Chronic renal failure in India
Chronic renal failure in India
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DOI：
10.3109/08860229709037216
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发表时间：
1997-01-01
期刊：
影响因子：
3
通讯作者：
Arora, P
中科院分区：
文献类型：
--
作者：
Mittal, S;Kher, V;Arora, P
本文对1994年5月至1995年4月在我院进行的所有新发慢性肾衰竭（CRF）病例的前瞻性研究，包括在院转诊。CRF的诊断基于临床、实验室和放射学特征。根据指示行肾活检。根据标准标准将患者细分为原发性肾病的不同病因组。共有835例CRF病例，中位年龄为43岁（10天至90岁）；其中67.8%为男性。肾小球肾炎（28.6%）、糖尿病肾病（23.2%）和间质性肾炎（16.5%）是CRF最常见的病因；其次是阻塞性肾病（6.4%）、良性肾硬化（4.1%）和多囊肾病（2%）。然而，在40岁以上的患者中，糖尿病肾病是最常见的原因（36.8%）。16.2%的病例发生CRF原因不明。121例患者（14.5%）在就诊时出现了潜在肾功能的急性恶化。最常见的原因是高血压加速（26.1%）、感染（22.4%）、容量耗竭（20.1%）和药物（14.9%）。消炎药是导致急性肾功能下降最常见的药物。512例（61.3%）终末期肾病患者首次就诊一年后，12.5%死亡，17%接受同种异体肾脏移植，12.7%接受某种形式的维护性透析，295例患者失去随访。323例轻重症患者中，死亡7例，门诊209例，失访107例。我们得出结论，印度的CRF模式与发达国家没有太大差异。然而，由于转诊较晚以及印度肾替代治疗的可得性和可负担性有限，它的预后较差。
A prospective study of all new cases of chronic renal failure (CRF) including inservice referrals was done at our hospital over a period of 1 year from May 1994 to April 1995. The diagnosis of CRF was based on clinical, laboratory, and radiological features. Kidney biopsies were done when indicated. The patients were subdivided into various etiologic groups of primary renal disease according to standard criteria. There were a total of 835 cases of CRF with a median age of 43 years (range 10 days to 90 years); 67.8% of them were men. Glomerulonephritis (28.6%), diabetic nephropathy (23.2%), and interstitial nephritis (16.5%) were the most common causes of CRF; followed by obstructive nephropathy (6.4%), benign nephrosclerosis (4.1%), and polycystic kidney disease (2%). However in patients more than 40 years of age, diabetic nephropathy was the most common cause (36.8%). The cause of CRF was unknown in 16.2% of the cases. One hundred twenty-one patients (14.5%) had an acute deterioration of their underlying renal dysfunction at presentation. This was most commonly due to accelerated hypertension (26.1%), infection (22.4%), volume depletion (20.1%), and drugs (14.9%). Anti-inflammatory drugs were the most common drugs responsible for the acute decline in renal function. One year after their initial presentation of the 512 patients (61.3%) with end stage renal disease, 12.5% had died, 17% had received a kidney allograft, 12.7% were on some form of maintenance dialysis, and 295 patients were lost to follow-up. Of the 323 patients with less severe illness, 7 died, 209 were on outpatient treatment, and 107 patients were lost to follow-up. We conclude that the pattern of CRF in India does not differ greatly from that in the developed countries. However, it carries a poorer prognosis due to late referral and limited availability and affordability of renal replacement therapy in India.