Introduction:
Chronic kidney disease (CKD) is caused when the estimated glomerular filtration rate (eGFR) is reduced and is associated with progression to end-stage renal disease (ESRD) with increased risks of premature mortality from cardiovascular disease (CVD). CKD is a common non-communicable condition worldwide. Kidney awareness prevention and monitoring society (KAPMS) reported that about 20 million people in Bangladesh have been suffering from some form of chronic kidney disease. Early detection can help reduce further complications of CKD. People with CKD have a higher risk of cardiovascular diseases compared to progression of end-stage kidney disease. To prevent and manage complications treatments are used according to the underlying cause. ESRD treatments can be costly like dialysis and kidney transplantation.
Chronic Kidney Disease (CKD) has been regarded as the 18th cause of global deaths in the year 2010 by Global Burden of Disease Study. Its previous rank was 27th in the year. 1990(1) .This shows the massive spike in CKD deaths over the last 20 years. Thus, making it the 3rd highest cause of years of life lost(1). Developing countries have particularly been suffering more from chronic illness such as this. A lot of countries in Asia and Africa are increasingly facing chronic illnesses which are associated with reduced birth rate and increased life expectancy(2). Countries such as Japan, South Korea, Malaysia and India are amongst the countries experiencing the highest annual occurrences of CKD(3). Bangladesh is not far away in the list of rising prevalence of CKD. If we take a look at the global review of six regions, including Bangladesh we can observe an estimated overall 14% prevalence of CKD (4).And it is an alarming rate of CKD prevalence for any region not to mention the ones in a developing stage. Therefore, it is of utmost importance that we start taking a deeper dive into the scenario of Chronic Kidney Disease in our country. From quite a recent study in Dhaka, conducted among adults aged 30 years and older, which is similar to ours, there have been reports of a 26% prevalence of CKD. While other studies reported a 13% prevalence of CKD amongst the inhabitants of Dhaka aged 15 years and older (5,6) .The eGFR declines with age, due to the various changes related with age in the structures reformation and function of kidney (7).
Staging of kidney mainly indicates how well the kidney can filter out all its waste and extra fluid. Early stages of kidney damage indicate that it can still separate waste from blood but later stages suggest that kidney may malfunction its filtration or may not be able to filter out waste at all. eGFR is a number based on blood test in creatinine by which the staging is done.
Methods:
Sample
A total of 142 patients aged between 20 and 95 years were taken for the study. All the patients of this study were previously diagnosed with AKI.
Statistical Analysis
Statistical analysis was performed with SPSS for Windows 12.01. Basic statistics
and a frequency table was used to explain data. Continuous variables were
compared between groups with unpaired t test. Dichotomized variables were
compared using Pearson 2 test. The null hypothesis was rejected at P >0.05.
Data are presented as mean SD. Univariate correlation was performed by
Spearman correlation analysis. Cox regression was used to test the associated factor
Study design
This is a cross-sectional study that extracted relevant data from the data archive of the North East Medical College, Sylhet, Bangladesh.
Results:
Chronic kidney disease can progress to end-stage kidney failure, which is fatal without artificial filtering (dialysis) or a kidney transplant. The risk factors like Diabetes Mellitus (DM), Hypertension (HTN) and combined diabetes and hypertension were found to be significantly associated with CKD. HTN is by far the most dominant factor behind CKD in Bangladesh even though some papers found DM to be the prime cause for both developing and developed country (8). From our study on a population containing 142 patients tested with CKD in fig1.1 it is seen that about (78%) had shown significant signs of HTN. Which in fact was the main reason behind their CKD. Out of this (78%) of patients, (44%) had both HTN and DM and the rest (34%) had only HTN. Thus making it very clear from the graphs that HTN is the most cause of CKD in Bangladesh. Besides this, we can also see in fig 1.2 that HTN is the predominant factor behind CKD for both sexes. In fig1.3 that for each age group HTN remains the key factor behind their CKD prevalence.
Fig:1.1 - Histogram showing counts of each risk factor or cause of CKD from our sample of 142 patients
Fig:1.2 - Histogram showing the prominence of each risk factor or cause of CKD according to sex
Fig:1.3 - Histogram showing counts of each risk factor or cause of CKD based on age
Older people were found to be more vulnerable to chronic kidney diseases. People belonging to age group between 50 and 70 were more susceptible to kidney injuries. Our studies also show that 69.23% of males displayed signs of progression compared to the 51% of that of the females even though males were more affected by CKD.
Out of our tested 142 patients, (11.3%) required dialysis among which few of them passed away.
Fig:1.4 - Histogram showing outcomes of people with CKD based on age
Fig:1.3 - Histogram showing outcomes of people with CKD based on sex
Conclusions:
This study may help address shortcomings in risk assessment and improve disease recognition. Most people with renal insufficiency/ CKD are not even aware of their conditions and thus are unable to take preventive measures from damaging their kidney. Our study emphasizes the need to take necessary measures to control Diabetes Mellitus and Hypertension at an early age. And to take steps in order to increase the progression rate of Chronic Kidney Disease amongst women by raising awareness.
Finally, our findings point to a need for additional awareness on early life modification for prevention and control of renal insufficiency or CKD.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.