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病因不明的慢性肾脏病患者的临床流行病学特征:一项基于印度中部一家医院的横断面研究。

Clinico-Epidemiological Profile of Patients with Chronic Kidney Diseases of Unknown Etiology: A Hospital-Based, Cross-Sectional Study from Central India.

作者信息

Galhotra Abhiruchi, Rathore Vinay, Pal Rahul, Nayak Saurabh, Ramasamy Senthilkumar, Patel Suprava, Joshi Parvati, Nagarkar Nitin M, Jha Vivekanand

机构信息

Department of Community and Family Medicine, AIIMS, Raipur, Chhattisgarh, India.

Department of Nephrology, AIIMS, Raipur, Chhattisgarh, India.

出版信息

Indian J Nephrol. 2024 May-Jun;34(3):241-245. doi: 10.4103/ijn.ijn_68_23. Epub 2023 Oct 10.

Abstract

BACKGROUND

Chronic kidney disease (CKD) not associated with known risk factors, called CKD of unknown etiology (CKDu), has been reported from several geographically distinct regions across the world. This study reports the clinical and epidemiological profile of patients with CKDu from a new hotspot in central India.

MATERIALS AND METHODS

This cross-sectional study describes the sociodemographic, clinical, and laboratory profile of the patients diagnosed with CKDu visiting a tertiary care public hospital in the state of Chhattisgarh in central India between June 2019 and June 2021. CKDu was diagnosed as progressive CKD, minimal proteinuria, absence of hematuria, diabetes, severe hypertension, systemic illness, glomerulonephritis or other urinary tract diseases, and presence of symmetrically contracted kidneyon ultrasound.

RESULTS

A total of 166 (3.1%) out of 5365 patients with CKD were diagnosed with CKDu. The mean age was 53.6 ± 11.8 years. The patients were predominantly male ( = 113, 68.1%), belonged to rural areas ( = 147, 88.6%), and were engaged in farming ( = 105, 63.3%). The estimated glomerular filtration rate (eGFR) at presentation was 21.5 ± 15.1 ml/min/1.73m. Forty-four (26.5%) had stage 3 CKD, 57 (34.3%) had stage 4 CKD, and 65 (39.2%) had stage5 CKD. There was an over-representation of CKDu cases in patients with CKD from Gariyaband (36.0%) and Mahasamund (25%) districts of Chhattisgarh and Nuapada (35.0%) and Balangir (30.0%) districts of Odisha.

CONCLUSION

The study suggests clustering of cases of CKDu in certain districts of Orissa and Chhattisgarh.

摘要

背景

慢性肾脏病(CKD)若与已知风险因素无关,则被称为病因不明的慢性肾脏病(CKDu),全球多个地理区域均有相关报道。本研究报告了来自印度中部一个新热点地区的CKDu患者的临床和流行病学特征。

材料与方法

这项横断面研究描述了2019年6月至2021年6月期间,在印度中部恰蒂斯加尔邦一家三级护理公立医院就诊的被诊断为CKDu的患者的社会人口学、临床和实验室特征。CKDu的诊断标准为进行性CKD、微量蛋白尿、无血尿、糖尿病、重度高血压、全身性疾病、肾小球肾炎或其他泌尿系统疾病,且超声检查显示双侧肾脏对称性缩小。

结果

5365例CKD患者中,共有166例(3.1%)被诊断为CKDu。平均年龄为53.6±11.8岁。患者以男性为主(n = 113,68.1%),来自农村地区(n = 147,88.6%),从事农业工作(n = 105,63.3%)。就诊时的估计肾小球滤过率(eGFR)为21.5±15.1 ml/min/1.73m²。44例(26.5%)为3期CKD,57例(34.3%)为4期CKD,65例(39.2%)为5期CKD。恰蒂斯加尔邦加里班德(36.0%)和马哈萨姆德(25%)地区以及奥里萨邦努阿帕达(35.0%)和巴朗吉尔(30.0%)地区的CKD患者中,CKDu病例的比例过高。

结论

该研究表明,奥里萨邦和恰蒂斯加尔邦的某些地区存在CKDu病例聚集现象。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8096/11302502/a0694a654719/IJN-34-3-241-g001.jpg

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