Screening for Chronic Kidney Disease and Associated Risk Factors among First-Degree Relatives of Chronic Kidney Disease Patients Attending Nephrology Department

Abstract

Background: A family history of kidney disease is associated with an increased risk for occurrence of kidney disease. First-degree relatives of chronic kidney disease (CKD) patients have a greater prevalence of CKD risk factors than the general population and should be screened for impaired renal function. Screening of those who are known to be at high risk for the development of Nephropathy would be a cost-effective solution in low-resource settings. Objectives: (1) To study the prevalence of CKD among first-degree relatives of CKD patients. (2) To study the distribution of risk factors for CKD among first-degree relatives. (3) To study the association between various risk factors and CKD. Materials and Methods: The Study Design is a Cross-sectional study. The study was conducted from August 2012 to August 2013. The study area was the Department of Nephrology of Kurnool Medical College, Kurnool. The screening was limited to first-degree relatives aged more than 18 years of CKD patients attending to nephrology ward. Statistical analysis such as proportions, percentages, Chi-square, odds ratio (OR), and multiple logistic regression analysis using SPSS (version 17.0). Results: A total of 815 first-degree relatives of 203 index patients with CKD were screened in this study among whom 34.72% (283) had different stages of CKD according to National Kidney Foundation 2002 guidelines. Hypertension (OR: 6.6187), diabetes (OR: 14.5487), renal stones, use of non-steroidal anti-inflammatory drugs (NSAIDS) for a longer duration, h/o smoking, waist circumference, overweight, and obesity were significant risk factors for CKD among first-degree relatives of patients with CKD. On multiple regression analysis, old age, female sex, hypertension, diabetes mellitus, use of NSAIDS, alcohol consumption, and central obesity are significantly associated with impaired estimated glomerular filtration rate (<90 ml/min/1.73 m2 ). Conclusion: Targeted screening among first-degree relatives would be the initial step in reducing the burden of CKD.