马哈拉施特拉邦农村慢性肾病患者血清电解质和钙的研究

Dr. Saranya RK, Dr. Rashmi Nagdeve
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摘要

背景:慢性肾脏疾病(CKD)被定义为肾脏结构或功能异常,存在>3个月。随着肾功能的逐渐丧失,电解质和酸碱的紊乱不可避免地发生,并导致患者预后不良。本研究旨在研究慢性肾病不同阶段的血清钙和电解质水平。方法:本研究对2018年2月1日至2019年10月31日期间在亚瓦马尔Shri Vasantarao Naik政府医学院三级医院内科病房和门诊就诊的150例新诊断的CKD患者进行了研究。这些患者符合国家肾脏基金会肾病预后质量倡议诊断CKD的标准。对它们进行了临床研究和评价,并进行了实验室调查。结果:以ⅲ期患者居多(34.7%),其次为V期(32.7%)和IV期(30%)。随着CKD的恶化,超声检查显示肾脏回声变差。随着CKD的进展,血清白蛋白降低,尿白蛋白升高。在CKD不同阶段,血清钠水平的变化不显著(p>0.05),而随着CKD恶化,血清钾升高、钙降低的变化显著(p<0.05)。结论:由于疏忽和缺乏意识,大多数患者在CKD晚期才被发现,并伴有广泛的电解质和钙异常。因此,有必要在CKD的早期阶段识别这些患者,并及时和早期识别电解质和钙的紊乱。
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A study of serum electrolytes and calcium in chronic kidney disease in rural Maharashtra
Background: Chronic kidney disease (CKD) is defined as abnormalities of kidney structure or function, present for >3 months. With progressive loss of kidney function, derangements in electrolytes and acid-base inevitably occur and contribute to poor patient outcomes. The present study was undertaken to study the serum levels of calcium and electrolytes in various stages of CKD.Method: This study was conducted in 150 newly diagnosed cases of CKD admitted in Medicine ward and those visiting OPD of Tertiary Care Hospital, Shri Vasantarao Naik Government Medical College, Yavatmal during a period from 1 February 2018 to 31 October 2019. These patients fulfilled the criteria set by National Kidney Foundations’ Kidney Disease Outcome Quality Initiative for diagnosing CKD. They were studied and evaluated clinically, and laboratory investigated.Results: Most of the patients were presented in stage III (34.7%) followed by in stage V (32.7%) and stage IV (30%). As CKD deteriorates, there was worsening in renal echogenicity in ultrasonography. The serum albumin was found to be decreased and urine albumin increased as CKD progresses. In different stages of CKD, the variation in level of serum sodium was insignificant (p>0.05), while that of increase in potassium and decrease in calcium as CKD deteriorates was significant (p<0.05). Conclusion: Because of negligence and lack of awareness, most of the patients are detected in advanced stages of CKD and is associated with wide electrolyte and calcium abnormalities. Therefore, it is necessary to identify these patients in their early stages of CKD along with prompt and early recognition of derangements in electrolytes and calcium.
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