Health experts for early investigation on suspicion of kidney disease

Islamabad: Health experts on Sunday advised the people for early investigation on suspicion of kidney disease to avoid from future medical complications.According to them, 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 population.Nephrologist and Head of Kidney Transplant Unit at PIMS, Dr Khawar Sultan said that the probability of chronic kidney disease (CKD) in different age groups is increasing in Pakistan due to diabetes.He said that according to a recent research conducted at 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.He said the research also revealed that the chronic kidney disease was progressively increasing in South Asian countries like Pakistan, and the reason for it was multifactorial.He added 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 average age of the population was 46 years, with the 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 added. 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%), tubulo-interstitial 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.He added the average population served by the centre belonged to a vast area of Punjab, Khyber Pakhtunkhwa, Azad Jammu Kashmir and the Federal Capital.Dr Wasim Khawaja from PIMS said that there was a separate dedicated CKD clinic and transplant unit, besides the outpatient department.He added daily around 70 patients visited the PIMS dialysis centre and received free services, he added. Dr Khawja said sufficient number of paramedical staff, nurses and doctors performed their duties at the dialysis centre and Nephrology ward at PIMS.

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