Author(s): Sawjib Borphukan1, Surajit Gogoi2
The exact prevalence of CKD in India is not known due to lack of regular national registry data and is provided only by small observational studies or personal experiences, and the quality of data is quite uneven. This study was undertaken with a view to throw some light on the present clinical and aetiological profile of CKD in this part of the country. We tried to find out, retrospectively, the possible aetiology and special emphasis on the history of intake of indigenous medicines in this part of the country.
This study is cross-sectional, retrospective and hospital based. The study was conducted at Medicine and Nephrology Departments of Assam Medical College and Hospital, Dibrugarh, Assam for one year starting from 1st September 2014 to 31st August 2015. Patients below 13 years, renal transplant recipients, pregnant women, patients with acute kidney injury (AKI) were excluded from the study. Informed consent was taken from all the patients. The patients were evaluated from detailed history and clinical examination. The history also included enquiry for use of herbal medications. All relevant lab and imaging investigations were recorded.
A total of 105 cases were taken up randomly for the study. The study showed male preponderance M:F ratio 1.6:1. The age of the cases ranged from 15 years to 78 years and the mean age was 47.70±17.58. The most common symptom was easy fatigability, with 93 cases (88.57%) and pallor (91 cases, 86.67%) was the most common clinical finding. Anaemia was found in all the patients. The aetiological incidence in the present study was highest for Diabetic Nephropathy (36.2%) followed by the Idiopathic group (16.8%), Chronic Glomerulonephritis (CGN) (15.2%), Hypertensive Nephropathy (11.4%) and Chronic Interstitial Nephritis (CIN) was found in 8.6%, obstructive uropathy in 4.9% of cases while Lupus Nephritis was found in 3.8% of cases. Polycystic Kidney Disease (PKD) was found in 3 patients (3.1%). 30.5% patients had history of intake of indigenous medicine at some point of time. Category wise, the prevalence of indigenous medications use was highest among the patients with chronic interstitial nephritis (80%).
In the present study, Diabetic nephropathy emerged as the commonest cause of chronic kidney disease (CKD) in this part of India, followed by the Idiopathic group of patients. This is in line with the latest Indian CKD registry data (2012). From this small study of only 105 patients, it is difficult to draw a definite conclusion regarding the aetiological profile. However, a larger longitudinal study will be required to substantiate the above findings. In this study, quite a significant number of patients had history of indigenous or herbal medications.