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三级护理教学医院中病因不明的慢性肾脏病

Chronic Kidney Disease of Unknown Etiology in a Tertiary Care Teaching Hospital.

作者信息

Mughni Mohammed A, Mateen Mohammed A, Asifuddin Mohammed, Khan Khaja K, Khan Ariyan, Khan Maria, Prajjwal Priyadarshi, Ranjan Raunak

机构信息

Internal Medicine, Shadan Institute of Medical Sciences, Teaching Hospital and Research Center, Hyderabad, IND.

Internal Medicine, Deccan College of Medical Sciences and Research Center, Hyderabad, IND.

出版信息

Cureus. 2023 Feb 25;15(2):e35446. doi: 10.7759/cureus.35446. eCollection 2023 Feb.

Abstract

Background Several primary studies have looked at the burden of chronic kidney disease among diabetic patients, but their results have shown significant variance in India. In order to determine the combined prevalence of chronic kidney disease and associated risk factors among patients with diabetes, this study used a combination of methods. Methods Over the course of two years, a cross-sectional observational study was undertaken in the Tertiary Care Teaching Hospital's Department of General Medicine including all chronic kidney disease patients of 18 years of age and above of either gender. People not suffering from the disease were chosen as controls. Kidney Injury Molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin-ELISA (NGAL-ELISA) sample analysis by the kit method was done. The study was carried out in accordance with Schedule Y, ICH GCP principles, and the Helsinki Declaration after receiving approval from the institutional ethics committee. Results In our study, the urinary mean KIM-1 was 49.75±4.35 μg/g Cr in the Chronic Kidney Disease of Unknown etiology (CKDu) group and 1.43±0.15 μg/g Cr in the controls group. The mean NGAL levels of the CKDu Group and the controls group were 8.94±1.31 μg/g and 0.41±0.05 μg/g, respectively. In CKDu and the controls group, the mean eGFR (ml/min/1.73m) was 69.83±7.91 and 108±3.7, respectively. The mean serum creatinine (mg/dL) was reported 3.79 in the CKDu group and 1.0 in the controls group. Conclusion Despite the urban centers previously being thought of as a non-endemic location, for the first time in the city, 60 CKDu patients are reported in this study. This is the first study to use the urinary biomarkers KIM-1 and NGAL to find suspected cases of CKDu and early kidney damage in local communities in the urban centers.

摘要

背景 多项初步研究关注了糖尿病患者中的慢性肾脏病负担,但在印度,其研究结果存在显著差异。为了确定糖尿病患者中慢性肾脏病的合并患病率及相关危险因素,本研究采用了多种方法。

方法 在两年时间里,在三级医疗教学医院的普通内科开展了一项横断面观察性研究,纳入了所有18岁及以上的慢性肾脏病患者,不分性别。选取未患该疾病的人群作为对照。采用试剂盒法进行肾损伤分子-1(KIM-1)和中性粒细胞明胶酶相关脂质运载蛋白酶联免疫吸附测定(NGAL-ELISA)样本分析。本研究在获得机构伦理委员会批准后,按照《药品临床试验管理规范》(ICH GCP)原则和《赫尔辛基宣言》进行。

结果 在我们的研究中,病因不明的慢性肾脏病(CKDu)组尿KIM-1平均为49.75±4.35μg/g肌酐,对照组为1.43±0.15μg/g肌酐。CKDu组和对照组的NGAL平均水平分别为8.94±1.31μg/g和0.41±0.05μg/g。在CKDu组和对照组中,平均估算肾小球滤过率(eGFR,ml/min/1.73m²)分别为69.83±7.91和108±3.7。CKDu组血清肌酐平均报告值为3.79mg/dL,对照组为1.0mg/dL。

结论 尽管城市中心此前被认为是非流行地区,但本研究首次在该市报告了60例CKDu患者。这是第一项使用尿生物标志物KIM-1和NGAL在城市中心当地社区发现疑似CKDu病例和早期肾损伤的研究。

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