute because of tuberculosis in India. This study focuses to study the clinico-radiological profile of treated pulmonary tuberculosis patients and to evaluate the risk factors that can influence the treatment outcome in a tertiary care hospital and to evaluate the type of limitation in lung function by spirometry in treated pulmonary tuberculosis patients.

scholarly journals Knowledge, Self-Efficacy, Self-Management Behavior of the Patients With Predialysis Chronic Kidney Disease

2019 ◽  
Vol 42 (2) ◽  
pp. 38-48
Author(s):  
Satchina Moktan ◽  
Sirirat Leelacharas ◽  
Wonnapha Prapaipanich
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Self Efficacy ◽  
Tertiary Care ◽  
Healthcare Providers ◽  
Public Health Problem ◽  
Self Management ◽  
Care Hospital ◽  
Global Public Health ◽  
Management Behavior

Background: Chronic kidney disease (CKD) is an emerging global public health problem. Control of risk factors and prevention of complications can delay the progression to end-stage renal disease. Self-efficacy and self-management behavior in patients with predialysis CKD has not been investigated in Nepal. Objectives: To describe knowledge of CKD, self-efficacy, and self-management behavior in patients with predialysis CKD and to determine the relationships between knowledge in CKD and self-efficacy with self-management behavior. Methods: Ninety-seven predialysis CKD patients visiting nephrology clinic of a tertiary care hospital in Kathmandu, Nepal were recruited from November 2016 to December 2016. Questionnaires comprised of sociodemographic data, CKD knowledge, self-efficacy, and self-management behavior questionnaires were used. Data were analyzed, using descriptive statistics and Pearson product moment correlation coefficient. Results: The mean age of 97 participants was 45.67 years. There were 3 stages of CKD among participants: stage G4 (54.64%), stage G3 (42.27%), and stage G2 (3.09%), respectively. Hypertension was the most common comorbidity (81.44%) followed by diabetes mellitus (30.92%). Predialysis CKD patients had a moderate level of knowledge on CKD and self-efficacy and high level of self-management behavior. There were positive relationships between knowledge in CKD and self-management behavior (r = 0.52; P < .05), and between self-efficacy and self-management behavior (r = 0.39; P < .05). Conclusions: This study suggested that education, counseling, workshop to increase the knowledge, self-efficacy, and self-management behavior might be helpful for the predialysis CKD patients. Healthcare providers can educate, motivate, and train the patients to practice self-management behavior to delay the progression of CKD.

scholarly journals A clinico-epidemiological study of cutaneous changes in chronic kidney disease

2016 ◽  
Vol 2 (4) ◽  
pp. 103
Author(s):  
Chirag Maheshwari ◽  
Ajay Kumar ◽  
Sanjeev Gupta
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Tertiary Care ◽  
Public Health Problem ◽  
North India ◽  
Major Public Health Problem ◽  
Care Hospital ◽  
Urban Background ◽  
Cutaneous Manifestations

<p class="abstract"><strong>Background:</strong> Chronic kidney disease (CKD) has emerged as a major public health problem in South Asia. This is attributable to the increase in prevalence of co-morbidities particularly hypertension and diabetes mellitus. Cutaneous manifestations are observed throughout the course of the disease and serve as markers of the disease and its progression. Early diagnosis and treatment is critical in halting the progression of the disease. The objective was to study the prevalence of co-morbidities as well as cutaneous changes in patients with CKD from a rural or semi-urban background in a tertiary care hospital.</p><p class="abstract"><strong>Methods:</strong> A total of 50 patients with CKD aged 18 years or above detected and managed at a tertiary care teaching hospital in North India were included in the study.<strong></strong></p><p class="abstract"><strong>Results:</strong> The age of the patients ranged from 18 to 78 years. 35 patients (70%) had a rural background while 15 patients (30%) had a semi-urban background. 37 patients (74%) had co-morbidities including hypertension, diabetes mellitus or both. 17 patients (34%) were on conservative management while 33 patients (66%) were undergoing haemodialysis. Skin changes included nephrogenic pruritus in 30 patients (60%), xerosis in 25 patients (50%), cutaneous infections and infestations in 25 patients (50%), pallor in 22 patients (44%), acquired perforating disorders in 6 patients (12%), purpura in 5 patients (10%), hyperpigmentation in 4 patients (8%) and yellow skin in 1 patient (2%). Hair changes were observed in 20 patients (40%), nail changes in 24 patients (48%) and mucosal changes in 20 patients (40%). None of the patients were found to have bullous dermatoses, calcific uraemic arteriolopathy or nephrogenic systemic fibrosis. 4 patients (8%) included in the study initially reported to dermatology OPD with a specific dermatosis and were detected to have CKD.</p><p><strong>Conclusions:</strong> The prevalence of co-morbidities including hypertension and diabetes associated with CKD may be lower in rural and semi-urban populations. Nephrogenic pruritus is the most distressing change which impairs the quality of life in these patients. Cutaneous changes may help in early detection and treatment of CKD. </p>

scholarly journals Evaluation of role of heart rate variability with holter monitoring in chronic kidney disease

2020 ◽  
Vol 8 (6) ◽  
pp. 2188
Author(s):  
Naveen Reddy Avula ◽  
Tusahr Dighe ◽  
Atul Sajgure ◽  
Charan Bale ◽  
Pavan Wakhare
Keyword(s):  
Chronic Kidney Disease ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Kidney Disease ◽  
Kidney Diseases ◽  
Tertiary Care ◽  
Holter Monitoring ◽  
Stage Iii ◽  
Care Hospital ◽  
Ckd Stage

Background: Chronic kidney disease is prevalent disease even in absence of diabetes and hypertension in 12% adults over 65 yrs of age. Autonomic imbalance is not studied in detail which could be a risk factor for chronic kidney disease.Methods: This Study was observational study in a tertiary care Hospital in pune, india and was conducted for a period of 1 year with sample size of 52. All subjects were known cases of chronic kidney disease from stage III to VD. All individuals of age >18yrs and eGFR ≤60ml/min/1.73m2 according to CKD- EPI equation were included in the study and who were not giving consent were excluded. 24 hrs Holter monitoring was done in stages from ckd stages III to V, for ckd stage VD on both Hemodialysis day and Non hemodialysis. Analysis was done using SPSS version 20 (IBM SPSS Statistics Inc., Chicago, Illinois, USA) Windows software program. The paired t test, analysis of variance (ANOVA) and Chi-square test were used. Level of significance was set at p≤0.05.Results: In this study when Heart rate variability (HRV) parameters were compared in different stages of ckd from stage III to VD (on Hemodialysis day) SDNN, SDNN Index were found to be statistically significant and on non Hemodialysis day SDNN Index was found to be statistically significant. In each subgroup of ckd stage V when diabetic subjects were compared with non-diabetic subjects, HRV parameters like ratio of P/S which was found to be low and significant in ckd stage V diabetic subjects.Conclusions: Chronic kidney disease itself can affect the HRV parameters. Causal relationship between HRV and chronic kidney diseases can be vice versa and further needs larger and prospective studies.

scholarly journals Outcome of Urgent Hemodialysis in Chronic Kidney Disease in a Rural Tertiary Care Hospital

KYAMC Journal ◽  
2013 ◽  
Vol 3 (2) ◽  
pp. 277-281
Author(s):  
Sheik Salahuddin Ahmed ◽  
Md. Zulfikar Ali ◽  
Tarafdar Runa Laila ◽  
Moniruzzaman
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Failure ◽  
Kidney Disease ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Public Health Problem ◽  
Care Hospital ◽  
Dialysis Unit ◽  
End Stage Renal Failure ◽  
End Stage

Chronic kidney disease is a worldwide public health problem with an increasing incidence and prevalence. Outcomes of chronic kidney disease include not only complications of decreased kidney function and cardiovascular disease but also end stage renal failure causing increased morbidity and mortality. The development of acute but serious uremic complications in advanced kidney disease may put the patient's life at risk requiring immediate dialysis. The objective of this study was to find out the outcomes of urgent hemodialysis in advanced kidney disease, the minimum number of hemodialysis required for satisfactory clinical improvement, and to detect uremic emergencies associated with those patients. Twenty two patients with end stage renal failure admitted in a rural tertiary care private hospital of Bangladesh for emergency and short term dialysis were included in this study. For each patient hemodialysis was done at one day interval three times in a week in a dialysis unit. Results show that two sessions of hemodialysis produced 72 % and three sessions, almost 100% clinical recovery at satisfactory level. Urgent hemodialysis was found to be life saving in observed uremic emergencies like acute pulmonary edema, cerebral encephalopathy, metabolic acidosis, hyperkalemia, gross fluid overload and pericardial effusion. Dialysis therapy ameliorates many of the clinical manifestations of renal failure and postpones otherwise imminent death and for these logical reasons it is recommended that dialysis should not be delayed in uremic emergencies for the best interest of clinical outcomes. KYAMC Journal Vol. 3, No.-2, January 2013, Page 277-281 DOI: http://dx.doi.org/10.3329/kyamcj.v3i2.15167

Correlation of Iron Profile with Different Stages of Chronic Kidney Disease in Children Presenting at a Tertiary Care Hospital

2021 ◽  
Vol 15 (8) ◽  
pp. 2013-2016
Author(s):  
Shahid Ishaq ◽  
Muhammad Imran ◽  
Hashim Raza ◽  
Khuram Rashid ◽  
Muhammad Imran Ashraf ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Iron Overload ◽  
Serum Ferritin ◽  
Serum Iron ◽  
Tertiary Care ◽  
Transferrin Saturation ◽  
Maintenance Hemodialysis ◽  
Care Hospital ◽  
Iron Profile

Aim: To determine correlation of iron profile in children with different stages of chronic kidney disease (CKD) presenting to tertiary care hospital. Methodology: A total of 81 children with chronic kidney disease stage having glomerular filtration rate (GFR) less than 90 (ml/min/m2) aged 1 – 14 years of either sex were included. Three ml serum sample was taken in vial by hospital duty doctor for serum ferritin level, serum iron, transferrin saturation and total iron binding capacity. The sample was sent to hospital laboratory for reporting. Iron profiling was done evaluating hemoglobin (g/dl), serum iron (ug/dl), serum ferritin (ng/ml), transferrin saturation (%) and total iron binding capacity (ug/dl) while iron load was defined as serum ferritin levels above 300 ng/ml. Correlation of iron profile with different stages of CKD was determined applying one-way analysis of variance (ANOVA). Results: In a total 81 children, 46 (56.8%) were boys while overall mean age was 7.79±2.30 years. Mean duration on hemodialysis was 11.52 ± 9.97 months. Iron overload was observed in 26 (32.1%) children. Significant association of age above 7 years (p=0.031) and residential status as rural (p=0.017) was noted with iron overload whereas iron overload was increasing with increase in stages of CKD (p=0.002). Hemoglobin levels decreased significantly with increase in stages of CKD (p<0.001). Serum iron levels increased significantly with increase in the CKD stages (p=0.039). Serum ferritin levels were increasing significantly with the increase in CKD stages (p=0.031). Transferrin saturation also increased significant with increase in CKD stages (p=0.027). Conclusion: High frequency of iron overload was noted in children with CKD on maintenance hemodialysis and there was linear relationship with stages of CKD and iron overload. Significant correlation of hemoglobin, serum iron, serum ferritin and transferrin saturation was observed with different stages of CKD. Keywords: Iron overload, maintenance hemodialysis, ferritin level.

scholarly journals A study of secondary hyperparathyroidism in patients with chronic kidney disease in a tertiary care hospital

2019 ◽  
Vol 6 (2) ◽  
pp. 271
Author(s):  
Vishnu Shankar H. ◽  
Mahendra Kumar K. ◽  
Jagadeesan M. ◽  
Kannan R. ◽  
Chitrambalam P. ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Secondary Hyperparathyroidism ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Study Population ◽  
Chronic Morbidity ◽  
Spss Software

Background: Secondary hyperparathyroidism (SHPT) is one of the less recognized complications in patients with chronic kidney disease (CKD). The prevalence of SHPT in various stages of CKD was evaluated by measuring the levels of intact parathyroid hormone (iPTH).Methods: This cross-sectional study was carried out in 100 CKD patients. Serum creatinine, calcium, phosphorous and iPTH levels were measured and statistical analysis was carried out using the SPSS software (IBM, NY, USA).Results: Among the 100 participants, the mean age (SD) was 59.3 (7.8) years. In our study population, 52% were men and the rest were females. Hypertension (75%) was the most common chronic morbidity. Prevalence of hyperparathyroidism among chronic kidney disease patients was 22% (95% CI: 14.7-30.9%). The prevalence of secondary hyperparathyroidism among dialysis and non-dialysis patients were 30% and 14% respectively which was statistically significant.Conclusions: SHPT is an important complication which is often underdiagnosed. Secondary hyperparathyroidism starts to develop when eGFR falls below 60ml/min. PTH levels starts to rise as the disease progress. Hence it is important for the treating physicians to monitor the PTH levels early in the course of CKD to prevent and treat bone mineral disease.

scholarly journals HEMATOLOGICAL PROFILE IN PATIENTS OF CHRONIC KIDNEY DISEASE WITH ITS SEVERITY IN A TERTIARY CARE HOSPITAL, NORTH ODISHA

2020 ◽  
pp. 182-187
Author(s):  
BIBHU PRASAD BEHERA
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Hematological Parameters ◽  
Tertiary Care ◽  
Microcytic Anemia ◽  
Treatment Modalities ◽  
Unknown Etiology ◽  
Care Hospital ◽  
College Hospital ◽  
Correct Treatment

Objective: Efforts can be made to normalize the hematological parameters and slow the progress of the disease so that the morbidity and mortality in these patients with chronic kidney disease could be effectively reduced. Methods: The observational study was carried out in the Department of General Medicine, Pandit Raghunath Murmu Medical College Hospital, Baripada, between May 2018 and January 2019. Two hundred seventy patients of chronic kidney disease (CKD) above 15 years of age, satisfying the inclusion and exclusion criteria, were included in the study. Results: In our study, 179 (66.30%) were male, and 91 (33.70%) were female with M:F of 1.97:1. The average age of the patients in the study was 55.72±12.77 years. About 42.59 % (115) of the patients were between 46 and 60 years of age. About 35.56% of CKD cases had determined etiology and, 64.44% of cases had unknown etiology. Hemoglobin, RBC, and packed cell volume were significantly lower in the patients with CKD compared to the controls (p=0.0001), and RDW was considerably higher in the patients with CKD compared to the controls (p=0.0001). Microcytic anemia was the most prevalent type of anemia. There was a hugely significant association between the prevalence of thrombocytopenia and the severity of CKD (p=0.006). Conclusion: This study concluded that patients with CKD show abnormal hematological parameters. Evaluation of hematological parameters in these patients helps in classifying the type of anemia, aids in choosing the correct treatment modalities, and decreases mortality.

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