Abstract：
The present study was undertaken to study clinical, biochemical and echocardiographic characteristics of patients with Chronic Kidney Disease crash- landing and initiating hemodialysis at first presentation in our centre.
METHODS: Ours was a cross-sectional study of one hundred and seventy patients with chronic kidney disease starting hemodialysis. Detailed history and examination were done. Apart from routine biochemical tests and CKD-MBD profile, all patient underwent ultrasonography, urine examination and echocardiography. Efforts were made to delineate etiology in each patient.
METHODS: Out of 170 patients 64% were males, 36% were females. Mean age at presentation in our study was 41.27 (±16.47) yrs. Chronic glomerulonephritis was the most common etiology accounting for 54% of cases followed by Diabetes (20%). Mean eGFR at presentation was <5 ml/min/1.73 m². Hypocalcemia was present in 87.1%, hyperphosphatemia in 84.2% and elevated PTH levels in 98% with mean PTH levels being 588.07±309.58 ng/ml. LVH on echocardiogram was present in 58.4 % of patient with diastolic dysfunction being reported in 31 % of patients. DCM was present in 28% of patients and 21% of patients had frank left ventricular failure at presentation.
CONCLUSIONS: Chronic Kidney Disease patients referred late have clinical and lab characteristics which are worse as compared to routine CKD patients .This calls for a mandatory CKD screening programme for increasing awareness and early identification of CKD patients.
METHODS: Ours was a cross-sectional study of one hundred and seventy patients with chronic kidney disease starting hemodialysis. Detailed history and examination were done. Apart from routine biochemical tests and CKD-MBD profile, all patient underwent ultrasonography, urine examination and echocardiography. Efforts were made to delineate etiology in each patient.
METHODS: Out of 170 patients 64% were males, 36% were females. Mean age at presentation in our study was 41.27 (±16.47) yrs. Chronic glomerulonephritis was the most common etiology accounting for 54% of cases followed by Diabetes (20%). Mean eGFR at presentation was <5 ml/min/1.73 m². Hypocalcemia was present in 87.1%, hyperphosphatemia in 84.2% and elevated PTH levels in 98% with mean PTH levels being 588.07±309.58 ng/ml. LVH on echocardiogram was present in 58.4 % of patient with diastolic dysfunction being reported in 31 % of patients. DCM was present in 28% of patients and 21% of patients had frank left ventricular failure at presentation.
CONCLUSIONS: Chronic Kidney Disease patients referred late have clinical and lab characteristics which are worse as compared to routine CKD patients .This calls for a mandatory CKD screening programme for increasing awareness and early identification of CKD patients.
摘要：
本研究是为了研究临床，在我们中心首次就诊时，慢性肾脏病患者的生化和超声心动图特征。
方法：我们的研究是对一百七十名慢性肾脏病患者开始血液透析的横断面研究。进行了详细的病史和检查。除了常规生化测试和CKD-MBD概况外，所有患者都接受了超声检查，尿液检查和超声心动图。努力描述每位患者的病因。
方法：在170名患者中，64％为男性，36%是女性。我们研究中的平均年龄为41.27（±16.47）岁。慢性肾小球肾炎是最常见的病因，占54％，其次是糖尿病（20％）。演示时的平均eGFR为<5ml/min/1.73m²。87.1%出现低钙血症,84.2%的高磷血症和98%的PTH水平升高，平均PTH水平为588.07±309.58ng/ml。超声心动图上的LVH在58.4％的患者中存在，在31％的患者中报告了舒张功能障碍。28％的患者存在DCM，21％的患者在就诊时出现明显的左心室衰竭。
结论：晚期转诊的慢性肾脏病患者的临床和实验室特征比常规CKD患者更差。这需要强制性的CKD筛查计划，以提高对CKD患者的认识和早期识别。
方法：我们的研究是对一百七十名慢性肾脏病患者开始血液透析的横断面研究。进行了详细的病史和检查。除了常规生化测试和CKD-MBD概况外，所有患者都接受了超声检查，尿液检查和超声心动图。努力描述每位患者的病因。
方法：在170名患者中，64％为男性，36%是女性。我们研究中的平均年龄为41.27（±16.47）岁。慢性肾小球肾炎是最常见的病因，占54％，其次是糖尿病（20％）。演示时的平均eGFR为<5ml/min/1.73m²。87.1%出现低钙血症,84.2%的高磷血症和98%的PTH水平升高，平均PTH水平为588.07±309.58ng/ml。超声心动图上的LVH在58.4％的患者中存在，在31％的患者中报告了舒张功能障碍。28％的患者存在DCM，21％的患者在就诊时出现明显的左心室衰竭。
结论：晚期转诊的慢性肾脏病患者的临床和实验室特征比常规CKD患者更差。这需要强制性的CKD筛查计划，以提高对CKD患者的认识和早期识别。
