FREQUENCY AND CAUSES OF END STAGE RENAL DISEASE (ESRD) IN PATIENTS WITH HIGHLY SUSPECTED CLINICAL FEATURES OF ESRD

ABSTRACT
Objective: To determine the frequency of ESRD and common factors leading to it among patient presenting with highly
suspected clinical features.
Material and methods: This is a descriptive (cross sectional) study carried out at the Department of Nephrology, Lady
Reading Hospital Peshawar, from 5th August 2011 to 4th February 2012. A total of 292 patients presenting with highly
suspected clinical features of ESRD were included in this study.
Results: Out of 292 patients, 176(60.3%) were male and 116(39.7%) were female. Male to female ratio was 1.52:1.
Mean age at presentation was 46.44 +12.96 years (yrs) SD, with a range 19-64 yrs. The ESRD was found in 59(20.2%)
patients, the most common risk factor found was glomerulonephritis (GN) in 117(40.1%) patients, followed by hypertension
(HTN) 74(25.3%), diabetes mellitus (DM) 33(11.3%) and renal calculi in 15(5.1%) patients.
Conclusion: GN is the most common risk factor for ESRD. HTN is present in one fourth, while DM is the also an important
reason for it. Epidemiology changes consistently and so our strategies should, to combat the confronting challenges.
Key words: End Stage Renal Disease, Hypertension, Diabetes Mellitus, Glomerulonephritis.
Operational definition of highly suspected clinical presentation: Were considered among patients presenting with 2 or
more than 2 of the following features with duration of minimum 2 weeks:
1. Dyspnea (labored and difficult breathing) on clinical examination at the time of presentation.
2. Persisting vomiting (to eject part or all of the contents of stomach through the mouth usually in a series of involuntary
spasmic moment) which occurs with intake of any type of solid or liquid material.
3. Acidotic breathing (deep, slow and gasping type breathing) on clinical examination.