Clinical and laboratory profile of diabetes hypertension kidney disease syndrome - dhkd syndrome" - a one year cross sectional study at kles dr prabhakar kore hospital and mrc

Abstract

Introduction: Diabetes Mellitus and hypertension remain one of the most common causes of structural and functional kidney abnormalities leading to chronic kidney disease. Diabetes Hypertension Kidney Disease Syndrome is a new term introduced in medical terminology. The present study was conducted to examine clinical & laboratory profile of diabetes hypertension kidney disease syndrome – “DHKD syndrome” over a period of one year. Materials and Methods: Hospital-based observational cross-sectional was done in the department of general medicine & nephrology among 120 patients with diabetes & hypertension in combination with kidney disease, with any duration of Diabetes > 2 years & any duration of hypertension >2 years presenting to the OPD. Renal function tests performed include serum creatinine, Blood urea nitrogen, serum electrolytes. Urinalysis includes urine protein and urine albumin to creatinine ratio whichwere calculated by taking the ratio between urinary albumin or urine protein & urinary creatinine in random spot urine. The patients were then scored based on MDRD formula and CKD EPI formula to calculate the estimated glomerular function rate & placed into various stages of CKD. Results: A total of 120 subjects were included in the final analysis. Mean age was 63.64 ± 10.80 in the study population.72.5% of the study participants were males. Mean years of diabetes was 16.15 ± 7.5 in the study population. Among the study population, 39 (32.5%) had a past history of dialysis & 80 (66.7%) had a present history of dialysis. In study population among no albuminuria group , 1 (50%) had gfr 30-44 (grade 3 ckd) and 1 (50%) had gfr<=15 (grade 5), among microalbuminuria group , 1 (4.45%) had gfr 60-89 (grade 2) & 1 had gfr 45-59 (grade 3a), 3 (13.64%) had gfr 30-44 (grade 3b), 9 (40.91%) had gfr 15-29 (grade 4) , 8 (36.36%) had gfr<=15 (grade 5) , among macroalbuminuria group , 4 (4.6%) had gfr 45-59 ( grade 3a), 8 (9.2%) had gfr 30-44 (grade 3b) , 12 (13.79%) had gfr 15-29 ( grade 4 ) and 63 (72.41%) had gfr<=15 (grade 5 ) . Majority had macro albuminuria. The proportion of the difference between SBP & macroalbuminuria was statistically significant. (P value<0.05). The proportion of the difference between insulin usage with macroalbuminuria was statistically significant. (P value<0.05)