Clinical Characteristics of Patients with Ckd Crash Landing and Initiating Dialysis…… Is it Time for Mandatory Screening Programme for Detection of CKD?

UNLABELLED: The present study was undertaken to study clinical, biochemical and echocardiographic characteristics of patients with Chronic Kidney Disease crash- landing and initiating hemodialysis at first presentation in our centre.

MATERIAL: Ours was a cross-sectional study of one hundred and seventy patients with chronic kidney disease starting hemodialysis. Detailed history and examination were done. Apart from routine biochemical tests and CKD-MBD profile, all patient underwent ultrasonography, urine examination and echocardiography. Efforts were made to delineate etiology in each patient.

OBSERVATION: Out of 170 patients 64% were males, 36% were females. Mean age at presentation in our study was 41.27 (±16.47) yrs. Chronic glomerulonephritis was the most common etiology accounting for 54% of cases followed by Diabetes (20%). Mean eGFR at presentation was <5 ml/min/1.73 m². Hypocalcemia was present in 87.1%, hyperphosphatemia in 84.2% and elevated PTH levels in 98% with mean PTH levels being 588.07±309.58 ng/ml. LVH on echocardiogram was present in 58.4 % of patient with diastolic dysfunction being reported in 31 % of patients. DCM was present in 28% of patients and 21% of patients had frank left ventricular failure at presentation.

CONCLUSION: Chronic Kidney Disease patients referred late have clinical and lab characteristics which are worse as compared to routine CKD patients .This calls for a mandatory CKD screening programme for increasing awareness and early identification of CKD patients.