Abstract: TH-PO1056
Clinical Characteristics and Predictors of Glomerular Filtration Rate Decline in Patients with CKD of Unknown Etiology (CKDu) in Agricultural Communities of Odisha, a CKDu Hotspot
Session Information
- CKD Progression and Complications: Diagnosis, Prognosis, Risk Factors
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Meena, Priti, All India Institute of Medical Sciences - Bhubaneswar, Bhubaneswar, Orissa, India
- Panda, Sandip, All India Institute of Medical Sciences - Bhubaneswar, Bhubaneswar, Orissa, India
- Das, Paromita, All India Institute of Medical Sciences - Bhubaneswar, Bhubaneswar, Orissa, India
- Garg, Anish, All India Institute of Medical Sciences - Bhubaneswar, Bhubaneswar, Orissa, India
Background
Chronic Kidney Disease of Unknown Etiology (CKDu) is characterized by the absence of traditional risk factors for CKD such as diabetes mellitus hypertension, and glomerulonephritis. Odisha in India has been identified as a potential ‘hotspot’ for CKDu.
Methods
Patients aged 18–60 years who met clinical criteria for CKDu from 1st April 2021 to 31st April 2023 were enrolled in the study. A kidney biopsy was performed according to the feasibility. The study's primary objective is to describe the clinical characteristics and predictors for glomerular filtration rate (eGFR) decline.
Results
A total of 120 patients were enrolled in the study. The mean age of participants was 39.78 ± 8.85 years, with 85 % males. About 96.3% of cases belonged to rural areas, 90 % belonged to lower socioeconomic classes, and only 3 % had a family history of diseases. 75.4 % were farmers, exposure to agrochemicals was reported in 20.4% of cases; and 25.7 % of patients had no formal education. 40% and 25% of the participants were of CKD stage 3 and stage 4 respectively. The mean hemoglobulin level and uric acid levels were 10.3/ dl and 5.9 mg/ dl respectively. A kidney biopsy was performed on 20 patients. Histopathology was predominantly interstitial fibrosis with mononuclear infiltration, tubular atrophy, and global glomerulosclerosis. After adjustments for confounding factors, predictors of GFR decline were found to be baseline GFR, baseline serum albumin, low haemoglobin, and male sex.
Conclusion
There is a need for a multipronged approach to address the CKDu epidemic, particularly in CKDu hotspots. The need to take steps to increase awareness, prevention, appropriate screening, and surveillance is imperative.