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Diabetes-linked chronic kidney disease cases on rise

ISLAMABAD: The probability of chronic kidney disease (CKD) in different age groups is increasing in Pakistan due to diabetes, according to a recent research conducted at the Pakistan Institute of Medical Sciences (PIMS).
The annual incidence of new cases of end-stage renal disease (ESRD) was 100 per million population in Pakistan while diabetes was the leading cause of CKD, Nephrologist and Head of Kidney Transplant Unit at PIMS, Dr. Khawar Sultan said on Sunday while sharing details of a cross-sectional study conducted by the Nephrology Department of PIMS.
He said the research also revealed that chronic kidney disease was progressively increasing in South Asian countries like Pakistan, and the reason for it was multifactorial. Most of the people had inadequate knowledge about health-care provision due to lack of health education and, most importantly, the increasing prevalence of risk factors for CKD such as diabetes and hypertension.
In addition, other causes like glomerulonephritis and renal stones were prevalent due to infections and dry weather conditions, Dr Khawar added.
He said a total of 500 patients were considered for final analysis based on data adequacy. The mean age of the population was 46 years, with a minimum age of 20 years and the maximum being 83 years.
The common causes of CKD identified in the patients included diabetic nephropathy 28% (140 patients), glomerulonephritis 22% (110 patients), hypertension 14.6% (73 patients), tubulo-interstitial disease 13.4% (67patients)and renal stone disease 8% (40 patients, he added.
Dr Khawar said the cause was unknown in a significant percentage of patients which was 10.6% ((53 patients). Other causes including post-partum renal failure, constituted 2% of the cases.
He said 268 of the patients were below the age of 50 years. The common etiology of CKD in that age-group included glomerulonephritis (33.2%), diabetic nephropathy (17.9%), tubulointerstitial disease (10%) and renal stone disease (13.8%). The patients who had CKD of unknown cause comprised 12.31%.
Among the 232 patients, who were over 50 years, the causes of CKD were identified as diabetic nephropathy (39.6%), hypertension (19.8%), renal stone disease (12.9%), tubulointerstitial disease (5.6%) and adult polycystic kidney disease (3%). Only 8.6% of patients in this age-group had CKD of unknown etiology.
Dr. Khawar said CKD was a worldwide public health issue, the incidence, and prevalence of which were increasing, resulting in high cost and poor outcomes.
He said nephrology unit at PIMS, which was part of a large tertiary care hospital, catered to a large population in the region. The average population served by the center belonged to a vast area of Punjab, Khyber Pakhtunkhwa, Azad Jammu Kashmir, and the Federal Capital.
He said there were a separate dedicated CKD clinic and transplant unit, besides the outpatient department. Daily around 70 patients visited the PIMS dialysis center and received free services, he added.
Dr. Khawar said a sufficient number of paramedical staff, nurses and doctors performed their duties at the dialysis center and Nephrology ward at PIMS.
He said keeping in view the increasing burden of chronic kidney disease in Pakistan, there was a need for aggressive screening to check the presence of kidney disease in the population. He advised the people for early investigation on suspicion of kidney disease.

M M Alam

M. M. Alam is a Pakistan-based working journalist since 1981. Karachi University faculty gold medalist Alam began his career four decades ago by writing for Dawn, Pakistan’s highest circulating English daily. He has worked for region’s leading publications, global aviation periodicals including Rotors (of USA) and vetted New York Times as permanent employee of daily Express Tribune. Alam regularly covers international aviation and defense-related events including Salon Du Bourget (France), Farnborough (United Kingdom), Dubai (UAE). Alam has reported thousands of events and interviewed hundreds of people in Pakistan, UAE, EU, UK and USA. Being Francophone Alam also coordinates with a number of French publications.