Prospective Study on Evidence Based Management of chronic Kidney Disease with Comorbidities
Chronic kidney disease (CKD) is a global public health problem affecting the adult population in several continents and increasing the risk of adverse outcomes. This prospective study has been conducted to understand the evidence based pharmacotherapy, Rationality of prescribed medications, Prevalence of co-occurring conditions and also to know the rate of progression of Glomerular Filtration. This research has been conducted on randomly selected inpatients (n=70) in Thumbay New Life Hospital during the months of January and February. The tools used include Informed Consent Form, Patient Counselling, Patient Medical and Laboratory Reports. Finally, the study conclude that the most common symptom of CKD is pedal edema, Most commonly occurred stage of CKD is G5, prevalence of comorbidities from High include Hypertension, Diabetes Mellitus and Coronary Artery Disease respectively. Estimated GFR has been improved in most of the patients from the duration of admission to discharge but statistical analysis shows a non-significant p value.
2. Chen RA, Scott S, Mattern WD, Mohini R, Nissenson AR. The case for disease management in chronic kidney disease. Dis Manag. 2006; 9:86–92.
3. Levey AS, Coresh J. Chronic kidney disease. Lancet. 2012; 379:165–180.
4. Eknoyan G, Levin NW. K/DOQI clinical practice guidelines for chronic kidney disease: Evaluation, classification, and stratification. Am J Kidney Dis. 2002; 39(2):S1–S266.
5. Levey AS, Atkins R, Coresh J, et al. Chronic kidney disease as a global public health problem: Approaches and initiatives - A position statement from Kidney Disease Improving Global Outcomes. Kidney Int. 2007; 72:247–259.
6. Crowe E, Halpin D, Stevens P. Guidelines: Early Identification and Management of Chronic Kidney Disease: Summary of NICE Guidance. BMJ. 2008; 337:a1530.
7. Chadban SJ, Briganti EM, Kerr PG, et al. Prevalence of kidney damage in Australian adults: The Aus Diab kidney study. J Am Soc Nephrol. 2003; 14:S131–S138.
8. Hallan SI, Coresh J, Astor BC, et al. International comparison of the relationship of chronic kidney disease prevalence and ESRD risk. J Am Soc Nephrol. 2006; 17:2275–2284.
9. Coresh J, Selvin E, Stevens LA, et al. Prevalence of chronic kidney disease in the United States. Jama. 2007; 298:2038–2047.
10. Wen CP, Cheng TY, Tsai MK, et al. All-cause mortality attributable to chronic kidney disease: a prospective cohort study based on 462 293 adults in Taiwan. Lancet. 2008; 371:2173–2182.
11. World Health Organization: Preventing Chronic Disease: A Vital Investment. Geneva, WHO, 2005
12. Dash SC, Agarwal SK: Incidence of chronic kidney disease in India. Nephrol Dial Transplant 2006; 21:232–233.
13. Hyre AD, Fox CS, Astor BC, Cohen AJ, Muntner P. The impact of reclassifying moderate CKD as a coronary heart disease risk equivalent on the number of US adults recommended lipid-lowering treatment. Am J Kidney Dis 2007; 49:37–45.
14. Wanner C, Krane V, Ma¨rz W, Olschewski M, Mann JF, Ruf G, Ritz E; German Diabetes and Dialysis Study Investigators. Atorvastatin in patients with type 2 diabetes mellitus undergoing hemodialysis. N Engl J Med 2005; 353:238–248.
15. Culleton B. Introduction to the Canadian Clinical Practice Guidelines. J Am Soc Nephrol 2006;17:S1-3
16. Hypertension in CKD: Core Curriculum 2019 Ku, Elaine et al. American Journal of Kidney Diseases, 2019; 74 (1):120-131
17. UMHS Chronic Kidney Disease Guideline, July 2019
18. Tuttle KR, Bakris GL, Bilous RW, et al. Diabetic kidney disease: a report from an ADA Consensus Conference. Diabetes Care 2014; 37:2864–2883
19. Afkarian M, Zelnick LR, Hall YN, et al. Clinical manifestations of kidney disease among US adults with diabetes, 1988-2014. Jama 2016; 316:602– 610
20. De Boer IH, Rue TC, Hall YN, Heagerty PJ, Weiss NS, Himmel farb J. Temporal trends in the prevalence of diabetic kidney disease in the United States. JAMA 2011; 305:2532–2539
21. de Boer IH; DCCT/EDIC Research Group. Kidney disease and related ﬁndings in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications study. Diabetes Care 2014; 37:24–30
22. United States Renal Data System. Annual Data Report: Epidemiology of Kidney Disease in the United States. Bethesda, MD, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, 2016
23. Fox CS, Matsushita K, Woodward M, et al.; Chronic Kidney Disease Prognosis Consortium. S114 Microvascular Complications and Foot Care Diabetes Care Volume 41, Supplement 1, January 2018 Associations of kidney disease measures with mortalityand end-stagerenal disease in individuals with and without diabetes: a meta-analysis. Lancet 2012; 380:1662–1673
24. Jafar TH, Stark PC, Schmid CH, Landa M, Maschio G, de Jong PE, et al. Progression of chronic kidney disease: the role of blood pressure control, proteinuria, and angiotensin-converting enzyme inhibition: a patient-level meta-analysis. Ann Intern Med. 2003; 139:244–252.
25. Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Cardiology and the European Society of Hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Cardiology and the European Society of Hypertension. J Hypertens. 2018; 36:1953–2041.
26. Zamboli P, De Nicola L, Minutolo R, Chiodini P, Crivaro M, Tassinario S, et al. Effect of furosemide on left ventricular mass in non-dialysis chronic kidney disease patients: a randomized controlled trial. Nephrol Dial Transplant. 2011; 26:1575–1583.
27. Edwards NC, Steeds RP, Stewart PM, Ferro CJ, Town end JN. Effect of spironolactone on left ventricular mass and aortic stiffness in early-stage chronic kidney disease: a randomized controlled trial. J Am Coll Cardiol. 2009; 54:505–512.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
AUTHORS WHO PUBLISH WITH THIS JOURNAL AGREE TO THE FOLLOWING TERMS:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial 4.0 Unported License. that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).