A prospective study on the burden of renal replacement therapy and pattern of comorbidities among chronic kidney disease patients in clinical practice

Abstract

Background: The high rate of renal replacement therapy, respective clinical staging, and pattern of associated specific comorbidities/complications among chronic kidney disease (CKD) patients can influence and predispose them to increase morbidity, mortality, and health-care cost. In addition, there could also be a prolongation in the length of hospital stay and recurrent frequency of hospitalization. Aim: This study was predominantly designed to highlight and create awareness concerning the burden of renal replacement therapy and pattern of associated specific comorbidities/complications among CKD patients in renal practice. Materials and Methods: This was a descriptive, prospective study of 18-month duration that was carried out to review the medical case records of consented adult CKD patients attending a Nigerian Tertiary Kidney Care Hospital from January 2015 to June 2016. Results: This study involved 123 consented adult CKD patients made up of 82 (66.67%) males and 41 (33.33%) females with a mean age of 53.81 ± 16.03 years. Eighty-six (69.9%) of the patients were in CKD Stage 5, 15 (12.2%) were in CKD Stage 4, 19 (15.5%) were in CKD Stage 3, 2 (1.6%) in CKD Stage 2, and the remaining one (0.8%) in CKD Stage 1. Regarding the form of nephrological interventions offered, majority of the respondents, i.e. 66 (53.66%) were on maintenance dialysis, followed by 53 (43.09%) on conservative care, while 4 (3.25%) were on renal graft transplant. Among these CKD patients, the prevalence of renal replacement therapy was 56.91%. Most proportion of the respondents 45 (36.59%), were having two number of comorbidities with hypertension 103 (83.70%), diabetes mellitus 39 (31.70%), obesity 24 (19.51%), heart failure 11 (8.90%), obstructive uropathy 8 (6.50%), human immunodeficiency virus (HIV) infection 7 (5.70%), and stroke 5 (4.10%) being the most frequent. Conclusion: The prevalence rates for renal replacement therapy, hypertension, diabetes mellitus, and obesity were significantly high among these CKD patients. In this study, the high rate of renal replacement therapy, respective clinical staging, and pattern of associated specific comorbidities/complications among these CKD patients may significantly increase the risk of morbidity, mortality, recurrent frequency of hospitalization, length of hospital admission, and health-care costs.