DEMOGRAPHICS AND CLINICAL PROFILE OF HEMODIALYSIS PATIENTS ATTENDING TERTIARY CARE HOSPITAL IN SOUTH INDIA

Chronic kidney disease (CKD) has emerged as one of the most prominent causes of death and suffering in the 21st century. Due in part to the rise in risk factors, such as obesity and diabetes mellitus, the number of patients affected by CKD has also been increasing, affecting an estimated 843.6 million individuals worldwide in 2017. A systematic review and meta-analysis done in 2021 reported the CKD prevalence between 12% to 21% in different regions of India.

Chronic kidney disease is defined as abnormalities of kidney structure or function, present for a minimum of 3 months, with implications for health. CKD is classified based on cause, glomerular filtration rate (GFR) category (G1-G5) and Albuminuria category (A1-A3), abbreviated as CGA.

Criteria for CKD (present for > 3 months) are markers of kidney damage (albuminuria > 30mg/g, urine sediment abnormalities, persistent hematuria, electrolyte and other abnormalities, histological abnormalities, structural abnormalities on imaging or history of kidney transplant) and GFR < 60ml/min/1.73 m2.                              

Common risk factors for development of CKD include Diabetes mellitus and Hypertension while contributing factors include heart disease, obesity, advanced age, family history of diabetes, recurrent urinary tract infections, renal stone disease, autoimmune diseases and others (genetic, indigenous medication use).

This record-based descriptive study included 120 patients who had been on regular hemodialysis for at least three months at Princess Esra Hospital, Hyderabad. After obtaining consent, relevant demographic details, comorbid conditions, and laboratory values were collected from hospital records. Parameters such as age, sex, body mass index (BMI), and associated conditions like diabetes, hypertension, coronary artery disease, and cerebrovascular accidents were recorded. Laboratory investigations included serum urea, creatinine, sodium, potassium, calcium, hemoglobin, and albumin. Data were entered into Microsoft Excel and analyzed using SPSS version 20 to generate descriptive statistics, including mean, standard deviation, and frequency distribution.

Among the 120 patients, 63 (52.1%) were males and 57 (47.1%) were females. The majority of the patients were between 41 and 60 years of age (51.2%), followed by those aged 21–40 years (28.9%), indicating that CKD predominantly affected middle-aged adults. Most of the study participants had a normal BMI (52.9%), while 26.4% were overweight, 7.4% obese, and 12.4% underweight. Hypertension was the most prevalent comorbidity (93.4%), followed by diabetes mellitus (39.7%), coronary artery disease (28.9%), and cerebrovascular accidents (9.1%). Hypothyroidism was observed in 9.9% of patients, whereas renal calculi, COPD, and ADPKD each accounted for less than 1%.

Biochemical evaluation showed markedly elevated mean serum urea (111.75 ± 38.84 mg/dL) and creatinine (7.86 ± 2.63 mg/dL), confirming advanced renal impairment. Electrolyte values were largely within normal ranges—sodium (139.35 ± 3.69 mmol/L) and potassium (4.46 ± 0.51 mmol/L)—reflecting adequate dialysis maintenance. Serum calcium levels were marginally lower (8.35 ± 0.49 mg/dL), while hemoglobin levels (9.9 ± 1.69 g/dL) indicated a high prevalence of anemia. The mean serum albumin level (3.37 ± 0.59 g/dL) was mildly decreased, suggestive of nutritional deficiency and chronic inflammation. When analyzed by etiology, patients with hypertension and diabetes had the highest biochemical derangements, particularly higher urea and creatinine levels with lower hemoglobin and albumin concentrations. These findings underline the systemic nature of metabolic changes in CKD, irrespective of the underlying cause.

The present study highlights that chronic kidney disease predominantly affects middle-aged men, with hypertension and diabetes being the principal causes leading to end-stage renal disease. The biochemical findings consistently revealed marked azotemia, anemia, and hypoalbuminemia, which are characteristic features of advanced CKD. Maintenance of near-normal sodium and potassium levels reflects effective dialysis and fluid balance. The results emphasize the urgent need for early detection of hypertension and diabetes, strict control of blood pressure and glycemia, and attention to nutritional support to delay CKD progression. Comprehensive management, including correction of anemia and monitoring of calcium and albumin levels, remains essential to improve the overall survival and quality of life in these patients.