English

Abstract

BACKGROUND Chronic kidney disease (CKD) is a global health problem which is progressive and asymptomatic until the end stage in recent years which is most common in patients of middle and low socio-economic status. The disease is mostly associated with diabetes or hypertension, young and middle-aged individuals living in agricultural communities and drinking well water. We want to study the clinicopathological profile of chronic kidney disease of unknown aetiology (CKDU) cases admitted in a rural tertiary care hospital. METHODS A retrospective study was conducted among fifty patients who reported with ultrasonography (USG) report showing small shrunken kidneys and / or kidney biopsy suggestive of chronic tubulointerstitial nephritis with absence of immune deposits and admitted in the Medicine department of AVBRH Hospital and JNM College of Medical Sciences, Sawangi (M) Wardha of Central India. RESULTS The mean age was 36.46 ± 10.90 years with majority of the patients between the ages of 35 to 55 years. The body mass index (BMI) of the study group was within 22.52 ± 1.96. CKDU was more commonly seen in males (64 %) as compared to females (36 %). The subjects were predominantly farmers (54 %) who used to drink well water. USG showed small shrunken kidneys in all the study subjects, which was in 100 % cases. Pesticide exposure was seen in 32 % cases. The glomerular filtration rate (GFR) revealed that 30 % of the patients were in grade II. The biochemical report revealed the mean value of haemoglobin to be 8.75 ± 1.39, mean serum urea level to be 64.96 ± 15.19, mean serum creatinine level to be 4.5 ± 2.67, mean serum sodium level to be 132.48 ± 5.83 and mean serum potassium to be 4.43 ± 0.78. The mean random blood sugar (RBS) value was 98.64 ± 19.62, serum calcium level was 8.87 ± 0.43, serum phosphorus level was 5.05±0.39 and urine protein / creatinine ratio was 0.90 ± 0.12. CONCLUSIONS This study highlights the need to review health policies and allocates resources for prevention and treatment of CKDU in Central India, Maharashtra. KEY WORDS Chronic Kidney Disease of Unknown Aetiology (CKDU), Hypertension, Diabetes, Shrunken Kidneys