In developing countries the spectrum of chronic kidney disease (CKD) and its outcome is expected to be different from the developed world. In India, the proportion of aged population (>60 yrs) was around 7.6% in 2000. This amounts to an absolute number of 76 million people. Hence, systematic information regarding the spectrum of CKD in this fast growing population is required. Thus, this prospective study was undertaken to better understand the causes and outcomes of CKD in elderly. This prospective study was carried out over 12 months. Patients included
were elderly patients (age > 60 years) who either attended an outpatient
renal clinic and / or were hospitalized. During the year, 33,301 patients
were attended to;, of these 4255 (12.7%) were elderly of which 137 (3.2%)
had CKD. The mean age was 65.1ｱ 4.2 years (60-86 years). Diabetic nephropathy
was the commonest primary kidney disease seen in 80 (58.4%) followed by
chronic interstitial nephritis in 13 (9.5%) and chronic glomerulonephritis
in 12 (8.7%). Obstructive nephropathy and ischemic nephropathy accounted
for CKD in 10 (7.3%) each while nephrosclerosis was the cause in 9 (6.4%)
patients. Mean serum creatinine was 6.2 ｱ 3.3 mg/dl at presentation. Associated
coronary artery disease was present in 57 (41.6%), stroke in 15(10.9%),
chronic obstructive airway disease in 9 (6.6%) and chronic liver disease
in 1 patient (0.7%). Of the137 patients, 53 (38.7%) presented in end stage
renal disease (ESRD). The other 84 patients (61.3%) (not in ESRD at presentation)
received conservative treatment. During follow up 4 (4.7%) died, 3 (3.6%)
progressed to ESRD and were initiated on maintenance dialysis but discontinued
later. Forty (47.6%) patients were lost to follow up and only 37 (44 %)
were still being followed up at the end of one year. |