CLINICAL SPECTRUM OF CHRONIC KIDNEY DISEASE: A STUDY OF 50 PATIENTS AT LUMHS
SONIHA ASLAM, ASLAM GHOURI, ANIL KUMAR , SHAHZAMAN KHAN , YASMEEN IQBAL
ABSTRACT
OBJECTIVE: To evaluate different clinical presentations of chronic kidney disease (CKD) and to raise the index of clinical
suspicion so to diagnose and treat CKD at the earliest.
STUDY DESIGN: A cross sectional observational study.
PLACE AND DURATION: Medical unit III, Liaquat University hospital, Jamshoro from 1 Apr – 30 Sep'2014.
METHODOLOGY: We studied fifty patients of CKD, diagnosed by standard clinical criteria. A self administered
questionnaire was used to record patient's history and clinical examination. Complete blood count, urine analysis,
urea, creatinine, electrolytes, sugar, calcium, spot urine albumin to creatinine ratio and renal ultrasound were done
in every patient. In selected cases, renal biopsy was also done.
RESULTS: Out of 50 patients, 62% (n = 31) were men, a mean age of 46.22 years (± 12.89 SD), a mean creatinine
clearance of 5 mmol/24 hours (±2.16 SD), a mean albumin: creatinine ratio of 49 mg/g (±11.33 SD) and a mean serum
creatinine of 16.5 mg/dl (±6.65 SD). Chronic glomerulonephritis (30%), hypertension (24%) and diabetic nephropathy
(20%) were the leading causes of CKD. Anemia (94%) was universal finding on laboratory work up. Gastrointestinal
manifestations stand out among the clinical presentations with anorexia (76%), nausea (60%) vomiting (40%) and
abdominal pain (26%).
CONCLUSION: We observed that gastrointestinal disturbances are the commonest clinical presentations in CKD along
with anemia, fatigue, dyspnea, hiccups, itching, hypertension and edema. Early diagnosis and management of CKD
may prevent or delay the progress to end stage renal disease.
KEYWORDS: Chronic kidney disease, Glomerulonephritis, Hypertension, Diabetes, Gastrointestinal manifestations.