Singh Prit P, Patel Prem S, Krishna Amresh, Kuntal Shefali, Kumar Sanjay, Kumar Om
Nephrology, Indira Gandhi Institute of Medical Sciences, Patna, IND.
Community Medicine, Indira Gandhi Institute of Medical Sciences, Patna, IND.
Cureus. 2024 Jul 17;16(7):e64719. doi: 10.7759/cureus.64719. eCollection 2024 Jul.
Background Chronic kidney disease (CKD) is a major public health concern globally, often co-occurring with type 2 diabetes (T2D), hypertension (HTN), and cardiovascular disorders (CVD), which complicate its management and exacerbate outcomes. This study aims to investigate the epidemiological and clinical characteristics of CKD in Bihar, a region often underrepresented in national data. Methods This cross-sectional observational study was conducted at the Department of Nephrology, Indira Gandhi Institute of Medical Sciences (IGIMS) in Patna, Bihar, India. A total of 2,534 adult patients of both sexes who consented to participate were included. We collected demographic and clinical data, calculated the estimated glomerular filtration rate using the CKD-Epidemiology (CKD-EPI) Collaboration creatinine equation, and classified CKD stages. Statistical analyses were performed using IBM SPSS Statistics for Windows, version 29.0.2.0 (IBM Corp., Armonk, NY). Result The majority of the study population was male (66.5%), with a significant number residing in rural areas (76.8%). The prevalent causes of CKD included HTN (41.2%), chronic tubulointerstitial nephritis (31.8%), and T2D (23.2%). Approximately one-third of patients were in the early stages (Stages 1 and 2) of CKD. A high prevalence of anemia was noted across all stages, increasing significantly with glomerular filtration rate (GFR) reduction. Treatment analysis showed suboptimal use of angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARBs) and other standard treatments like diuretics and statins, especially among T2D patients. Conclusion Chronic kidney disease in Bihar affects predominantly young males and is associated with significant rural prevalence and comorbidities like T2D, HTN, and CVD. Our results highlight the need for improved management practices, especially in the use of ACEi/ARBs and erythropoiesis-stimulating agents, to slow GFR reduction. Further multicentric, community-based studies are recommended to provide a more comprehensive understanding of CKD in Bihar.
背景 慢性肾脏病（CKD）是全球主要的公共卫生问题，常与2型糖尿病（T2D）、高血压（HTN）和心血管疾病（CVD）同时发生，这使其管理复杂化并加剧不良后果。本研究旨在调查比哈尔邦CKD的流行病学和临床特征，该地区在国家数据中往往代表性不足。方法 这项横断面观察性研究在印度比哈尔邦巴特那的英迪拉·甘地医学科学研究所（IGIMS）肾脏病科进行。共纳入2534名同意参与的成年男女患者。我们收集了人口统计学和临床数据，使用CKD流行病学（CKD-EPI）协作组的肌酐方程计算估计肾小球滤过率，并对CKD阶段进行分类。使用IBM SPSS Statistics for Windows 29.0.2.0版（IBM公司，纽约州阿蒙克）进行统计分析。结果 研究人群中大多数为男性（66.5%），相当数量的人居住在农村地区（76.8%）。CKD的常见病因包括HTN（41.2%）、慢性肾小管间质性肾炎（31.8%）和T2D（23.2%）。约三分之一的患者处于CKD早期阶段（1期和2期）。在所有阶段均观察到贫血的高患病率，且随着肾小球滤过率（GFR）降低而显著增加。治疗分析显示血管紧张素转换酶抑制剂（ACEi）或血管紧张素受体阻滞剂（ARBs）以及利尿剂和他汀类等其他标准治疗的使用未达最佳，尤其是在T2D患者中。结论 比哈尔邦的慢性肾脏病主要影响年轻男性，且农村患病率较高，并与T2D、HTN和CVD等合并症相关。我们的结果强调需要改进管理措施，特别是在使用ACEi/ARBs和促红细胞生成剂方面，以减缓GFR降低。建议进一步开展多中心、基于社区的研究，以更全面地了解比哈尔邦的CKD情况。
