A Prospective Study on the Burden of Renal Replacement Therapy and Pattern of Comorbidities among Chronic Kidney Disease Patients in Clinical Practice

Background: The high rate of renal replacement therapy, respective clinical staging, and pattern of associated  specific  comorbidities/complications  among  chronic  kidney  disease  (CKD)  patients  can  influence and predispose them to increase morbidity, mortality, and health‑care cost. In addition, there could also be a prolongation in the length of hospital stay and recurrent frequency of hospitalization. Aim: This study was predominantly designed to highlight and create awareness concerning the burden  of  renal  replacement  therapy  and  pattern  of  associated  specific  comorbidities/complications  among CKD patients in renal practice. Materials and Methods: This was a descriptive, prospective  study of 18-month duration that was carried out to review the medical case records of consented adult CKD patients attending a Nigerian Tertiary Kidney Care Hospital from January 2015 to June 2016. Results:  This  study  involved  123  consented  adult  CKD  patients  made  up  of  82  (66.67%)  males and 41 (33.33%) females with a mean age of 53.81 ± 16.03 years. Eighty‑six (69.9%) of the  patients  were  in  CKD  Stage  5,  15  (12.2%)  were  in  CKD  Stage  4,  19  (15.5%)  were  in  CKD  Stage 3, 2 (1.6%) in CKD Stage 2, and the remaining one (0.8%) in CKD Stage 1. Regarding the form  of  nephrological  interventions  offered,  majority  of  the  respondents,  i.e.  66  (53.66%)  were  on maintenance dialysis, followed by 53 (43.09%) on conservative care, while 4 (3.25%) were on renal graft transplant. Among these CKD patients, the prevalence of renal replacement therapy was 56.91%. Most proportion of the respondents 45 (36.59%), were having two number of comorbidities with hypertension 103 (83.70%), diabetes mellitus 39 (31.70%), obesity 24 (19.51%), heart failure 11  (8.90%),  obstructive  uropathy  8  (6.50%),  human  immunodeficiency  virus  (HIV)  infection  7  (5.70%), and stroke 5 (4.10%) being the most frequent. Conclusion: The prevalence rates for renal replacement  therapy,  hypertension,  diabetes  mellitus,  and  obesity  were  significantly  high  among  these CKD patients. In this study, the high rate of renal replacement therapy, respective clinical staging,  and  pattern  of  associated  specific  comorbidities/complications  among  these  CKD  patients  may significantly increase the risk of morbidity, mortality, recurrent frequency of hospitalization, length of hospital admission, and health‑care costs.