Health Policy for Kidney Diseases in Pakistan- A Need of Time to Consider

Imtiaz, Dr.salman; Alam, Dr Ashar

doi:10.53778/pjkd64210

Cited by 5 publications

(6 citation statements)

References 8 publications

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“…In another countrywide analysis, prevalence of nephropathy in all age groups was found to be 21.2% which is not in line with our study. 21 A relatively higher frequency of microalbuminuria may be explained by the fact that the level was checked amongst high-risk patients only. A 16.8% prevalence of obesity was recorded in this study which is slightly higher than the country figures stated by the World Obesity Federation.…”

Section: Discussionmentioning

confidence: 99%

Diabetes and its associated factors: A Retrospective cohort analysis of a large database at Indus Hospital Health Network

Amin,

Imran,

Hafeez

et al. 2023

Pak J Med Sci

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Objectives: This is a retrospective cohort analysis of diabetes and its associated factors from Electronic Medical Record (EMR) of 2020-2022 of Indus Hospital Health Network (IHHN), Korangi campus Karachi. Methods: Retrospective cohort study was conducted at Indus Hospital & Health Network (IHHN), Korangi Karachi. Out-patient records of adult patients of 2020-2022 were extracted from EMR of IHHN in March 2023. Descriptive statistics were presented as median (IQR) and frequency and percentage. Chi-square test determined association of risk-factors with diabetes and Wilcoxon-sign-rank test compared change in HbA1C from baseline. Results: Data of 460,799 adult patients were extracted and analyzed. Median age of patients was 38.71 (27.87-52) years. Female preponderance was observed in our study. Out of 460,799, HbA1C was seen in 42,638 (9.25%) patients. Among these 29,596 (69.4%) had a HbA1C ≥ 6.5% while 13,042 (30.6%) had a HbA1C in the pre-diabetes range. Significant association was found between age, baseline creatinine, LDL and diabetes with no association depicted between gender, BMI, blood pressure, triglycerides, HDL and diabetes status. Patients in general had higher HbA1C at baseline as compared to last visit (p-value<0.001). Conclusion: High blood pressure, obesity, increased creatinine, micro albuminurea, high LDL and Triglycerides were important risk factors for diabetes. This study reports a snap shot of the status of diabetes and associated risk-factors in the Pakistani population. This was the first time that a large data was extracted and analyzed from a healthcare institution in Pakistan, which would guide physicians and public health practitioners to take evidence-based decisions for prevention and management of diabetes. doi: https://doi.org/10.12669/pjms.40.2(ICON).8948 How to cite this: Amin F, Imran M, Hafeez SA, Zehra B. Diabetes and its associated factors: A Retrospective cohort analysis of a large database at Indus Hospital Health Network. Pak J Med Sci. 2024;40(2):S10-S14. doi: https://doi.org/10.12669/pjms.40.2(ICON).8948 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionmentioning

confidence: 99%

Diabetes and its associated factors: A Retrospective cohort analysis of a large database at Indus Hospital Health Network

Amin,

Imran,

Hafeez

et al. 2023

Pak J Med Sci

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“…The current study reported that a total of 57(58.7%) CKD patients had IDA. This result is comparable to the ndings of the studies conducted in Ethiopia (53.5%) [15] , Oman (29.3%) [16], Malaysia (47.9-76.9%) [17][18][19] , Ecuador (80.22%) [20], Japan (0-95%) [21], and Pakistan (38.83-80.5%) [11,[22][23][24]. A meta-analysis conducted to determine the pooled prevalence of anemia and revealed that it was 59.15% in CKD patients [25].…”

Section: Yesmentioning

confidence: 99%

Iron Deficiency Anemia in Patients with Chronic Renal Insufficiency at Tertiary Care Hospital in Northern Punjab

Shuaib,

Imran,

Khan

et al. 2024

PJHS

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Anemia is a frequently encountered complication of chronic kidney disease (CKD) leading to worse outcomes in terms of quality of life and premature death. However, the current prevalence of iron deficiency anemia (IDA) in CKD is understudied in Pakistan. Objective: To assess the frequency of IDA in patients with CKD at Bewal International Hospital, Gujar Khan, Pakistan. Methods: A cross-sectional was executed at the Department of Nephrology, Bewal International Hospital, Pakistan from January 1, 2022, to June 30, 2022. The study comprised 97 patients aged >13 years of either gender having CKD (GFR <60 ml/min/1.73m²) for at least 90 days. All patients were tested for serum creatinine, ferritin, and hemoglobin levels. IDA was considered if hemoglobin was ≤12 mg/dL in women and ≤13 mg/dL in men. Results: Among 97 patients, there were 57(58.7%) males and 40(41.3%) females. The mean age was 51.23 ± 12.99 years while the mean disease duration was 6.01 ± 1.610 years. 57(58.7%) patients had IDA. IDA was more frequent in women with CKD (67.5%), compared to men (52.64%). However, this association was statically insignificant (p>0.05). When data was stratified, a substantial association was found between IDA and the stage of CKD (p=0.007). There was no significant association between IDA and disease duration (p>0.05). Conclusions: It was concluded that anemia is common in CKD patients, with a high prevalence in females. Stage 3–5 CKD is significantly associated with developing iron deficiency anemia. Early identification and timely management can avoid unfavorable outcomes in these patients.

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“… 1 Diabetic nephropathy (DN) is a major known complication of diabetes and a leading cause of morbidity & mortality in type-1 and type-2 diabetics worldwide 2 including Pakistan. 3 , 4 It ultimately leads to end-stage renal disease (ESRD) and there is no cure other than hemodialysis or renal transplant. It starts with increased creatinine levels and finally decreased glomerular filtration rate (GFR).…”

Section: Introductionmentioning

confidence: 99%

“… 8 , 11 Almost 25% out of 50% developing diabetic nephropathy (marked by microalbuminuria & (urinary albumin to creatinine ratio) uACR 30-300mg/g/day, eGFR > 90 ml/min/1.73 m2) exhibit frank proteinuria and advanced renal failure (uACR >300mg/g, eGFR < 60 ml/min/1.73 m2 to < 15 ml/min/1.73 m2) despite use of angiotensin receptor blockers (ARBs) or angiotensin converting enzyme (ACE) inhibitors. 3 …”

Section: Introductionmentioning

confidence: 99%

Determination of Glyoxalase-1 levels and Identification of Genetic Variants in GLO1 Gene in Patients of Diabetic Nephropathy

Shah,

Rashid,

Majeed

2024

Pak J Med Sci

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Objective: To determine the association of diabetic nephropathy with glyoxalase-1 enzyme levels and a genetic missense variation (SNP rs4746) in its gene (GLO-1). Methods: This cross-sectional comparative study was conducted at the Department of Biochemistry and Molecular Biology, Army Medical College, Rawalpindi from November 2020 to December 2022. One hundred patients and one hundred and thirteen healthy controls were enrolled using the nonprobability convenience sampling method. Medical history and 10ml blood were obtained from each individual after written informed consent. Blood samples were subjected to biochemical tests and DNA extraction which was later used for single nucleotide polymorphism (SNP) analysis (C332C variant of rs4741 GLO-1 gene) using Tetra primer ARMS PCR and gel electrophoresis. Glyoxalase-1 enzyme activity in serum was measured using ELISA. Results: There was a significant difference in serum glyoxalase-1 levels in the two groups (p-value< 0.001). The patient group had lower levels (16.24 ± 22.51mg/dl) of glyoxalase-1 as compared to the control group (48.70 ± 42.54mg/dl). In genotypic analysis, 98 out of 100 control individuals had AA genotype-while only one had CC and another AC genotype. In the patient group, 94 out of 100 patients showed AA genotype, three AC, and three CC genotypes. As the statistical significance (p-value) was 0.37, there was no significant association found between AC or CC genotype and diabetic nephropathy. Conclusion: Glyoxalase-1 levels are linked to the development of diabetic nephropathy in our patients while a known missense variant rs4746 in the GLO-1 gene is not associated with increased risk. doi: https://doi.org/10.12669/pjms.40.4.8258 How to cite this: Shah SZH, Rashid A, Majeed A. Determination of Glyoxalase-1 levels and Identification of Genetic Variants in GLO1 Gene in Patients of Diabetic Nephropathy. Pak J Med Sci. 2024;40(4):652-656. doi: https://doi.org/10.12669/pjms.40.4.8258 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Health Policy for Kidney Diseases in Pakistan- A Need of Time to Consider

Cited by 5 publications

References 8 publications

Diabetes and its associated factors: A Retrospective cohort analysis of a large database at Indus Hospital Health Network

Diabetes and its associated factors: A Retrospective cohort analysis of a large database at Indus Hospital Health Network

Iron Deficiency Anemia in Patients with Chronic Renal Insufficiency at Tertiary Care Hospital in Northern Punjab

Determination of Glyoxalase-1 levels and Identification of Genetic Variants in GLO1 Gene in Patients of Diabetic Nephropathy

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