Traditional Cardio vascular Risk factor prevalance and cardiovascular events among CKDu patients: Case control study

W.M.R.S. Wijekoon1, P.B. Subasinghe1, R.P.G.K.S. Weerakoon1, N. Nanayakkara2

1St. Thomas’ College (National School), Matale

2Kandy Teaching Hospital, Kandy

 

Introduction

Chronic Kidney Disease (CKD) is a condition characterized by a gradual and irreversible loss of kidney functions over time. Cardiovascular mortality is known to be high in patients with CKD and at least 50% of patients die of CVS events. Chronic Kidney Disease of Unknown etiology(CKD-u) is considered as the number one health hazard in Sri Lanka which is an evolving disease with uncertain mortality and morbidity pattern.  High blood pressure, Lipids (Cholesterol), Overweight, tobacco use, smoking, diabetics, age, gender etc. are main traditional risk factors that are associated with cardiovascular events. Therefore this case control study is conducted to find the prevalence of traditional risk factors and CVS events in a cohort of CKD-u patients comparison to a non CKDu participants from the same area.

Aim/Objective

  • describe the pattern of cardiovascular system risk factor manifestation in CKDu
  • find the prevalence of cardiovascular events and cardiovascular risk factors in CKDu in comparison to healthy endemic normals.

Methodology

26 CKDu patients and 18 healthy participants (non CKDu) were randomly selected from Wilgamuwa area. The study was conducted at the Nephrology clinic at Wilgamuwa Hospital. Interviews were conducted with the selected participants and survey sheets were filled regarding age, gender, family history, diabetics, high blood pressure, smoking and habits of betel chewing with tobacco. Height, weight and blood pressure were examined.  Blood samples were taken for after about 12 hour fasting period to investigate lipid profile, fasting blood sugar. Serum creatinine was also investigated. Urine samples were taken and checked for urine protein and urine sugar using dip stick tool kit. According to following standards data analyses were conducted: history of hypertension > 140/90 Hgmm,  Age > 65, fasting blood sugar > 110 mg/dl, Dipstick sugar  1+, BMI > 25, smoking, chewing betel with tobacco, any lipid higher than or lower than the normal range (total cholesterol > 200 mg/dl, Triglycerides > 150 mg/dl, HDL < 40 mg/dl, LDL > 130 mg/dl).   Data were entered into MS Excel and statistically analyzed using R software.

Results:

Risk factor count results showed that CKDu patients had 3.38 (mean) 1.17 (SD) while non CKDu had 2.78  1.26. t-test results indicated no significant difference between the risk factors of CKDu and non-CKDu particpants (P value -0.1153,95% confident interval -0.16,1.37). Spearman correlation was done for CKDu stage (stage was calculated using data) Vs. number of risk factors. The results showed a positive correlation (0.42).

Conclusion

There is no major cardiovascular event in either patients or non-CKDu. Hence the association cannot be determined.

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