Dr Arun Kumar Chanda, Lecturer, Department of Physiology, Sylhet MAG Osmani Medical College, Sylhet, Bangladesh; E-mail:
Mymensingh Med J. 2024 Apr;33(2):554-560.
The kidney carries out a variety of physiological processes, including the excretion of nitrogenous waste products, maintenance of fluid, electrolyte, acid-base, and mineral homeostasis, regulation of blood pressure, as well as the synthesis and release of erythropoietin and other endocrine substances. Chronic kidney disease (CKD) can lead to end-stage renal disease (ESRD) and increased cardiovascular morbidity and mortality. CKD has a long period of asymptomatic stage. The symptoms of CKD usually present at the advanced stage of the disease. Chronic kidney disease (CKD) is a potentially fatal that impacts various physiological systems. This cross-sectional observational study was conducted in the Department of Physiology in collaboration with the Department of Nephrology, Sylhet MAG Osmani Medical College Hospital (SMAGOMC&H), from July 2022 to June 2023 to observe the status of kidney function among the employees of SMAGOMC&H, Bangladesh. The study population consisted of all willingly participating volunteers working at SMAGOMC&H between the ages of 18 and 59 years. Participants with acute illness, malignancy, pregnancy, diagnosed case of CKD, and history of kidney transplant were excluded from the study. A thorough history was taken, and a physical examination was done. Serum creatinine, and spot urine albumin creatinine ratio (ACR) of each participant were measured. eGFR (estimated glomerular filtration rate) was estimated by using NKF (National Kidney Foundation) eGFR calculator app. A Semi-structured questionnaire was used for data collection. Most of the participants were between 50-59 years (46.0%). The mean age of these study subjects was 45.25±10.08 years. The mean serum creatinine level was 0.85±0.18 mg/dl, the mean eGFR was 102.92±16.21 ml/min/1.73m² and the mean urinary ACR was 27.44±12.48 mg/gm found in this study. Out of the total participants, 16.5% were at stage 1 CKD, 6.5% were at stage 2 CKD and 2.5% were at stage 3 CKD, according to eGFR by CKD-EPI (Chronic kidney disease epidemiology collaboration) equation. Seventy five percent (75.0%) of the participants had normal to mildly increased ACR and 25.0% had moderately increased ACR. Pearson's correlation test revealed a significant negative correlation of eGFR with age, serum creatinine, and urinary ACR (p<0.001). This study revealed that 16.5%, 6.5% and 2.5% of the study participants were at CKD stage 1, stage 2, and stage 3, respectively. Assessment of renal function can help early identification of CKD in apparently healthy asymptomatic subjects.
肾脏执行多种生理过程，包括排泄氮废物、维持液体、电解质、酸碱和矿物质平衡、调节血压、合成和释放促红细胞生成素和其他内分泌物质。慢性肾脏病（CKD）可导致终末期肾病（ESRD），并增加心血管发病率和死亡率。CKD 有一个无症状期很长的阶段。CKD 的症状通常出现在疾病的晚期。慢性肾脏病（CKD）是一种潜在致命的疾病，影响多种生理系统。这项横断面观察性研究是在生理学系与肾脏病学系合作下在孟加拉国希莱特玛格奥马尔医科大学医院（SMAGOMC&H）进行的，目的是观察 SMAGOMC&H 员工的肾功能状况。研究人群包括年龄在 18 至 59 岁之间的所有自愿参加的志愿者。患有急性疾病、恶性肿瘤、怀孕、已确诊 CKD 病例和肾脏移植史的参与者被排除在研究之外。对每位参与者进行了详细的病史采集和身体检查。测量了每位参与者的血清肌酐和尿液白蛋白肌酐比（ACR）。使用 NKF（国家肾脏基金会）eGFR 计算器应用程序估计 eGFR（估计肾小球滤过率）。使用半结构式问卷进行数据收集。大多数参与者的年龄在 50-59 岁之间（46.0%）。这些研究对象的平均年龄为 45.25±10.08 岁。研究发现，平均血清肌酐水平为 0.85±0.18mg/dl，平均 eGFR 为 102.92±16.21ml/min/1.73m²，平均尿 ACR 为 27.44±12.48mg/gm。根据 CKD-EPI（慢性肾脏病流行病学合作）方程，总参与者中有 16.5%处于 CKD 1 期，6.5%处于 CKD 2 期，2.5%处于 CKD 3 期。75.0%（75.0%）的参与者的 ACR 正常或轻度升高，25.0%的参与者的 ACR 中度升高。Pearson 相关检验显示 eGFR 与年龄、血清肌酐和尿 ACR 呈显著负相关（p<0.001）。这项研究表明，16.5%、6.5%和 2.5%的研究参与者分别处于 CKD 1 期、2 期和 3 期。评估肾功能有助于早期发现无症状的明显健康的 CKD 患者。
