Epidemiology of chronic kidney disease in two tertiary referral centres in Sri Lanka

Abstract

INTRODUCTION AND OBJECTIVES: Chronic kidney disease (CKD) has become a major public health problem in Sri Lanka. The worldwide leading underlying causes for CKD are diabetes, hypertension and glomerulonephritis. There is regional variation in CKD prevalence in Sri Lanka due to the presence of a CKD of uncertain aetiology (CKDu). The objectives of our study were to identify aetiology, clinical stage and associated co-morbid diseases in patients with CKD referred to the Nephrology Service. METHODOLOGY: This cross-sectional descriptive study was carried out over one-year at Colombo North Teaching Hospital (CNTH), Ragama and District General Hospital, Negombo, from May 2018. All data was obtained from CNTH Renal Registry. RESULTS: Data of 1147 patients were studied. Mean age was 61.8 (SD 13.6) years, 683 (59.8%) were male and the majority [969 (84.5%)] were from Gampaha District. The primary renal disease was diabetes in 645 (56.2%), hypertension in 251 (22%) and glomerulonephritis in 40 (3.5%). There were only 16 (1.4%) patients with CKD-u and none were from Gampaha district. 539 (47%) were in CKD stage III, 329 (28.7%) in stage IV and 147 (12.8%) in stage V; there was no significant difference in the mean age of patients in each CKD stage. The commonest co-morbidity was hypertension, present in 180 (15.7%) patients. CONCLUSION: The commonest causes of CKD in Gampaha district were diabetes and hypertension, with no cases of CKDu. Screening patients with diabetes and hypertension for CKD is mandatory. More research is needed in to CKD due to identifiable causes in the non-CKDu regions of the country, since this appears to be an emerging and under-appreciated problem.